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Specialty: Cardiology
Procedure: Carotid Endarterectomy

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Total 244 results found since Jan 2013.

Systemic Glucocorticoids Are Associated With Mortality After Carotid Endarterectomy
Abstract: Glucocorticoids (GCs) are widely used anti-inflammatory drugs well known to cause many adverse effects. Still, there is a dearth of data on the long-term cardiovascular effects of GCs in patients with established cardiovascular disease and the effect on atherosclerotic plaque composition. A total of 1894 patients who underwent carotid endarterectomy (CEA), of whom 40 patients received systemic GCs, were included in the Athero-Express Biobank. Atherosclerotic plaque samples and peripheral blood samples were obtained during CEA. Cardiovascular events during 3 years of follow-up were investigated using Cox regressio...
Source: Journal of Cardiovascular Pharmacology - October 1, 2015 Category: Cardiology Tags: Original Article Source Type: research

Carotid Artery Stenting–Historical Context, Trends, and Innovations
Int J AngiolDOI: 10.1055/s-0035-1556842Surgical carotid endarterectomy (CEA) has been proven effective in both primary and secondary stroke prevention and, until recently, has been considered the standard treatment approach for patients with severe carotid artery disease. Because of its technical limitations and less favorable outcomes, carotid artery stenting (CAS) has been offered preferably to patients considered to be too comorbid to undergo surgical treatment. However, CAS has evolved over time into a reliable method and is currently considered an alternative to CEA. The aim of this review was to discuss the historica...
Source: International Journal of Angiology - August 19, 2015 Category: Cardiology Authors: Spacek, MiloslavVeselka, Josef Tags: Review Article Source Type: research

Carotid Endarterectomy: Current Concepts and Practice Patterns
Conclusions Vascular surgeons are uniquely positioned to treat carotid artery disease through medical therapy, CEA, and stenting. Although data from randomized trials differ, it is important for surgeons to make clinical decisions based on the patient. We believe that CAS can be adopted with low complication rate in a selected subgroup of patients, but CEA should remain the standard of care. This current evidence should be incorporated into practice of the modern vascular surgeon.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text
Source: International Journal of Angiology - August 14, 2015 Category: Cardiology Authors: Saha, Sibu P.Saha, SubhajitVyas, Krishna S. Tags: Original Article Source Type: research

Intravascular Near-Infrared Spectroscopy: A Possible Tool for Optimizing the Management of Carotid Artery Disease
Int J AngiolDOI: 10.1055/s-0035-1558644Stroke is the second most common cause of morbidity and mortality in the Western nations. It is estimated that approximately one-fifth of all strokes or transient ischemic attacks are caused by carotid artery disease. Thus, treatment of carotid artery disease as a mean of stroke prevention is extremely important. Since the introduction of carotid endarterectomy, debate has persisted over the treatment strategy for carotid artery disease. Current recommendations have many potential flaws because they are often based on older trials performed before the introduction of modern pharmacoth...
Source: International Journal of Angiology - August 6, 2015 Category: Cardiology Authors: Horváth, MartinHájek, PetrŠtěchovský, CyrilHoněk, JakubVeselka, Josef Tags: Review Article Source Type: research

Medical and Revascularization Therapies for Asymptomatic Carotid Stenosis
Abstract Asymptomatic internal carotid artery stenosis increases with age and is more common in men. Carotid endarterectomy and stenting have reduced stroke rates in patients with asymptomatic carotid stenosis in clinical trials. A variety of risk stratification methods are available for selection of patients with carotid stenosis for revascularization. In the past decade, there is increasing evidence that the rate of stroke declined with the use of aggressive multi-modal medical therapy. These developments have led to new clinical trials to compare revascularization versus aggressive medical therapy in patients ...
Source: Current Atherosclerosis Reports - June 13, 2015 Category: Cardiology Source Type: research

Comparative Review of the Treatment Methodologies of Carotid Stenosis
Int J AngiolDOI: 10.1055/s-0035-1545073The treatment of carotid stenosis entails three methodologies, namely, medical management, carotid angioplasty and stenting (CAS), as well as carotid endarterectomy (CEA). The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) have shown that symptomatic carotid stenosis greater than 70% is best treated with CEA. In asymptomatic patients with carotid stenosis greater than 60%, CEA was more beneficial than treatment with aspirin alone according to the Asymptomatic Carotid Atherosclerosis (ACAS) and Asymptomatic Carotid Stenosis Tr...
Source: International Journal of Angiology - May 18, 2015 Category: Cardiology Authors: Bae, ConeySzuchmacher, MauricioChang, John B. Tags: Review Article Source Type: research

