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Carotid Endarterectomy - Europe PMC

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Last Updated: 03 September 2022

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Perioperative stroke during carotid endarterectomy: benefits of multimodal neuromonitoring - a case report.

Carotid endarterectomy is routinely performed after an ischemic stroke due to carotid stenosis. Clinicians should be aware of their risks and the added value of transcranial dopplers. a case study The case of an 85-year-old male with perioperative haemodynamic stroke after carotid endarterectomy is presented here. The Ischemic stroke was triggered by suddenly raised carotid stenosis, which resulted in a significant neurologic deficit. Circulation was restored with endovascular surgery, and neurologic deficit was quickly addressed. To minimize the risk of persistent neurologic dysfunction following perioperative stroke during carotid endarterectomy, we recommend the use of multimodal neuromonitoring, as well as transcranial doppler whenever possible.

Source link: https://europepmc.org/article/MED/36045331


Risk of bleeding complications per different perioperative antithrombotic regimes during carotid endarterectomy: a national registry analysis.

History of the Patients with carotid artery stenosis are characterized by antithrombotic therapy as one of the prevention of ocular or cerebral ischaemic events. In the three weeks following the index event, randomized controlled trials on antithrombotic therapy for patients with minor ischaemic stroke and transient ischaemic injury have all been recommending dual antiplatelet therapy. The appropriate antithrombotic therapy in the perioperative period of carotid endarterectomy remains unclear. Methods Symptomatic and symptomatic patients with carotid artery stenosis undergoing primary CEA from the Dutch Audit for Carotid Interventions registry between June 2013 and December 2020 were eligible for inclusion. No connection was found between the primary results in ASA plus clopidogrel and ASA plus dipyridamole, according to multiple logistic regression studies. Conclusions The results and safety of DAPT in patients undergoing CEA and prospective studies need to be determined further.

Source link: https://europepmc.org/article/MED/36031046


The impact of sex on outcomes following carotid endarterectomy.

Background: Previous studies have shown significant sex differences in vascular surgery outcomes. Following carotid endarterectomy in women vs. men, we examined stroke or death rates. Methods The Vascular Quality Initiative was used to identify all patients who underwent CEA between 2010 and 2019. During the examination period, 52,137 women and 79,974 men underwent CEA in VQI sites. Women were younger and more likely to have hypertension and diabetes, but not as likely to be diagnosed with coronary artery disease. A greater percentage of male patients were receiving cardiovascular risk reduction products and had symptomatic carotid stenosis. Stroke or death at 30 days and 1 year were nearly similar between the two groups, which persisted in symptomatic patients and symptomatic patients. Conclusions Despite gender and procedural differences, both women and men have similar 30-day and 1-year outcomes following carotid endarterectomy.

Source link: https://europepmc.org/article/MED/36029946


Endarterectomy, Stenting, or Medical Treatment for Symptomatic Carotid Near-Occlusion: Results from CAOS, a Multicenter Registry Study.

Our aim was to evaluate the results of carotid endarterectomy and carotid artery stent placement in patients with symptomatic carotid near-occlusion and determine factors contributing to technological failure, periprocedural abnormalities, and restenosis. Within six months after the incident, two carotid artery stent placement and 23 carotid endarterectomy procedures were performed within six months. With carotid artery stent placement, it was 8. 3%; with carotid artery stent placement, it was 10. 5%; and with carotid endarterectomy, it was 4. 5 percent. In the carotid artery stent placement group, the rate of ipsilateral stroke was 48 percent for carotid endartarterectomy and 13. 9% for medical therapy. Patients with complete or partial collapse tended to suffer more often in patients with full recovery than in patients without complete breakdown. Conclusions Carotid artery stent placement and carotid endartarterectomy are both associated with high incidences of failure and periprocedural stroke.

Source link: https://europepmc.org/article/MED/35981762


Risk Factors for Carotid Restenosis in Patients After Eversion Endarterectomy vs Stenting: A Single-Center Experience.

After previous eCEA stenting for carotid restnosis, the primary aim of the present study is to determine and compare the incidence of carotid restenosis in patients following eversion carotid endarterectomy, primary carotid endarterectomy, and stenting, with stenting for carotid artery restenosis. There were 223 patients with obvious carotid restnosis at the time. In 95 percent of cases, patients with carotid restenosis were asymptomatic. Patients with eCEA also suffered transient ischemic injury, according to patients in the CASp group, although no difference was found regarding cerebrovascular insult.

Source link: https://europepmc.org/article/MED/35968755


The role of patch closure in current-day carotid endarterectomy.

