OBJECTIVES: To assess timeliness of carotid endarterectomy services in the United Kingdom. DESIGN: Observational study with follow-up to March 2008. SETTING: UK hospitals performing carotid endarterectomy. PARTICIPANTS: UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007. MAIN OUTCOME MEASURES: Provision and speed of delivery of appropriate assessments of patients; carotid endarterectomy and operative mortality; 30 day postoperative mortality. RESULTS: 240 (61% of those eligible) consultant surgeons took part from 102 (76%) hospitals and trusts. Of 9913 carotid endarterectomies recorded on hospital episode statistics, 5513 (56%) were included. Of the patients who underwent endarterectomy, 83% had a history of transient ischaemic attack or stroke. Of these recently symptomatic patients, 20% had their operation within two weeks of onset of symptoms and 30% waited more than 12 weeks. Operative mortality was 0.5% during the inpatient stay and 1.0% (95% confidence interval 0.7%
TY - JOUR. T1 - Higher risk factor burden and worse outcomes in urban carotid endarterectomy patients. AU - Chaturvedi, Seemant. AU - Madhavan, Ramesh. AU - Santhakumar, Sunitha. AU - Mehri-Basha, Maysaa. AU - Raje, Nikita. PY - 2008/11/1. Y1 - 2008/11/1. N2 - BACKGROUND AND PURPOSE-Previous multicenter carotid endarterectomy (CEA) studies had screening criteria for patient comorbidities and very few blacks. We assessed the hypothesis that CEA results from two urban hospitals would approximate those of the previous multicenter trials. METHODS-A retrospective chart review was completed at two urban hospitals for CEA procedures done in 2003 and 2004. Demographic information and past medical history was recorded. In hospital perioperative complications (stroke or myocardial infarction [MI]) were noted. We calculated an expected perioperative stroke rate based on trial figures and our proportion of symptomatic and asymptomatic patients. RESULTS-Patients in our cohort had significantly higher rates ...
Carotid endarterectomy reduced death and strokes in patients with ipsilateral high-grade stenosis and recent hemispheric transient ischemic attacks or nondisabling strokes. The ECST and the NASCET are landmark studies. Many clinicians believed that persons with cerebral ischemic symptoms associated with high-grade carotid stenosis benefited from carotid endarterectomy. However, considerable doubt arose about a net benefit to society, given the high risk of surgery reported from some communities and the reported high frequency of inappropriate indications for carotid endarterectomy. These studies do not completely allay the doubt. In both studies the surgeons were carefully chosen and demonstrated lower perioperative morbidity and mortality than shown in community surveys. The major surprise in these studies is the high risk for stroke in the patients who did not have surgery; 22% in 3 years in ECST and 28% in 2 years in NASCET. The apparently higher risk in NASCET may be at least partly an ...
Il nostro Team vanta ventanni di esperienza nella cura del piede diabetico ed è stato parte importante nella evoluzione della cura di questa patologia, in. Background Previous studies have shown that carotid endarterectomy in patients with symptomatic severe carotid stenosis (defined as stenosis of 70 to 99 percent of. Background Previous studies chirurgia vascolare carotids shown that carotid endarterectomy in patients with symptomatic severe carotid stenosis (defined as stenosis of 70 to 99 percent of. Il nostro Team vanta ventanni di esperienza nella cura del piede diabetico ed è stato parte importante nella evoluzione della cura di questa patologia, in. Background Carotid-artery stenting and carotid endarterectomy are both options for treating carotid-artery stenosis, an important cause of stroke. Methods We randomly. ...
