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Contralateral Occlusion and Concomitant Procedures Drive Risk of Non-ipsilateral Stroke After Carotid Endarterectomy.
CONCLUSION: Non-ipsilateral stroke after CEA is rare. Features driving risk surround global disease burden, combined procedures, and haemodynamic fluctuations. Contralateral occlusion independently increases non-ipsilateral stroke risk. Regardless of laterality or location, effects of stroke after CEA on long-term survival are similar. PMID: 30940430 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 29, 2019 Category: Surgery Authors: Clouse WD, Boitano LT, Ergul EA, Kashyap VS, Malas MB, Goodney PP, Patel VI, Conrad MF Tags: Eur J Vasc Endovasc Surg Source Type: research

Reduction in Early Stroke Risk in Carotid Stenosis With Transient Ischemic Attack Associated With Statin Treatment
In patients with acute symptomatic carotid stenosis, statin pretreatment is associated with reduced stroke risk. Carotid endarterectomy (CEA) in patients with associated symptoms is highly effective for secondary stroke prevention. Maximum benefit appears to be in those who undergo surgery ≤2 weeks of symptom onset; however, the safety of very early CEA has been questioned. Data from the Swedish Vascular Registry indicated an 11.5% stroke and death rate in patients undergoing CEA ≤48 hours of symptom onset. This is a fourfold increase in the odds of a poor outcome compared with those undergoing CEA from 3 to 7 days (S...
Source: Journal of Vascular Surgery - January 24, 2014 Category: Surgery Authors: Á. Merwick, G.W. Albers, E.M. Arsava Tags: Abstracts Source Type: research

Clinical Response to Procedural Stroke Following Carotid Endarterectomy: A  Delphi Consensus Study
CONCLUSION: In patients having a stroke following carotid endarterectomy, expedited diagnostics should be performed initially in most phases. In patients who experience an ipsilateral intra-operative stroke following carotid clamp release, immediate re-exploration of the index carotid artery is recommended.PMID:34312072 | DOI:10.1016/j.ejvs.2021.05.033
Source: PubMed: Eur J Vasc Endovasc ... - July 27, 2021 Category: Surgery Authors: Armelle J A Meershoek Djurre D de Waard Jaap Trappenburg Clark J Zeebregts Richard Bulbulia Jaap L J Kappelle Gert-Jan de Borst Delphi consensus experts panel Source Type: research

Delays in the presentation to stroke services of patients with transient ischaemic attack and minor stroke.
CONCLUSION: Two-thirds of patients were not aware they were having a stroke, one-third were unaware of the FAST campaign and nearly one-third presented with eye symptoms. Inclusion of eye symptoms and reaffirmation of the need to react might avoid unnecessary delays in the presentation of patients with TIA and minor stroke. PMID: 27529453 [PubMed - as supplied by publisher]
Source: The British Journal of Surgery - August 15, 2016 Category: Surgery Authors: Hurst K, Lee R, Sideso E, Giles M, Handa A Tags: Br J Surg Source Type: research

Safety of Carotid Intervention Following Thrombolysis in Acute Ischaemic Stroke.
CONCLUSIONS: Early CEA post-thrombolysis appears safe, with stroke or death rates similar to that of the operation without thrombolysis. However, the wide CI obtained highlights the uncertainty of this result. Further, we emphasise that this recommendation is supported by low-quality evidence. Additional data are required to confirm the safety of surgery and early endovascular therapy post-thrombolysis. PMID: 25216626 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - September 9, 2014 Category: Surgery Authors: Mandavia R, Qureshi MI, Dharmarajah B, Head K, Davies AH Tags: Eur J Vasc Endovasc Surg Source Type: research

Risk of Early Recurrent Stroke in Symptomatic Carotid Stenosis.
CONCLUSIONS: The data suggest that the early risk of recurrent stroke in symptomatic significant carotid stenosis is not as high as some earlier studies have shown. The risk is similar to several studies in which a modern medical treatment regime could be assumed. PMID: 25548062 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - December 26, 2014 Category: Surgery Authors: Strömberg S, Nordanstig A, Bentzel T, Österberg K, Bergström GM Tags: Eur J Vasc Endovasc Surg Source Type: research

Pre-operative Carotid Plaque Echolucency Assessment has no Predictive Value for Long-Term Risk of Stroke or Cardiovascular Death in Patients Undergoing Carotid Endarterectomy.
CONCLUSION: In ACST-1, carotid plaque echolucency assessment in patients undergoing CEA offered no predictive value with regard to peri-operative or long-term stroke risk or of cardiovascular (non-stroke) death. PMID: 28651865 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - June 23, 2017 Category: Surgery Authors: de Waard D, de Borst GJ, Bulbulia R, Pan H, Halliday A, ACST-1 collaborative group Tags: Eur J Vasc Endovasc Surg Source Type: research

