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Bian Su-Yan - - 2012
Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese ...
Kang Kyusik - - 2012
Poor renal function is associated with cardiovascular complications attributable to large-vessel diseases such as arterial calcification, heart failure, myocardial infarction, and cardiac mortality. The aim of this study was to evaluate the association between renal function and intracranial arterial stenosis (IAS). We analyzed the records of 283 stroke-free Korean adults ...
Kawai Hideki - - 2012
Background: The differences in the coronary plaque characteristics between patients with mild chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] 30-59ml·min(-1)·1.73m(2)) and those without CKD (eGFR ≥60) by 320-row area detector computed tomography (CT) have not been studied. Methods and Results: We enrolled 487 patients undergoing coronary CT angiography ...
Marchidann Adrian - - 2011
The management of carotid stenosis has enjoyed renewed interest in the neurological community in recent years due to the advent of endovascular approaches. In concert, progress in medical treatment of these patients has rekindled the debate regarding the best management of carotid stenosis overall, both for symptomatic and asymptomatic disease. ...
Schmidt Kathrin I - - 2010
We report the case of a 51-year-old woman who underwent pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. On postoperative day 1 she developed bilateral pulmonary thrombosis due to preoperatively undiagnosed heparin-induced thrombocytopenia. Systemic thrombolytic therapy with alteplase on postoperative days 5 and 6 resulted in marked clinical improvement. To our ...
Barnett Henry J M - - 2010
Carotid angioplasty and stenting has become a popular alternative to carotid endarterectomy for the treatment of carotid stenosis in stroke. Evidence from early randomized controlled trials comparing these interventions revealed mixed results. The largest such trial, the Carotid Revascularization Endarterectomy vs. Stenting Trial recently showed equivalence of the procedures in ...
Ballotta Enzo - - 2010
Carotid endarterectomy (CEA) is associated with a risk of cerebral ischemia during carotid clamping, hence various cerebral protection strategies, including pharmacological management and routine or selective shunting, are commonly available. This study aimed to analyze the results of CEA with intraoperative electroencephalographic (EEG) monitoring to identify factors associated with EEG ...
Barrett Kevin M - - 2010
Recent randomized clinical trial data support the safety and efficacy of carotid artery stenting and carotid endarterectomy for treatment of symptomatic and asymptomatic carotid occlusive disease. Endarterectomy is more effective in preventing stroke, but this may be countered by a higher risk of perioperative myocardial infarction. Age is an important ...
Meier Pascal - - 2010
Stroke has a high incidence and is associated with a dramatic degree of morbidity and mortality. Carotid stenosis is responsible for approximately 20% of strokes in all patient populations, and is especially prevalent in elderly patients. Therapies to decrease the risk of stroke are urgently warranted. The first established therapy ...
Chen Yu - - 2010
To evaluate the application of carotid endarterectomy (CEA) in the treatment of patients with bilateral moderate to severe carotid stenosis. We retrospectively analyzed the clinical data of 82 patients with bilateral moderate to severe carotid stenosis who were admitted to our hospital from January 2006 to December 2009. Of these ...
Liu Xinfeng - - 2010
Stroke induces heavy socioeconomic burdens particularly in developing countries. Considering the multisectional discrepancies, strategies of stroke prevention and management adapted for western populations are not always applicable for patients in developing countries. Currently, carotid endarterectomy is the recommended treatment for severe carotid stenosis in the west. Carotid angioplasty and stenting ...
Prasad Sunil M - - 2010
Management of patients with concomitant carotid and coronary artery disease has been controversial. Divergent strategies have been employed, including simultaneous carotid endarterectomy and coronary bypass (SCC) versus various staged procedures. Although no strict comparison group is available, this study defines current outcomes of SCC, compared qualitatively to two reference categories. ...
Sterpetti Antonio V - - 2010
The author presents a technique for endarterectomy and reconstruction of the carotid bifurcation in difficult cases when the plaque extends high into the internal carotid artery. The technique combines the aspects of the 2 most commonly performed procedures: carotid endarterectomy after a longitudinal arteriotomy extending from the common carotid artery ...
Keldahl Mark L - - 2010
Carotid artery stenting has rapidly grown as an alternative to carotid endarterectomy for stroke prevention among selected patients with extracranial carotid artery stenosis. Development of mechanical embolic protection devices (EPDs) has been associated with improved clinical outcomes and is now a strongly advocated adjunct to the procedure. Characteristically, EPDs have ...
Bowens Nina M - - 2010
Despite the lack of Level I evidence, carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CEA). Furthermore, CAS has been met with considerable enthusiasm due to its minimally invasive nature and potential application to high-risk patient populations. Several investigations including multicenter registries and randomized controlled trials ...