Introduction It has long been debated whether it is best to perform conventional carotid endarterectomy with or without patch closures. Methods Analyzing over 118,000 records from the Vascular Quality Initiative to determine the impact of patch use on critical outcomes of traditional carotid endarterectomy. Any ipsilateral neurologic event, return to operating room for the neurologic event, and an increase in rankin score postoperatively were all included in the composite short-term results. The late composite achievement incorporated restenosis, as well as early and late ipsilateral neurologic activities. Patch use for traditional carotid endarterectomy closure was found to be a good predictor of both early and late outcomes, as shown by its Akaike importance weight of 0. 99. Examining pre-discharge events, patch closure is associated with a decrease in major negative events. Conclusions From a large modern-day database, patch closure of traditional carotid endarterectomy results improved short- and long-term outcomes.

Source link: https://europepmc.org/article/MED/35963459


Diagnostic accuracy of DSA in carotid artery stenosis: a comparison between stenosis measured on carotid endarterectomy specimens and DSA in 644 cases.

DSA is the gold standard for testing carotid artery stenosis. However, the connection between DSA and stenosis is not well documented. Comparison of CS as determined by DSA to carotid artery specimens obtained from carotid endarterectomy surgery is compared by the following tables. 54% ECST, 40% NASCET, and 72% ESs were among the 84 percent stenosis group's average stenosis group's average stenosis group. The mean stenosis in the moderate stenosis group was 66% ECST, 60% NASCET, and 77% ES. The mean stenosis in the severe cohort was 80% ECST, 76% NASCET, and 79% ES. 0. 16 and 0. 1 CC in the mild group; in the moderate group, the CC was 0. 05 and 0. 01; and in the severe group, the CC was 0. 23 and 0. 10 ; and in the severe group, the CC was 0. 17 and 0. 10. Conclusion The DSA and ES methods' ability to measure CS is almost random.

Source link: https://europepmc.org/article/MED/35945355


Treatment results of carotid endarterectomy and carotid artery stenting for patients with radiation-induced carotid stenosis.

The results regarding the most effective revascularization technique for RICS differ, due to the characteristics of radiation-induced carotid stenosis. paraphrased artery stenting in RICS, this research compared treatment outcomes between carotid endarterectomy and carotid artery stenting. paraphrased stenosis indefinite patients who underwent CEA or CAS. Methods This was a single-center retrospective review of consecutive patients who underwent CEA or CAS for carotid stenosis. On either side, RICS was described as carotid stenosis with the prior neck irradiation for cancer therapy. Both patients with RICS and 2,407 patients with non-RICS underwent carotid revascularization by CEA or CAS, between November 1994 and June 2021. RICS had fewer atherosclerotic risk factors and more frequent acute carotid stenosis and contralateral carotid occlusions than non-RICS. Due to more common unfavorable carotid anatomy, CAS was more commonly used than CEA for RICS. However, there was no significant difference between CEA and CAS in RICS in terms of neurologic results and restenosis rates.

Source link: https://europepmc.org/article/MED/36017138


Carotid Endarterectomy is Safe in Octogenarians.

Carotid endarterectomy has been shown to have improved outcomes for stroke risk reduction in patients with symptomatic and asymptomatic high-grade carotid stenosis. This paper aims to publish high-volume single institution results as a long-term follow-up to the one examining risk factors for post-operative stroke and stroke free survival among symptomatic and symptomatic patients undergoing CEA. Patients over 80 years old were compared to those under the age of 80, examining freedom from stroke and death. After CEA, octogenarians had a similar stroke rate to younger patients. Hispanic ethnicity was one of the primary risk factors for post-operative strokes. Patients u2265 80 — had a reduced 5 year stroke free life in patients u2265 80 years old, but overall estimated 5 year survival was similar to that of the general population across both age groups.

Source link: https://europepmc.org/article/MED/35940506


Segmented carotid endarterectomy for treatment of Riles type 1A common carotid artery occlusion.

Because it has patent outflow tract that was removed from collateral circulation by patent exclusive carotid artery, Riles type 1A CCAO is the most likely to profit from revascularization. We described a new surgical approach for the treatment of Riles type 1A CCAO's type 1A CCAO. Methods We thoroughly tested ten patients with symptomatic Riles type1A CCAO surgery from January 2017 to May 2019 and performed a complete preoperative analysis of the inadequate collateral circulation compensation. The patch CEA only treated one patient with a history of neck radiotherapy. In the postoperative period, cerebral perfusion on the ipsilateral site improved in all patients, myocardial infarction occurred in one patient, and chronic laryngeal nerve damage occurred in another.

Source link: https://europepmc.org/article/MED/35930077

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions