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Specialty: Cardiology
Procedure: Carotid Endarterectomy

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Total 244 results found since Jan 2013.

The current role of carotid duplex ultrasonography in the management of carotid atherosclerosis: foundations and advances.
Authors: Byrnes KR, Ross CB Abstract The management of atherosclerotic carotid occlusive disease for stroke prevention has entered a time of dramatic change. Improvements in medical management have begun to challenge traditional interventional approaches to asymptomatic carotid stenosis. Simultaneously, carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CE). Finally, multiple factors beyond degree of stenosis and symptom status now mitigate clinical decision making. These factors include brain perfusion, plaque morphology, and patency of intracranial collaterals (circle of Willis...
Source: International Journal of Vascular Medicine - December 1, 2014 Category: Cardiology Tags: Int J Vasc Med Source Type: research

Lesion-Related Carotid Angioplasty and Stenting with Closed-Cell Design without Embolic Protection Devices in High-Risk Elderly Patients—Can This Concept Work Out? A Single Center Experience Focusing on Stent Design
Int J AngiolDOI: 10.1055/s-0034-1390084To compare the performance differences of three carotid artery stents in high-risk elderly patients without embolic protection devices (EPDs) on the basis of stent design, procedure-related complications, conveniences in handling, in-stent restenosis, 30-day outcome, and long-term follow-up. A total of 101 symptomatic internal carotid stenoses of 94 patients were prospectively treated with stent-protected angioplasty to 94 patients. Three closed-cell stents, one of those being hybrid cell design, were chosen depending on vascular anatomy: curved vessel, lesion length > 1 cm: 64...
Source: International Journal of Angiology - November 11, 2014 Category: Cardiology Authors: Hopf-Jensen, SilkeMarques, LeonardoPreiß, MichaelMüller-Hülsbeck, Stefan Tags: Original Article Source Type: research

Peri-procedural outcome of series of 104 carotid artery stenting procedures
Conclusion CAS with EPDs seems a feasible and safe procedure and could be performed with an acceptable rate of periprocedural adverse events.
Source: The Egyptian Heart Journal - November 6, 2014 Category: Cardiology Source Type: research

Testing for asymptomatic carotid disease in patients with arterial disease elsewhere
Publication date: December 2013 Source:Reviews in Vascular Medicine, Volume 1, Issue 4 Author(s): Ankur Thapar , Alex Munster , Joseph Shalhoub , Alun Huw Davies Moderate to severe asymptomatic carotid atherosclerosis is found in 2–7% of the European population aged over 60 years; however the prevalence is highest in those with peripheral arterial disease (25%). The number of individuals needed to scan to prevent one extra stroke through referral for endarterectomy is 143 for claudicants, 250 for those with aortic aneurysmal disease and 333 for those with contralateral symptomatic carotid stenosis. The cost per stroke ...
Source: Reviews in Vascular Medicine - November 6, 2014 Category: Cardiology Source Type: research

Impact of coronary artery disease presence on the long-term follow-up of carotid artery stenting.
CONCLUSIONS: Patients with symptomatic or asymptomatic carotid stenosis are a high-risk individuals. The presence of CAD increases the risk of MACCE in such patients during long-term follow-up. PMID: 25371310 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - November 5, 2014 Category: Cardiology Authors: Arif S, Bartus S, Dziewierz A, Chyrchel M, Brzezinski M, Rakowski T, Bartus K, Dudek D, Dubiel J Tags: Kardiol Pol Source Type: research

Comparison of Trends and Outcomes of Carotid Artery Stenting and Endarterectomy in the United States, 2001 to 2010 Peripheral Vascular Disease
Conclusions— In US hospitals between 2001 and 2010, CAS was associated with worse in-hospital outcomes, partly attributable to selection and ascertainment bias. Asymptomatic patients undergoing CAS versus CEA had similar adjusted rates of major adverse events. CAS outcomes improved significantly during the course of the decade likely attributable to improvements in patient selection, operator skills, and technological advancements.
Source: Circulation: Cardiovascular Interventions - October 21, 2014 Category: Cardiology Authors: Kim, L. K., Yang, D. C., Swaminathan, R. V., Minutello, R. M., Okin, P. M., Lee, M. K., Sun, X., Wong, S. C., McCormick, D. J., Bergman, G., Allareddy, V., Singh, H., Feldman, D. N. Tags: Carotid endarterectomy, Angioplasty and Stenting Peripheral Vascular Disease Source Type: research

Treatment with betablockers is associated with higher grey-scale median in carotid plaques
Conclusions: These results suggest the use of standardized ultrasound techniques as an important tool in evaluating the effect of anti-atherosclerotic medications and underline the need of.further prospective randomized studies on larger patient cohorts in order to confirm these results.
Source: BMC Cardiovascular Disorders - August 30, 2014 Category: Cardiology Authors: Giuseppe AsciuttoNuno DiasAna PerssonJan NilssonIsabel Gonçalves Source Type: research

Carotid Artery Stenting
Carotid artery stenting (CAS) has achieved clinical equipoise with carotid endarterectomy (CEA), as evidenced by 2 large U.S. randomized clinical trials, multiple pivotal registry trials, and 2 multispecialty guideline documents endorsed by 14 professional societies. The largest randomized trial conducted in patients at average surgical risk of CEA, CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) found no difference between CAS and CEA for the combined endpoint of stroke, death, and myocardial infarction (MI) after 4 years of follow-up. The largest randomized trial comparing CAS and CEA in patients a...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - August 11, 2014 Category: Cardiology Source Type: research