Young Kate C - - 2010
Endarterectomy and angioplasty with stenting have emerged as 2 alternative treatments for carotid artery stenosis. This study's objective was to determine the cost-effectiveness of carotid artery stenting (CAS) compared with carotid endarterectomy (CEA) in symptomatic subjects who are suitable for either intervention. A Markov analysis of these 2 revascularization procedures ...
- - 2010
Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis Original Article, N Engl J Med 2010:363;11-23. In the third paragraph of the Discussion section (page 21), the third sentence should have ended ". . . in ICSS, the protocol did not require formal examination until 30 days after the procedure," rather ...
Patel Manesh R - - 2010
BACKGROUND: Little is known about patterns in the use of carotid revascularization since a 2004 Medicare national coverage decision supporting carotid artery stenting. We examined geographic variation in and predictors of carotid endarterectomy and carotid stenting. METHODS: Analysis of claims from the Centers for Medicare & Medicaid Services from January ...
Paraskevas Kosmas I - - 2010
Carotid artery stenting (CAS) is considered by many as an alternative to carotid endarterectomy (CEA) for the management of carotid artery stenosis. However, recent trials demonstrated inferior results for CAS in symptomatic patients compared with CEA. We reviewed the literature to evaluate the appropriateness of CAS for symptomatic carotid artery ...
Van Damme H - - 2010
Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery stenting (CAS) over carotid artery endarterectomy (CEA). There is at the moment no level-I evidence to support widespread use of endovascular management of carotid ...
Schreiber Theodore L - - 2010
OBJECTIVES: The CASES-PMS (Carotid Artery Stenting With Emboli Protection Surveillance-Post-Marketing Study) multicenter, prospective, single-arm, surveillance study was designed to assess the safety and efficacy of carotid artery stenting (CAS) when performed by physicians with varied experience in CAS utilizing a formal training program. Whether the excellent results achieved at 30 ...
Endean Eric D - - 2010
A 61-year-old man with left amaurosis fugax and bilateral >80% internal carotid artery stenoses underwent a left carotid endarterectomy. On the first postoperative day, he developed hypotension, bradycardia, and chest pain with food ingestion. He was diagnosed as having deglutition syncope and was treated with oral anticholinergics. Similar symptoms occurred ...
Bracale Umberto Marcello - - 2010
BACKGROUND: A 74-year-old male patient complaining of crescendo TIAs, hypertension and hyperlipidaemia. INVESTIGATION: Duplex ultrasound scan MR angiography. DIAGNOSIS: Pseudoaneurysm stemming from the ICA. TREATMENT: An open or endovascular procedure for the right pECCA repair, or a left CEA or CAS.
Ricotta Joseph J JJ - - 2010
Extracranial carotid disease accounts for approximately 25% of ischemic strokes. Although carotid endarterectomy (CEA) is the established gold standard for carotid revascularization, carotid artery angioplasty and stenting (CAS) is continually developing into a safer and more efficacious method of stroke prevention and has gained popularity as an alternative to CEA. ...
Mommertz G - - 2010
AIM: According to the results of the large trials on carotid endarterectomy (CEA), this type of surgery is only warranted if perioperative mortality and morbidity are kept considerably low. Less attention has been paid to methods of cerebral protection during CEA, although intraoperative transcranial Doppler (TCD) can visualise intracerebral microemboli ...
Chung Christine - - 2010
Carotid artery occlusion is one of the most frequently identified and one of the most treatable causes of ischemic strokes. Although carotid endarterectomy (CEA) is recognized as the gold standard for treating symptomatic, severe carotid stenosis, the development of carotid angioplasty and stenting (CAS) has encouraged investigations to demonstrate its ...
- - 2010
The endovascular treatment of carotid atherosclerosis with carotid artery stenting (CAS) remains controversial. Carotid endarterectomy remains the benchmark in terms of procedural mortality and morbidity. At present, there are no consensus Australasian guidelines for the safe performance of CAS. We applied a modified Delphi consensus method of iterative consultation between ...
Brott Thomas G TG Mayo Clinic, Griffin 304, 4500 San Pablo Rd., Jacksonville, FL 32224, USA. - - 2010
Carotid-artery stenting and carotid endarterectomy are both options for treating carotid-artery stenosis, an important cause of stroke. We randomly assigned patients with symptomatic or asymptomatic carotid stenosis to undergo carotid-artery stenting or carotid endarterectomy. The primary composite end point was stroke, myocardial infarction, or death from any cause during the ...
Yilmaz Hasan - - 2010
Carotid stenosis is a major risk factor for stroke. With the aging of the general population and the availability of non-invasive vascular imaging studies, the diagnosis of a carotid plaque is commonly made in medical practice. Asymptomatic and symptomatic carotid stenoses need to be considered separately because their natural history ...
Hudorovic Narcis - - 2010
Published data suggest that the regional anesthetic technique used for carotid endarterectomy (CEA) increases the systolic arterial blood pressure and heart rate. At the same time local anesthesia reduced the shunt insertion rate. This study aimed to analyze risk factors and ischemic symptomatology in patients with postoperative internal carotid artery ...