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The significant risk of fatal myocardial infarction after carotid endarterectomy in patients with coronary disease long has been recognized. In 1,546 consecutive carotid endarterectomies performed in 1,238 patients over the last 10 years, angina pectoris was present in 17% (212/1,238) of patients; a further 32% (396/1,238) of patients were asymptomatic, but had a history of myocardial infarction. The perioperative mortality (30 day) in the 1,306 consecutive endarterectomies in 1,026 patients without symptomatic coronary artery disease was 1.5% (15/1,026 patients). Of the 212 patients with symptoms, 85 carotid endarterectomies were performed in 77 patients without prior coronary bypass operation with an operative mortality of 18.2% (14/77 patients). The remaining 135 patients had 155 carotid endarterectomies but were treated by either prior coronary artery bypass (84 patients) or simultaneous carotid endarterectomy and coronary artery bypass (51 patients) with an operative mortality of 3% (4/135 ...
I wish to congratulate Eric Russell for his conscientious and thought-provoking commentary on the status of carotid stenting. The technique of carotid stenting is about to begin a new phase of additional rigorous scrutiny and investigation. The National Institute of Neurologic Disorders and Stroke (NINDS) recently has approved and funded a large multicenter, multinational, randomized, controlled trial comparing carotid stenting with carotid endarterectomy. The Carotid Revascularization Endarterectomy vs. Stent Trial (CREST) plans to begin training and credentialing interventionalists this summer, and recruitment is expected to begin late this year or in early 2000. The trial will address the relevant efficacy of carotid stenting and carotid endarterectomy in a North American Symptomatic Carotid Endarterectomy Trial (NASCET)-like population of patients with symptomatic high-grade stenoses. We anticipate that 2500 patients will need to be recruited to satisfy the statistical requirements of the ...
CREST Trial Points to Endarterectomy as Preferred Stroke Preventive Strategy. A comparison of endarterectomy versus stenting in treating carotid artery stenosis shows that stent recipients are at higher risk for stroke within 30 days of the procedure, according to a New England Journal of Medicine study released online. Investigators in the CREST trial randomized some 2500 patients with carotid artery stenosis to either stenting or endarterectomy. After a median follow-up of 2.5 years, the groups showed no significant difference in the primary endpoint - a composite of stroke, myocardial infarction, or death from any cause during the periprocedural period, or ipsilateral stroke within 4 years.. However, the 4-year rate of stroke or death significantly favored endarterectomy. When the individual outcomes were examined, there were significantly more periprocedural strokes after stenting, and more MIs after endarterectomy.. Editorialists conclude that "endarterectomy remains the preferred treatment ...
OBJECTIVE To decrease the procedural risk of carotid revascularisation it is crucial to understand the mechanisms of procedural stroke. This study analysed the features of procedural strokes associated with carotid artery stenting (CAS) and carotid endarterectomy (CEA) within the International Carotid Stenting Study (ICSS) to identify the underlying pathophysiological mechanism. MATERIALS AND METHODS Patients with recently symptomatic carotid stenosis (1,713) were randomly allocated to CAS or CEA. Procedural strokes were classified by type (ischaemic or haemorrhagic), time of onset (intraprocedural or after the procedure), side (ipsilateral or contralateral), severity (disabling or non-disabling), and patency of the treated artery. Only patients in whom the allocated treatment was initiated were included. The most likely pathophysiological mechanism was determined using the following classification system: (1) carotid-embolic, (2) haemodynamic, (3) thrombosis or occlusion of the revascularised carotid
The rationale of carotid endarterectomy for asymptomatic carotid bifurcation lesions is based on the assumption that there will be a reduction in long-term stroke risk in the distribution of the artery. To achieve this objective, the following criteria must be fulfilled: (1) a lesion must be associated with a demonstrable stroke risk (2) removal of the lesion must eliminate or reduce long term stroke risk (3) the surgeon who operates on the asymptomatic carotid lesion must have a low rate of perioperative neurological morbidity and mortality. Perioperative and long-term results of surgical management are readily available from retrospective reviews. Comparison of these reviews with the natural history reports has resulted in a series of position or consensus statements. Finally, prospective randomized trials either completed or in progress will provide the most definitive evidence either supporting or refuting the efficacy of prophylactic carotid endarterectomy in asymptomatic patients.. Recent ...
Carotid artery disease is a major cause of stroke. Carotid endarterectomy when performed with a low complication rate in patients with severe lesions has been shown to reduce the subsequent risk of stroke in a series of randomised controlled trials in both symptomatic and asymptomatic populations. The CAVATAS trial demonstrated that simple balloon angioplasty of carotid stenoses was as good as endarterectomy in terms of stroke prevention and was associated with a lower complication rate. Carotid stenting performed with the use of distal protection devices has been shown to be superior to endarterectomy in patients considered to be at increased perioperative risk as assessed by a variety of clinical and angiographic parameters. Comparisons of carotid stenting and endarterectomy in patients considered to be of normal perioperative risk are ongoing. Optimal medical therapy is mandatory for all patients with carotid artery disease. ...
By American Academy of Neurology, Stroke affects more than 700,000 people in the United States per year. A blockage of a blood vessel is responsible for about 80 percent of strokes. Carotid endarterectomy is the most frequently performed operation to prevent stroke. There is scientific evidence to support its use to prevent future stroke, according to a clinical practice guideline published in the September 27, 2005 issue of Neurology, the scientific journal of the American Academy of Neurology (AAN). The guideline updates the 1990 AAN statement on carotid endarterectomy ...
Befor the surgery, your doctor will talk to you about how to prepare for carotid endarterectomy (CEA). Besides, he may conduct tests to examine your carotid arteries.
TY - JOUR. T1 - Safety and efficacy of fixed-dose heparin in carotid endarterectomy. AU - Poisik, Alexander. AU - Heyer, Eric J.. AU - Solomon, Robert A.. AU - Quest, Donald O.. AU - Adams, David C.. AU - Baldasserini, Catherine Moses. AU - McMahon, Donald J.. AU - Huang, Judy. AU - Kim, Louis J.. AU - Choudhri, Tanvir F.. AU - Connolly, E. Sander. PY - 1999/1/1. Y1 - 1999/1/1. N2 - OBJECTIVE: Although fixed dosage of heparin is frequently used during vascular surgery, there are very few studies that document the appropriateness of this type of dosing. We have undertaken a prospective study to determine the physiological response to a fixed dose of heparin, using a conventional measure of anticoagulation, and have correlated this measure with complications. METHODS: We studied 140 consecutive patients undergoing elective carotid endarterectomy. Serial activated clotting times (ACT values) were obtained in duplicate before administration of heparin, 15 minutes after application of a carotid ...
Carotid Endarterectomy with Iatrogenic Cranial Nerve Damage. This custom medical exhibit features a lateral view of the left neck revealing the anatomy in the region of a Carotid Endarterectomy surgery. Additional images show the location of the cranial nerves, and the function of CN X, XI and XII (vagus, glossopharyngeal and hypoglossal nerves) which were damaged in this particular case.
Carotid Endarterectomy with Iatrogenic Cranial Nerve Damage. This custom medical exhibit features a lateral view of the left neck revealing the anatomy in the region of a Carotid Endarterectomy surgery. Additional images show the location of the cranial nerves, and the function of CN X, XI and XII (vagus, glossopharyngeal and hypoglossal nerves) which were damaged in this particular case.
Carotid endarterectomy (CEA) is the most frequently performed noncardiac vascular procedure. CEA is preventative surgery aimed at reducing the rate of stroke in patients at high risk of such an event. Performing a CEA itself has considerable risk. The inherent risk of carotid surgery is perioperative stroke occurring at rates from 5 % to 7.5 % [1]. The causes of perioperative stroke are hypoperfusion, hyperperfusion or embolization during cross-clamping of the internal carotid artery. The co-morbidity associated with carotid disease is considerable. Many of these patients have existed ischaemic heart disease, chronic obstructive pulmonary disease or diabetes. In addition, they may be smokers and elderly. A significant number of patients undergoing coronary artery surgery have severe carotid artery disease. It is also true that up to half of the patients undergoing CEA have severe treatable coronary lesions. Stroke is the most serious postoperative risk. Other major complications that can occur ...
SCVS 2018 Abstracts: Differences in Predictors of Intraoperative versus Postoperative Strokes after Carotid Endarterectomy and Carotid Artery Stenting.
The results of this study suggest that carotid stenting is as effective as carotid endarterectomy for middle-term prevention of ipsilateral stroke, but the safety of carotid stenting needs to be improved before it can be used as an alternative to carotid endarterectomy in patients with symptomatic c …
The mean age was 70.2 ± 9.4 years; there were 39.6% female patients, 93.1% of white race, with 29.6% of CEAs being performed for symptomatic status. The overall rate of CHS was 0.18% (n = 94), with 55.1% occurring in asymptomatic and 44.9% occurring in symptomatic patients with an associated mortality rate of 38.2%. Multivariable analysis including preoperative variables showed that female gender (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.09-2.51; P = .019), ,1 month major ipsilateral stroke (OR, 5.36; 95% CI, 2.35-12.22; P , .001), coronary artery disease (OR, 1.77; 95% CI, 1.15-2.71; P = .009), and contralateral stenosis ≥70% (OR, 1.54; 95% CI, 1.00-2.36; P = .050) were independently associated with CHS and that ,1 month major stroke was the most important contributor to the model. With the additional inclusion of operative and postoperative variables, female gender (OR, 1.75; 95% CI, 1.14-2.67; P = .010), ,1 month ipsilateral major stroke (OR, 3.20; 95% CI, 1.32-7.74; P = ...
As for the current trials assessing the surgery vs. stenting debate, the panel hoped the Carotid Revascularization Endarterectomy versus Stent Trial (CREST) and the Carotid Angioplasty and Stenting vs. Endarterectomy in Asymptomatic Patients with Significant Extracranial Carotid Occlusive Disease Trial (ACT I) would provide some much needed answers. CREST is a NIH/NINDS sponsored trial contrasting the relative efficacy of carotid endarterectomy and carotid stenting in preventing primary outcomes of stroke, myocardial infarction, or death during a 30-day periprocedural period, or ipsilateral stroke over the follow-up period extending up to four years. Stroke events will be verified by an Adjudication Committee masked to the assigned treatment. The primary eligibility criterion is a significant (>50%) stenosis of the carotid artery in patients with transient ischemic attack or ipsilateral non-disabling stroke within the prior 180 days.. The trial is aiming to 2,500 patients (1,100 asymptomatic, ...
INTRODUCTION. Carotid artery stenosis leads to stroke and long-lasting disabilities. Atherosclerosis, which settles inside the bifurcation of common carotid artery, is one of the major causes of recurrent ischemic stroke[1]. Current medical approaches aim to slow down the progression of the disease and prevent stroke[2]. Since the first successful carotid endarterectomy (CEA) performed in the 1950s, surgical treatment has become the gold standard in the treatment of carotid stenosis[3]. Its superiority over medical therapy in cases with symptomatic and serious carotid stenosis has definitively been revealed in many studies[4-6]. CEA is a widely performed procedure in many medical centers, with low complication rates. Within the first 30 postoperative days, local neurological damage, hematoma and bleeding, cardiovascular complications, permanent or transient stroke, and death are the most frequently encountered complications[7]. CEA techniques differ among surgeons; however, no difference ...
TY - JOUR. T1 - Outcomes after carotid artery stenting and endarterectomy in the medicare population. AU - Wang, Fen Wei. AU - Esterbrooks, Dennis J.. AU - Kuo, Yong Fang. AU - Mooss, Aryan N.. AU - Mohiuddin, Syed M.. AU - Uretsky, Barry F.. PY - 2011/7. Y1 - 2011/7. N2 - Background and Purpose- Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for stroke prevention. The value of this therapy relative to CEA remains uncertain. Methods- In 10 958 Medicare patients aged 66 years or older between 2004 and 2006, we analyzed in-hospital, 1-year stroke, myocardial infarction, and death rate outcomes and the effects of potential confounding variables. Results- CAS patients (87% were asymptomatic) had a higher baseline risk profile, including having a higher percentage of coronary and peripheral arterial disease, heart failure, and renal failure. In-hospital stroke rate (1.9% CAS versus 1.4% CEA; P=0.14) and mortality (CAS 0.9% versus 0.6% CEA; P=0.20) were similar. By 1 ...
