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As the existing studies relating to an elevated body mass index in the aftermath of carotid endarterectomy are contradictory, the current study seeks to determine the relationship between an elevated body mass index with 30-day complications. 550 CEAs were performed in patients with normal body mass index, 750 in overweight, and 286 in obese patients out of them. Using univariate and multivariate logistic regression models, we found the correlation between overweight and obesity in the early stages of carotid endarterectomy. In addition, overweight patients were significantly more likely to have non-insulin-dependent diabetes mellitus-OR 1. 44, and more often used ACEI in hospital discharge therapy-OR 1. 41 than normal weight patients. Obese diabetic and non-insulin-dependent diabetes mellitus-OR 1. 83 and OR 2. 13 respectively, in comparison to normal weight patients, obese patients were significantly younger-OR 0. 98, and with insulin-dependent and non-insulin-dependent diabetes mellitus-OR 1. 83 and OR 2. 13 respectively.
Source link: https://doi.org/10.1371/journal.pone.0278298
Carotid Endarterectomy is the most common treatment for patients with symptomatic carotid stenosis. In patients with symptomatic carotid stenosis who underwent CEA in our center, we sought to detail our patients' profile and risk associated with periprocedural cerebral ischemic events. Methods: Retrospective review of patients with symptomatic carotid stenosis who underwent CEA between January 2011 and December 2021 was carried out. 207 patients with a mean age of 64 years were consulted only after a stroke. The mean time to CEA was 50 days, but only 26 patients underwent surgery within 2 weeks, according to the government. In 2. 2 percent, minor strokes and TIA occurred, while major strokes and death occurred in 4. 1 percent of patients. paraphrased stenosis patients undergoing CEA are a delay, according to the article. CEA can be performed safely in patients with significant intracranial tandem stenosis and contralateral carotid occlusion.
Source link: https://doi.org/10.1159/000528515
As the existing evidence regarding adiposity and carotid endarterectomy is conflicting, the present study seeks to investigate the correlation between an elevated body mass index with 30-day complications after carotid endarterectomy. Using univariate and multivariate logistic regression analysis, we found that the relationship of overweight and obesity predicts early results of carotid endarterectomy. In addition, overweight patients with non-insulin-dependent diabetes mellitus increased among overweight patients, and more often used ACEI in hospital discharge therapy (14. 1 than normal weight patients). Obese patients were significantly younger, with insulin-dependent and non-insulin-dependent diabetes mellitus, respectively, as compared to normal weight patients. They also had elevated triglyceride levelsu2013OR 1. 36 %, and more often used oral anticoagulants in therapy before the surgeryu2013OR 2. 16.
Introduction: The aim was to outline the anesthetic and surgical procedures of eversion carotid endarterectomy performed under sedation in an intermediate-deep cervical block, as well as the intraoperative and postoperative findings. Pain in acute postoperative pain in a numerical rating scale at 6, 12, 24 h, early and 30-day complications, and length of stay were all evaluated. paraphras: Average obometry values were 61. 7 and 68. 1 at baseline, while pre- and post-clamping were respectively 10. 6 8. 1 u00b1 8. 6-68. 1 68. 1 68. 1 u00b1 8. 6 percent u00b1 9. 6 and 68. 1 68. 1 68. 1 u00b1 10. 6/69. 1 u00b1 76. 4 and 68. 1 68. 1 6. 8 8. 6 percent b1 98. 1 u00b1 18. 1 761 e b1 98. 1 78 u00b1u00b1 u00b1 69. The pain assessment revealed a score that was less than or equal to 3. Conclusions: The combination of intermediate-deep cervical plexus block and low-dose sedation is a safe and effective alternative in awakened eversion carotid endarterectomy.
Source link: https://doi.org/10.3390/healthcare10101986
paraphrasedoutput:Methods: From the Gene Expression Omnibus database, two datasets, GSE97210 and GSE21545, were downloaded. The purpose of this study was to determine whether the IRGs could be used to predict ischemic events in patients undergoing carotid endarterectomy. Cluster 2 with a higher prognosis and greater immune response than cluster 1 according to an immune analysis conducted by filtration analysis shows that cluster 2 with a better prognosis has a higher immune response than cluster 1 with a greater immune response. The immune infiltration in the low-risk group with a higher prognosis was also more prominent than that in the high-risk group, according to a consensus. Conclusion: The expression of immune-related genes is linked to the immune microenvironment of atherosclerotic patients, and it may be used to estimate the ischemic events in patients receiving CEA correctly.