Do Integrated Systems of Stroke Care Improve Symptom to Surgery Times in Patients with Symptomatic Carotid Stenosis? A Single Centre Decision Tree Analysis.
CONCLUSIONS: An integrated stroke system of care is cost-effective and associated with significant improvements in quality adjusted life years. PMID: 30174270 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - August 30, 2018 Category: Surgery Authors: Mofidi R, Thomas M, Wong PF, Bergin A, Young G Tags: Eur J Vasc Endovasc Surg Source Type: research

Clinical and Imaging Features Associated with an Increased Risk of Early and Late Stroke in Patients with Symptomatic Carotid Disease.
Abstract OBJECTIVE: The aim of this review was to identify clinical and/or imaging parameters that are associated with an increased (decreased) risk of early/late stroke in patients with symptomatic carotid disease. IN THE FIRST 14 DAYS: Natural history studies suggest that 8-15% of patients with 50-99% stenoses will suffer a stroke within 72 hours of their index symptom. Currently, there are insufficient validated data to identify highest-risk patients for emergency carotid endarterectomy (CEA), but an increased risk of stroke appears to be predicted by (i) an ABCD(2) score of 4-7; (ii) the presence of acute cere...
Source: PubMed: Eur J Vasc Endovasc ... - March 3, 2015 Category: Surgery Authors: Naylor AR, Sillesen H, Schroeder TV Tags: Eur J Vasc Endovasc Surg Source Type: research

Delays in the presentation to stroke services of patients with transient ischaemic attack and minor stroke
ConclusionTwo‐thirds of patients were not aware they were having a stroke, one‐third were unaware of the FAST campaign and nearly one‐third presented with eye symptoms. Inclusion of eye symptoms and reaffirmation of the need to react might avoid unnecessary delays in the presentation of patients with TIA and minor stroke.
Source: British Journal of Surgery - July 31, 2016 Category: Surgery Authors: K. Hurst, R. Lee, E. Sideso, M. Giles, A. Handa Tags: Original article Source Type: research

Diastolic Blood Pressure is a Risk Factor for Peri-procedural Stroke Following Carotid Endarterectomy in Asymptomatic Patients.
CONCLUSION: In ACST-1, diastolic blood pressure was the only independent risk factor associated with peri-procedural stroke or death. While the underlying mechanisms of the association between lower diastolic blood pressure and peri-procedural risk remain unclear, good pre-operative control of blood pressure may improve procedural outcome of carotid surgery in asymptomatic patients. PMID: 28318997 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 15, 2017 Category: Surgery Authors: de Waard DD, de Borst GJ, Bulbulia R, Huibers A, Halliday A, Asymptomatic Carotid Surgery Trial-1 Collaborative Group Tags: Eur J Vasc Endovasc Surg Source Type: research

Restenosis after Carotid Interventions and Its Relationship with Recurrent Ipsilateral Stroke: A Systematic Review and Meta-analysis.
CONCLUSIONS: CAS patients with untreated asymptomatic > 70% restenosis had an extremely low rate of late ipsilateral stroke (0.8% over 50 months). CEA patients with untreated, asymptomatic > 70% restenosis had a significantly higher risk of late ipsilateral stroke (compared with patients with no restenosis), but this was only 5% at 37 months. Overall, 97% of all late ipsilateral strokes after CAS and 85% after CEA occurred in patients without evidence of significant restenosis or occlusion. PMID: 28363431 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 28, 2017 Category: Surgery Authors: Kumar R, Batchelder A, Saratzis A, AbuRahma AF, Ringleb P, Lal BK, Mas JL, Steinbauer M, Naylor AR Tags: Eur J Vasc Endovasc Surg Source Type: research

Timing of Carotid Endarterectomy After Stroke: Retrospective Review of Prospectively Collected National Database
Objective: Our objective was to identify the postoperative risk associated with different timing intervals of repair. Background: Timing of carotid intervention in poststroke patients is widely debated with the scales balanced between increased periprocedural risk and recurrent neurologic event. National database reviews show increased risk to patients treated within the first 2 days of a neurologic event compared to those treated after 6 days. Methods: Utilizing Vascular Quality Initiative data, all carotid interventions performed on stroke patients between the years 2012 and 2017 were queried. Patients were then ...
Source: Annals of Surgery - August 14, 2018 Category: Surgery Tags: Papers of the 138Th ASA Annual Meeting Source Type: research

Carotid Endarterectomy After Intracranial Endovascular Thrombectomy for Acute Ischaemic Stroke in Patients with Carotid Artery Stenosis
CONCLUSION: These results indicate that CEA is safe to perform after previous successful EVT for acute ischaemic stroke. Results were comparable with those undergoing CEA only, despite the EVT+CEA patients having more severe stroke symptoms prior to surgery, and timing was similar.PMID:34887207 | DOI:10.1016/j.ejvs.2021.10.034
Source: PubMed: Eur J Vasc Endovasc ... - December 10, 2021 Category: Surgery Authors: Magnus Jonsson Ellinoora Aro Katarina Bj örses Staffan Holmin Petra Ij äs Nicolas Martinez-Majander Pirkka Vikatmaa Carl-Magnus Wahlgren Maarit Venermo Martin Bj örck Source Type: research

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