Synonyms for Endarterectomy, carotid in Free Thesaurus. Antonyms for Endarterectomy, carotid. 4 words related to endarterectomy: ablation, cutting out, extirpation, excision. What are synonyms for Endarterectomy, carotid?
EVIDENCE BASED MEDICINE (MIMS April 2003) Stroke prevention Comparative effectiveness of various interventions. PRIOR TO STROKE OR TRANSIENT ISCHAEMIC ACCIDENT (TIA) Beneficial. 1. Antiplatelet treatment. 2. Cholestrerol reduction (for those patients who also have coronary heart disease). 3. Carotid endarterectomy (in patients with severe symptomatic carotid artery stenosis). Unknown effectiveness. 1. Cholesterol reduction (for patients without CHD). 2. Blood pressure reduction. 3. Carotid endarterectomy (in patients with severe symptomatic carotid artery stenosis). 4. Catotid angioplasty Likely to ineffective or even harmful. Oral anticoagulation ATRIAL FIBRILLATION AND A PRIOR STROKE OR TIA Beneficial 1. Oral anticoagulation. 2. Aspirin for patients with contraindications to an anticoagulant. ATRIAL FIBRILLATION BUT NO OTHER MAJOR RISK FACTORS FOR STROKE Likely to be beneficial.. KEY POINTS. In patients with a prior stroke or TIA. 1. Insufficient evidence to support routine blood presure ...
Objectives:. The aim of the study was to assess if technical and patient-related factors are related to outcome after carotid surgery.. Design:. Vascunet is a collaboration of national and regional registries with 10 contributing countries.. Patients and methods:. Data from 48 035 carotid endarterectomies (CEAs) performed in 383 centres, during 2003-2007, were merged into a common database.. Results:. CEA was performed without patch (34%), with patch (40%) or with eversion (26%) in 74% for symptomatic and in 26% for asymptomatic disease. Overall (in-hospital and 30-day) mortality was 0.45%. Type of CEA or anaesthesia did not affect mortality, nor did contralateral occlusion. Mortality was higher in patients above the age of 75 years, for both genders (p , 0.05). The overall (in-hospital) stroke rate was 1.9%, the method of anaesthesia did not affect stroke rate. It was higher in patients with contratateral occlusion (4.6% vs. 2.5%, p = 0.002). Standard CEA without patch had a higher stroke rate ...
Strokes arising from carotid stenosis are most often due to atheroembolisms.4-6 During carotid endarterectomy the plaque is completely removed; however, with carotid stenting, the plaque remains contained between the stent and the vessel wall. Stroke occurring after CAS is probably caused by the release of fractured plaque deposits through the struts of the stent. In the Carotid Revascularization Endarterectomy versus Stenting Trial,7 the periprocedural stroke rate was significantly higher in the stenting group than in the endarterectomy group (4.1% vs 2.3%, p=0.01).. Transcranial Doppler studies have demonstrated the generation of emboli with each passage across a stenosis with a guidewire, EPD, balloon or stent,8 ,9 with the highest potential for embolization occurring during post-dilatation when the balloon crushes friable plaque against the metal stent struts.8 ,9 Although the clinical significance of microemboli is unclear, Ackerstaff et al10 demonstrated in a study of 550 patients that ...
misc{5739745, author = {Riles, Thomas and Timaran, Dr and Van Herzeele, Isabelle and AbuRahma, Ali and Liapis, Christos and Golledge, Jonathan and Ricotta, John}, issn = {0741-5214}, language = {eng}, number = {3}, pages = {628--629}, series = {JOURNAL OF VASCULAR SURGERY}, title = {Intracranial hemorrhage after carotid endarterectomy and carotid stenting in the United States in 2005: discussion}, url = {http://dx.doi.org/10.1016/j.jvs.2008.09.065}, volume = {49}, year = {2009 ...
... (CEA) is a surgical treatment for carotid artery disease. The carotid arteries are the main blood vessels that carry oxygen and blood to the brain. In carotid artery disease, these arteries become narrowed. This reduces blood flow to the brain and could cause a stroke.
AHA guidelines recommend carotid endarterectomy (CEA) for severe carotid stenosis. But during CEA, there is little chance that the patient suffer from severe hypoperfusion or stroke. So we use TCD to monitor the blood flow of brain in the surgery and keep the blood pressure stable. The sudy is designed to find out whether the index which we found in previous work is more sensitive to show the blood flow of middle cerebral artery ...
TY - JOUR. T1 - Does carotid stenting measure up to endarterectomy? A vascular surgeons experience. AU - Eskandari, Mark K.. AU - Longo, G. Matthew. AU - Vijungco, Joseph D.. AU - Morasch, Mark D.. AU - Pearce, William H.. PY - 2004/7/1. Y1 - 2004/7/1. N2 - Hypothesis: Carotid angioplasty and stenting seems to have equal or better outcomes in high-risk patients than carotid endarterectomy. Design: Single-center case-control study. Setting: University hospital tertiary referral center. Patients: Individuals (n=53) undergoing elective carotid angioplasty and stenting for cervical carotid stenosis (n= 57) between April 2001 and October 2003. All patients were referred to and treated by the primary author (M.K.E.). Results: Mean±SD age was 68.8±1.2 years (64% men [34] and 36% women [19]), and overall mean±SD rate of stenosis was 79%±10%. Preprocedural neurologic symptoms were present in 42% of the group. Indications for treatment included prior neck surgery with irradiation (4), recurrent ...
Indications for carotid endarterectomy (CEA), based on prospective randomized trials, include the following: Symptomatic patients with greater than 70% stenosis - Clear benefit was found in the North... more
What is carotid endarterectomy, and how can it help prevent stroke? Learn about this procedure and about carotid stenosis with this neurosurgeon-edited guide.
Carotid endarterectomy (CEA) is a procedure to remove plaques from a carotid artery (one of the two main arteries supplying blood to the brain). The procedure is effective at reducing the risk of subsequent stroke. To access the artery, an incision is made in the artery wall which means that the artery must be clamped in order to prevent blood loss. Consequently, the blood supply (and therefore oxygen supply) to the brain is reduced. To ensure that the patient has sufficient oxygen to avoid brain damage, this procedure is often carried out under local anaesthetic as this means the anaesthetist can talk to them during the operation; by this means they can determine the patients conscious level and whether or not they need supplementary oxygen.. There are various ways to administer the supplementary oxygen. Most oxygen masks completely cover the mouth and nose which inevitably limits patient-doctor communication. Oxygen is therefore usually administered via nasal tubes. However, the actual level ...
TY - JOUR. T1 - Perioperative result of carotid endarterectomies with venous patch angioplasty. AU - Tsao, Nai Wen. AU - Hsu, Chiao Po. AU - Kan, Chung Ben. AU - Lai, Shiau Ting. AU - Yu, Tarng Jenn. AU - Weng, Zen Chung. AU - Shih, Chun Che. AU - Wang, Jih Shiuan. AU - Yung, Ming Chi. AU - Huang, Cheng Hsiung. PY - 2002. Y1 - 2002. N2 - Background. Carotid endarterectomy (CEA) is an effective treatment of carotid stenosis to reduce the risk of stroke. The purpose of the current study is to investigate the result of surgical treatment of carotid stenosis in Taipei Veterans General Hospital. Methods. The medical records of 103 patients receiving 113 CEA with or without patch angioplasty in our service between January 1993 and July 1999 were reviewed retrospectively. The clinical and operative variables were collected for analysis. According to the method of carotid arteriotomy closure, all operations were categorized into 3 groups: 76 CEA with venous patch angioplasty, 27 CEA with synthetic ...
