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E-107 Carotid artery stenting in patients with symptomatic non-stenotic carotid artery disease - a case series
ConclusionsIn this case series performed over a 10-year period at a high-volume stroke center we show that CAS is safe and efficient in patients with SyNC. Previous studies have established safety and effectiveness of CES in patients presenting with SyNC, however there is a paucity of reports in the literature regarding the effect of CAS in this patient population. Recent guidelines have brought specific attention to high-risk plaque characteristics which suggest that plaque instability plays a major role in the onset of ischemic events, regardless of lumen narrowing. Advanced imaging techniques, such as Optical Coherence ...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nedelcu, S., Kuhn, A., Singh, J., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Discharge prescription patterns for antiplatelet and statin therapy following carotid endarterectomy: an analysis of the vascular quality initiative
Conclusions Although statin use has substantially improved following CEA, more than half of individuals not on a statin preprocedure remained this way at discharge. In addition, DAPT at discharge was frequent, a quarter of whom were on SAPT preprocedure. Further efforts are needed to improve rates of new statin prescriptions, ensure appropriate APT intensity at discharge and determine how different discharge APT regimens impact outcomes.
Source: BMJ Open - July 25, 2023 Category: General Medicine Authors: Eppler, M., Singh, N., Ding, L., Magee, G., Garg, P. Tags: Open access, Cardiovascular medicine Source Type: research

Investigation of Combined Carotid Endarterectomy and Coronary Artery Bypass Graft Surgery Outcomes and Adverse Event Risk Factors in the Vascular Quality Initiative
CONCLUSIONS: Combined CEA and CABG provides excellent long-term mortality prevention in patients with co-existing severe coronary and carotid atherosclerosis. Simultaneous CEA and CABG provides equivalent stroke prevention and long-term survival to both a cohort of patients undergoing coronary revascularization within 5 years of CEA and patients undergoing isolated CEA or CABG in the literature. The two most impactful modifiable risk factors towards long-term stroke and mortality prevention for patients undergoing simultaneous CEA-CABG are patch placement at CEA site and adherence to statin medication therapy.PMID:37303074...
Source: Atherosclerosis - June 11, 2023 Category: Cardiology Authors: Ashley Penton Jonathan Lin Grant Kolde Matthew DeJong Matthew Blecha Source Type: research

Rates of Stroke in Patients With Different Presentations of Carotid Artery Stenosis
CONCLUSION: This cohort study showed no large differences in stroke rates among people with different presentations of carotid artery stenosis.PMID:37295600 | DOI:10.1016/j.ejvs.2023.05.041
Source: PubMed: Eur J Vasc Endovasc ... - June 9, 2023 Category: Surgery Authors: Dylan R Morris Tejas P Singh Tahmid Zaman Ramesh Velu Francis Quigley Jason Jenkins Jonathan Golledge Source Type: research

Optimising Secondary Prevention: a One Year Review of Lipid Lowering Therapy (LLT) and Cholesterol Monitoring in Patients Undergoing Carotid Surgery
Objective: Stroke is common (100 000 new cases annually in the UK), with carotid atherosclerotic disease a recognised cause.1 In such cases patients may require either surgical or endovascular carotid intervention but they should also receive optimal medical therapy including lipid lowering therapy (LLT).2 Statins have been shown to reduce the 10 year risk of stroke/death (17.9% vs. 7.6%) after carotid endarterectomy.3 Current European Society for Vascular Surgery (ESVS) Guidelines advise high intensity statin (HIS) treatment with a target LDL C level of
Source: European Journal of Vascular and Endovascular Surgery - May 1, 2023 Category: Surgery Authors: J.Y. Kwan, M. Sood, F. Stocco, N. Orozov, K. Spencer-jones, M. Bailey, P. Coughlin, J. Scott Source Type: research

Young Patients Undergoing Carotid Endarterectomy Have Increased Rates of Recurrent Disease and Late Neurologic Events
CONCLUSIONS: Young patients undergoing CEA are more likely to be African American, female, and active smokers. They are more likely to present symptomatically and undergo non-elective CEA. Although perioperative outcomes are similar, younger patients are more likely to experience carotid occlusion or restenosis as well as subsequent neurological events, during relatively short follow-up. These data suggest that younger CEA patients may require more diligent follow-up, and a continued aggressive approach to medical management of atherosclerosis to prevent future events related to the operated artery, given the particularly ...
Source: Atherosclerosis - March 4, 2023 Category: Cardiology Authors: Molly Ratner Karan Garg Heepeel Chang William Johnson Mikel Sadek Thomas Maldonado Neal Cayne Jeffrey Siracuse Glenn Jacobowitz Caron Rockman Source Type: research

Perioperative Medical Management for Symptomatic Carotid Artery Interventions
AbstractPurpose of ReviewThe goal of this review is to provide the reader with an overview of symptomatic carotid stenosis and the approach to medical management of patients undergoing surgical intervention with both carotid endarterectomy (CEA) and carotid artery stenting (CAS).Recent FindingsCEA is recommended for patients with moderate to severe symptomatic carotid stenosis and transient ischemic attack (TIA) or non-disabling stroke. More recently CAS has also been shown to be a beneficial, less invasive option for patients with symptomatic carotid stenosis. All patients need urgent medical therapy to reduce the risk of...
Source: Current Treatment Options in Cardiovascular Medicine - October 1, 2022 Category: Cardiology Source Type: research

Modern Treatment of Asymptomatic Carotid Stenosis —The Importance of Both Medical Therapy and Carotid Endarterectomy
Each year there are approximately 700  000 new ischemic strokes in the US, and 10% to 15% of them are caused by thromboembolism from a previously asymptomatic carotid stenosis (ACS). Three large randomized clinical trials, published in the 1990s and early 2000s, have demonstrated a significant benefit of carotid endarterectomy (CEA) i n preventing stroke in patients with severe ACS compared with medical therapy alone. They showed a 50% relative risk reduction in 5-year stroke rate and an approximately 1% per year absolute stroke risk reduction. Over the course of the past 2 decades, there has been significant improvement...
Source: JAMA Surgery - June 8, 2022 Category: Sports Medicine Source Type: research

High stroke rate in patients with medically managed asymptomatic carotid stenosis at an academic center in the Southeastern United States
Since the publication of randomized clinical trials defining the benefit of carotid endarterectomy (CEA) for asymptomatic carotid stenosis, medical management of carotid stenosis has changed significantly. With antiplatelet agents and statins, some question whether these trials are still relevant, suggesting that asymptomatic patients with>70% internal carotid artery (ICA) stenosis may do better with medial management alone, lessening the need for CEA and carotid stenting. The Vascular Quality Initiative (VQI) registry has shown that there are wide practice variations regarding the degree of stenosis that prompts surgical ...
Source: Annals of Vascular Surgery - April 22, 2022 Category: Surgery Authors: Sarah Weiner, Mary Hunter Benton, Benjana Guraziu, Yue Yange, Jie He, Yi Tang Chen, William A. Marston, Katharine L. McGinigle Tags: General Review Source Type: research

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