Source link: https://doi.org/10.3389/fgene.2022.1014264
After carotid endarterectomy, the patient's objective gait test scores obtained using a tri-axial accelerometer could reveal subjective change in gait as determined by the patient. When compared to preoperatively, each patient undergoing CEA for ipsilateral internal carotid artery stenosis determined whether their gait had subjectively improved at six months after CEA. Objective gait test scores obtained by the tri-axial accelerometer can be used to detect subjective gait changes after CEA.
Source link: https://doi.org/10.3390/s20226590
In patients awaiting carotid endarterectomy, the aim of this research was to determine the effects of prescription omega-3 fatty acid ethyl esters on blood pressure, plasma lipids, and inflammatory marker concentrations. Patients awaiting carotid endarterectomy were randomly randomized to Omacoru00ae or olive oil as placebo before surgery. When Omacoru00ae lowered the risk of triglyceride reduction was greater than placebo compared to placebo. The Omacor E-selectin concentration was significantly reduced in the Omacoru00ae group, but it increased in the placebo group. There were no differences in blood pressure or plasma lipid and inflammatory marker concentrations between the two groups at the end of the supplementation period. Omacoru00ae administered at 2 g/day to patients with advanced carotid atherosclerosis has decreased triglycerides and soluble E-selectin levels for an average of 21 days, but has no effect on the plasma lipid profile or inflammatory markers, according to the study.
Source link: https://doi.org/10.3390/md11093569
Background: Carotid endarterectomy is used to treat carotid stenosis, which is associated with cerebral infarction and can result in neurologic deficits such as stroke, transient ischemic attack, and local nerve injury. Methods: We did a retrospective review of 151 cases of CEA, of which 110 used surgical incisions and 41 used high mini-skin incisions, from March 2015 to December 2021 at a single institution, of which 151 used conventional incisions and 41 used high mini-skin incisions. Nerve injury risk factors were also evaluated. In addition, the HMI group had significantly shorter incision lengths than the conventional group. Nerve injury risk factors were discovered to include a high lesion level and clamp time. Conclusion: The use of the HMI in CEA for carotid stenosis was advantageous because it was shorter surgical time, shorter internal carotid artery clamp time, reduced neurologic difficulties, and increased esthetics.
Source link: https://doi.org/10.5090/jcs.22.044
Introduction: Ischemic postconditioning is one of several therapeutic techniques to reduce ischemic reperfusion injury after carotid endarterectomy. ICA stenosis, severe bilateral ICA stenosis, extensive ICA stenosis, severe ICA stenosis, and widespread ICA stenosis have been among IPCT procedures that have contralateral ICA occlusion and ICA subpoena. Patients in the IPCT group had significantly more frequent presence of heterogenous plaque, as well as ulcerated plaque, which was correlated with the lack of postoperative stroke and a significantly lower cumulative rate of TIA/stroke in comparison to the control group, which was also attributed to the absence of postoperative stroke and substantially lower cumulative risk of stroke. Conclusion: Our findings showed that IPCT reduced the incidence of postoperative cerebral ischemic complications in high-risk patients for IR injury following CEA in high-risk patients for IR injury relative to the control group.
Source link: https://doi.org/10.1177/10742484221137489
Background Transcarotid artery stenosis was approved by the Food and Drug Administration in 2015 for patients with carotid artery stenosis. According to the chart below, we did not find stroke or death after TCAR compared to carotid endarterectomy and transfemoral carotid artery stenting. Methods and Findings We used the Vascular Quality Initiative registry to identify patients who underwent TCAR, CEA, or TFu2010CAS from September 2016 to June 2021, as well as TFu2010CAS. For 1u2010year results, we used logistic regression for risk adjustment for perioperative outcomes and Cox regression for risk adjustment for 1u2010year outcomes. We examined 21 234 patients who underwent TCAR, 82 737 who underwent CEA, and 14 595 who underwent TFu2010CAS across 662 centers, including 834 centers. The IVu2010 adjusted odds ratio of perioperative stroke or death for CEA was 0. 74 percent for TCAR, while TF's was 1. 66 percent. For TF-u2010CAS, the one-year prevalence of stroke or death in TCAR, 5. 2% for CEA, and 9. 7% for TFu2010CAS. The IV-u2010 adjusted hazard ratio of 1 year stroke or death for CEA was 0. 97, while for TFu2010CAS was 1. 45. According to a TCAR survey, symptomatic patients with carotid stenosis had the lowest 1u2010year risk of stroke or death. At both time points, TCAR performed well when compared to TFu2010CAS. Although CEA is the gold standard for patients with carotid stenosis, TCAR appears to be a viable alternative to CEA and TFu2010CAS when used selectively, and may be especially useful when treating symptomatic patients.
Source link: https://doi.org/10.1161/JAHA.121.024964
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