SCVS 2018 Abstracts: Prolonged Length of Stay as Quality Measure in Asymptomatic and Symptomatic Patients Undergoing Carotid Endarterectomy
The accepted indications for carotid endarterectomy (CEA) balance the long-term benefit of stroke reduction with the risk of perioperative complications, requiring overall morbidity and mortality rates associated with CEA to be low; otherwise, the in
Which carotid endarterectomy or angioplasty surgeons in Arizona get the best outcomes? Find/compare surgeons plus their death and complication rates.
Alan B. Lumsden, MD, narrates this video of a carotid endarterectomy (CEA) case. This is part one of a two-part series that walks viewers through the procedure step by step, with opportunities for que...
Preoperative beta blocker use associated with cerebral ischemia during carotid endarterectomy. - Alexandra Florea, Janet van Vlymen, Samia Ali, Andrew G Day, Joel Parlow
Re: Emboli rate during an early after carotid endarterectomy after a single preoperative dose of 120 mg acetylsalicylic acid--a prospective double-blind placebo controlled randomized trial by Tytgat et al. Eur J Vasc Endovasc Surg 2005;29:156-161. ...
... : Comparison of Complications Between Transverse and Longitudinal Incision. Mendes GA1, Zabramski JM, Elhadi AM, Kalani MY, Preul MC, Nakaji
Endarterectomy is a surgical procedure to remove the atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of deposits. It is carried out by separating the plaque from the arterial wall. It was first performed on a superficial femoral artery in 1946 by Portuguese surgeon, João Cid dos Santos, at the University of Lisbon. In 1951, E. J. Wylie, an American, performed it on the abdominal aorta. The first successful reconstruction of the carotid artery was performed by Carrea, Molins, and Murphy in Argentina, later in the same year. The procedure is widely used on the carotid artery of the neck as a way to reduce the risk of stroke, particularly when the carotid artery is narrowed. A carotid endarterectomy may itself cause a stroke at the time of operation. Endarterectomy is also used as a supplement to a vein bypass graft at the sites of surgical anastomosis. Pulmonary hypertension caused by chronic thromboembolic disease (CTEPH) may be amenable to ...
TY - JOUR. T1 - Prediction Models for Clinical Outcome After a Carotid Revascularization Procedure. AU - Carotid Stenosis Trialists Collaboration. AU - Volkers, Eline J.. AU - Algra, Ale. AU - Kappelle, L. Jaap. AU - Jansen, Olav. AU - Howard, George. AU - Hendrikse, Jeroen. AU - Halliday, Alison. AU - Gregson, John. AU - Fraedrich, Gustav. AU - Eckstein, Hans Henning. AU - Calvet, David. AU - Bulbulia, Richard. AU - Brown, Martin M.. AU - Becquemin, Jean Pierre. AU - Ringleb, Peter A.. AU - Mas, Jean Louis. AU - Bonati, Leo H.. AU - Brott, Thomas G. AU - Greving, Jacoba P.. PY - 2018/8/1. Y1 - 2018/8/1. N2 - Background and Purpose- Prediction models may help physicians to stratify patients with high and low risk for periprocedural complications or long-term stroke risk after carotid artery stenting or carotid endarterectomy. We aimed to evaluate external performance of previously published prediction models for short- and long-term outcome after carotid revascularization in patients with ...
Page provides an overview of carotid artery disease, including an overview, causes, symptoms, tests, prevention and treatment. Also discusses the carotid endarterectomy procedure and its potential risks as well as possible alternatives.