64Cu-DOTATATE PET/MRI for Detection of Activated Macrophages in Carotid Atherosclerotic Plaques: Studies in Patients Undergoing Endarterectomy.
CONCLUSIONS: The novel PET tracer (64)Cu-DOTATATE accumulates in atherosclerotic plaques of the carotid artery. CD163 gene expression correlated independently with (64)Cu-DOTATATE uptake measured by real-time quantitative polymerase chain reaction in the final multivariate model, indicating that (64)Cu-DOTATATE PET is detecting alternatively activated macrophages. This association could potentially improve noninvasive identification and characterization of vulnerable plaques. PMID: 25977567 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - May 14, 2015 Category: Cardiology Authors: Folke Pedersen S, Vikjær Sandholt B, Høgild Keller S, Espe Hansen A, Ettrup Clemmensen A, Sillesen H, Højgaard L, Sejersten Ripa R, Kjær A Tags: Arterioscler Thromb Vasc Biol Source Type: research

Meta- analysis and meta-regression analysis of the associations between sex and the operative outcomes of carotid endarterectomy
Conclusions: Metanalyses of case series and databases dealing with CEA reveal inconsistent results regarding gender differences related to CEA-procedure and should not be transferred into clinical practice.
Source: BMC Cardiovascular Disorders - May 9, 2015 Category: Cardiology Authors: Thomas LuebkeJan Brunkwall Source Type: research

Expression of Vasohibin-1 in Human Carotid Atherosclerotic Plaque.
CONCLUSIONS: The VASH1 expression levels in atheroma reflect both enhanced neovascularization and the inflammatory burden. Therefore, the VASH1 level may be a novel biomarker for evaluating plaque instability in patients with carotid arteriosclerosis and predicting ischemic stroke. PMID: 25843115 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - April 9, 2015 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Readmissions After Carotid Artery Revascularization in the Medicare Population
ConclusionsAlmost 10% of Medicare patients undergoing carotid revascularization were readmitted within 30 days of discharge. Compared with CEA, CAS was associated with a greater readmission risk. However, hospitals' RSRR did not differ by their proportional CAS use.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Outcomes After Acute Ischemic Stroke in the United States: Does Residential ZIP Code Matter? Stroke
Conclusions Patients from lower-income quartiles had decreased reperfusion on the first admission day, compared with patients from higher-income quartiles. The cost of hospitalization of patients from higher-income quartiles was significantly higher than that of patients from lowest-income quartiles, despite longer hospital stays in the latter group. This might be partially attributable to a lower use of key procedures among patients from lowest-income quartile.
Source: JAHA:Journal of the American Heart Association - March 15, 2015 Category: Cardiology Authors: Agarwal, S., Menon, V., Jaber, W. A. Tags: Stroke Source Type: research

Carotid artery stenting: current role of proximal neuroprotection and technical advancements in stroke prevention
For more than 50 years, carotid endarterectomy has been considered the gold standard therapy to prevent stroke in patients with carotid artery disease. Carotid artery stenting (CAS) has emerged in the last 15 years as minimally invasive alternative to surgery, especially in patients at high surgical risk. Recent randomized trials have challenged this concept reporting a relatively high incidence rate (4–6%) of post-CAS neurological adverse events. The aim of this study is to evaluate the current role of CAS in all-comers with advanced carotid disease, managed with mandatory proximal neuroprotection in a high-volume c...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Cremonesi, A., Mussardo, M., Sbarzaglia, P., Spagnolo, B., Cavazza, C., Castriota, F. Tags: Articles Source Type: research

Contralateral occlusion increases the risk of neurological complications associated with carotid endarterectomy.
Conclusions. In our experience CO patients were at high risk for postoperative neurological complications particularly when presenting association of advanced age and preoperative brain infarction. PMID: 25705519 [PubMed]
Source: International Journal of Vascular Medicine - February 24, 2015 Category: Cardiology Tags: Int J Vasc Med Source Type: research

Ischemic Brain Lesions After Carotid Artery Stenting Increase Future Cerebrovascular Risk
ConclusionsIschemic brain lesions discovered on DWI after CAS seem to be a marker of increased risk for recurrent cerebrovascular events. Patients with periprocedural DWI lesions might benefit from more aggressive and prolonged antiplatelet therapy after CAS. (A Randomised Comparison of the Risks, Benefits and Cost Effectiveness of Primary Carotid Stenting With Carotid Endarterectomy: International Carotid Stenting Study; ISRCTN25337470)
Source: Journal of the American College of Cardiology - February 9, 2015 Category: Cardiology Source Type: research

Carotid artery stenting: an update
In patients with carotid disease, the purpose of carotid artery revascularization is stroke prevention. For >50 years, carotid endarterectomy has been considered the standard treatment for severe asymptomatic and symptomatic carotid stenoses. Carotid artery stenting (CAS) has emerged in the last 15 years as minimally invasive alternative to surgery. However, the value of the endovascular approach in the management of carotid disease patients remains highly controversial. The aims of this review are to elucidate the current role of CAS, to describe the major technology advancements in the field, and to speculate about th...
Source: European Heart Journal - January 7, 2015 Category: Cardiology Authors: Cremonesi, A., Castriota, F., Secco, G. G., Macdonald, S., Roffi, M. Tags: Clinical update Source Type: research