Clinical Prediction Model Suitable for Assessing Hospital Quality for Patients Undergoing Carotid Endarterectomy Stroke
Conclusions The NCDR CEA score, comprising 7 clinical variables, predicts in-hospital stroke or death after CEA. This model can be used to estimate hospital risk-adjusted outcomes for CEA and to assist with the assessment of hospital quality.
Source: JAHA:Journal of the American Heart Association - June 17, 2014 Category: Cardiology Authors: Wimmer, N. J., Spertus, J. A., Kennedy, K. F., Anderson, H. V., Curtis, J. P., Weintraub, W. S., Singh, M., Rumsfeld, J. S., Masoudi, F. A., Yeh, R. W. Tags: Stroke Source Type: research

Revascularization Strategies in Patients With Combined Carotid and Coronary Artery Disease
Shishehbor et al. (1) retrospectively compared 3 different approaches to carotid revascularization and open heart surgery (OHS) (coronary artery bypass graft in>80% of cases) analyzing the results obtained in 350 patients treated in a tertiary US center during a 12-year period. Their results revealed that staged carotid artery stenting (CAS)-OHS and combined carotid endarterectomy (CEA)-OHS are associated with better outcomes (a composite of death, stroke, or myocardial infarction) than staged CEA-OHS at 30 days. However, the outcomes were in favor of staged CAS-OHS after the first year. The authors concluded that staged ...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 16, 2014 Category: Cardiology Source Type: research

Risk Factors Associated With Cerebrovascular Recurrence in Symptomatic Carotid Disease: A Comparative Study of Carotid Plaque Morphology, Microemboli Assessment and the European Carotid Surgery Trial Risk Model Stroke
Conclusions The presence of carotid plaque hemorrhage is better associated with recurrent cerebrovascular events in patients with symptomatic severe carotid stenosis than the presence of microembolic signals; combining MES and MRIPH, further improves the association while the ECST risk score was insignificant.
Source: JAHA:Journal of the American Heart Association - June 3, 2014 Category: Cardiology Authors: Altaf, N., Kandiyil, N., Hosseini, A., Mehta, R., MacSweeney, S., Auer, D. Tags: Stroke Source Type: research

Abstract 28: Readmissions after Carotid Artery Revascularization in the Medicare Population Session Title: Concurrent III Session A: Oral Abstracts on Outcomes Issues
Conclusions: Almost 10% of Medicare patients undergoing carotid revascularization were readmitted within 30 days of discharge. Compared with CEA, CAS was associated with higher 30-day readmission rates. However, hospitals’ RSRR did not differ by their proportional use of CAS volume. Efforts to identify readmission risk factors are needed to reduce rates of readmissions following carotid revascularization.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Al-Damluji, M. S., Zhang, W., Stilp, E., Geary, L., Mena-Hurtado, C., Curtis, J. P. Tags: Session Title: Concurrent III Session A: Oral Abstracts on Outcomes Issues Source Type: research

Institutional Differences in Carotid Artery Duplex Diagnostic Criteria Result in Significant Variability in Classification of Carotid Artery Stenoses and Likely Lead to Disparities in Care Original Articles
Conclusions— Differences in diagnostic criteria to interpret carotid ultrasound result in significant variation in classification of carotid artery stenosis, likely leading to differences in the number and subsequent costs of revascularizations. This theoretical model highlights the need for standardization of carotid duplex criteria.
Source: Circulation: Cardiovascular Quality and Outcomes - May 20, 2014 Category: Cardiology Authors: Arous, E. J., Baril, D. T., Robinson, W. P., Aiello, F. A., Hevelone, N. D., Arous, E. J., Messina, L. M., Schanzer, A. Tags: Cerebrovascular disease/stroke, Carotid Stenosis, Doppler ultrasound, Transcranial Doppler etc., Carotid endarterectomy Original Articles Source Type: research

Reply Sometimes, Things Are Not Always What They Seem
Dr. Naylor, in his commentary on the report by Shishehbor et al. (1), has brought up an important point regarding the optimal treatment strategy for patients with asymptomatic unilateral carotid disease. Since the pivotal trials comparing carotid endarterectomy with medical therapy almost 2 decades ago (2,33), it has been accepted that carotid endarterectomy is superior to medical therapy in lowering the future risk for stroke in patients with asymptomatic high-grade carotid disease. Whether contemporary medical therapy with potent antiplatelet, lipid-lowering, and antihypertensive therapy has narrowed the gap between the...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - March 31, 2014 Category: Cardiology Source Type: research

Time Dependent Changes in Atherosclerotic Plaque Composition in Patients Undergoing Carotid Surgery.
CONCLUSIONS: In conclusion, over the past decade, atherosclerotic plaques harvested during carotid endarterectomy show a time dependent change in plaque composition characterized by a decrease in features currently believed to be causal for plaque instability. This seems to go hand in hand with improvements in risk factor management. PMID: 24637558 [PubMed - as supplied by publisher]
Source: Circulation - March 17, 2014 Category: Cardiology Authors: van Lammeren GW, den Ruijter HM, Vrijenhoek JE, van der Laan S, Velema E, de Vries JP, de Kleijn DP, Vink A, de Borst GJ, Moll FL, Bots ML, Pasterkamp G Tags: Circulation Source Type: research