Objective: Carotid endarterectomy is known as very reliable procedure for symptomatic and asymptomatic carotid stenosis treatment. Carotid restenosis represents recurrent stenosis that occurs as a result of neointimal hyperplasia in the early postoperative period (within 36 months) or recurrent atherosclerotic lesions in the following period. Several studies have shown that increased C-reactive protein (CRP) values is independent prognostic factor of future cardiological ischemic events, but there is a few studies that describe connection between CRP serum concentration, carotid atherosclerosis and other acute inflammatory phasec proteins. Aims: The aim of our study was to examine influence of increased values of markers of systemic inflammation (high sensitivity C-reactive protein (hs-CRP), C3 complement and fibrinogen) taken just before and after the surgery, its oscillations and its mutual impact on carotid restenosis development after eversion endarterectomy. We have also analyzed the impact ...
Background: Carotid endanerectomy is emerging as the treatment of choice for patients with symptomatic carotid artery stenosis at low operative risk. We sought determine if racial variations in the rate of carotid angiography and endarterectomy exist in the Veteran Affairs health care system among patients who are insulated from the cost of...
1. Liu Q, Dang DS, Chen YF et al. The influence of omeprazole on platelet inhibition of clopidogrel in various CYP2C19 mutant al-leles. Genet Test Mol Biomarkers 2012; 16(11): 1293- 1297. doi: 10.1089/ gtmb.2012.0119.. 2. Duck B. FDA gives plavix a 6 month extension-patent now expires on may 17 2012-in Europe patent expired in 2009. [online]. Available from URL: http:/ / ducknetweb.blogspot.com/ 2011/ 01/ fda-gives-plavix-6-month-extension.html.. 3. Flem--ing MD, Stone WM, Scott P et al. Safety of carotid endarterectomy in patients concur-rently on clopidogrel. Ann Vasc Surg 2009; 23(5): 612- 615. doi: 10.1016/ j.avsg.2009.06.004.. 4. Wait SD, Abla AA, Kil-lory BD et al. Safety of carotid endarterectomy while on clopidogrel (Plavix). Clinical article. J Neurosurg 2010; 113(4): 908- 912. doi: 10.3171/ 2009.12.JNS09707.. 5. Ferguson GG, Eliasziw M, Barr HW et al. The North American Symp-tomatic Carotid Endarterectomy Trial: surgical results in 1415 patients. Stroke 1999; 30(9): 1751- 1758.. 6. ...
Background: Atherosclerosis is an important cause of stroke. Ultrasound offers the convenience of real-time and detailed assessment of carotid plaque features as well as arterial wall thickening and composition. Evaluation of these features is important for determining patients risk of suffering vascular events and also contributes to selecting the best treatment strategy.. Methods: Using ultrasound data analysis we have determined plaque features in the bifurcation and internal carotid artery (ICA), including: surface plaque irregularities, calcification, echogenicity (grey scale median-GSM) and other textural plaque features (Juxtaluminal black area, entropy, coarseness). In addition, intima media thickens (IMT) and its grey scale median (IM-GSM) was measured in common carotid artery (CCA). Using Cone Beam CT (CBCT) we have quantified calcification volume of the carotid plaques extracted after carotid endarterectomy procedure. For the meta-analysis we have used comprehensive meta-analysis ...
A shunt and method of use for maintaining distal blood flow during an arteriotomy procedure is disclosed. The shunt includes first and second tubular members having proximal ports, distal ports, and lumens therebetween. The distal port of the second tubular member is adapted for releasable attachment to the proximal port of the first tubular member. A second lumen merges and communicates at its distal end with the lumen of the first tubular member and includes a hemostatic valve attached to its proximal end. In using the apparatus for performing open endarterectomy, a filter device is inserted into the vessel and deployed downstream the region of interest in the internal carotid artery. The distal end of the shunt is advanced over the filter device and secured onto the artery. The proximal end of the shunt is inserted upstream the region of interest, typically in the common carotid artery.