O'Kelly Cian J - - 2010
Symptomatic extracranial internal carotid artery stenosis poses a high short-time risk of ischemic cerebral stroke, as high as 20% to 30% in the first three months. Timely performed carotid endarterectomy (CEA) has been shown to be highly effective in reducing this risk although, in recent years, there has been great ...
Forbes Thomas L - - 2010
You are asked to see a 65-year-old man with an asymptomatic high-grade carotid artery stenosis. He is otherwise quite healthy, is receiving appropriate medical management, and has no contraindications for surgery. You recommend a carotid endarterectomy (CEA) as the best prophylactic measure against stroke. During the informed consent process, the ...
Accord Ryan E - - 2010
The surgical approach of the carotid artery for carotid endarterectomy demands knowledge of normal anatomy and anatomic variation. During carotid endarterectomy, a rare anatomic variant of the origin of the upper root of the ansa cervicalis was found. Contrary to commonly found anatomy, no upper root of the ansa cervicalis ...
Rosenkranz Michael - - 2010
Carotid artery stenosis is associated with the risk of stroke, myocardial infarction, and vascular death. In selected patients, revascularization of carotid narrowing by endarterectomy may reduce the risk of stroke distal to the stenosis. Carotid artery stenting has evolved as a potential alternative to endarterectomy. Four randomized clinical trials comparing ...
Ahmed Waqas - - 2010
Carotid artery stenting (CAS) has emerged as an attractive alternative to carotid endarterectomy (CEA). However, CAS in a high risk patient carries significant morbidity/mortality. We report a successful CAS procedure in an extremely high risk case with a unique underlying comorbid combination not previously reported in the literature.
- - 2010
Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded ...
Bosiers M - - 2010
The optimal treatment of patients with asymptomatic or symptomatic carotid artery disease (CAD) has been a long-lasting debate. The choice between carotid endarterectomy (CEA), carotid artery stenting (CAS) and/or optimal medical therapy to treat patients with CAD, depends on their risk profile. Recent data from EVA-3S, SPACE randomized trials failed ...
White Christopher J - - 2010
Revascularization of the extracranial carotid arteries is a commonly performed surgical procedure to prevent stroke. Open surgery (i.e., carotid endarterectomy [CEA]) is a well-established stroke prevention procedure but is being 'challenged' by a less invasive percutaneous procedure (i.e., carotid artery stent [CAS] placement). Clinical trials comparing CAS and CEA for ...
Emiru Tenbit - - 2010
Treatment of high-grade symptomatic carotid stenosis via carotid endarterectomy has been shown to be superior to medical management alone in several studies. Carotid angioplasty and stenting (CAS) has emerged as an alternative approach to endarterectomy to reduce the associated perioperative risks. Several anatomic and physiologic factors that increase the risk ...
Meier Pascal - - 2010
To evaluate the relative short term safety and intermediate term efficacy of carotid endarterectomy versus carotid artery stenting. Systematic review and meta-analysis. BIOSIS, Embase, Medline, the Cochrane central register of controlled trials, International Pharmaceutical Abstracts database, ISI Web of Science, and Google scholar and bibliographies, from 1 January 1990 to ...
Chen Xu-Jun - - 2009
BACKGROUND: Coexistent carotid and coronary artery diseases are common and patients with them remain at a high risk for perioperative stroke or myocardial infarction after coronary bypass surgery. The aim of this study was to investigate the effect of combined carotid endarterectomy (CEA) and off-pump coronary artery bypass grafting (CABG) ...
Habib Najibullah - - 2009
Carotid angioplasty and stenting has become a valuable alternative treatment for carotid endarterectomy. However, several complications can occur during this high-risk procedure. We describe a case of carotid stent procedure during carotid angioplasty in a 70-year-old man. Management of this complication with an overview of current literature is discussed. (c) ...
- - 2009
The endovascular treatment of carotid atherosclerosis with carotid artery stenting (CAS) remains controversial. Carotid endarterectomy (CEA) remains the benchmark in terms of procedural mortality and morbidity. Consensus Australasian guidelines for the safe performance of CAS were developed using the modified Delphi consensus method of iterative consultation. Selection of patients suitable ...
Tokunaga Koji - - 2009
OBJECTIVE: Carotid endarterectomy with a patch graft (Patch CEA) has been our standard treatment for patients with carotid artery stenosis, but carotid artery stenting (CAS) has emerged as an alternative. The purpose of this study was to compare the postoperative changes in the configurations and the flow velocities of carotid ...
Knur R - - 2009
Carotid occlusive disease is responsible for a significant proportion of major adverse cardiovascular events (death, stroke, myocardial infarction). Effective prevention by means of revascularization is a sufficient treatment, if performed at a center with an acceptably low procedural complication rate. Carotid surgery is the currently accepted standard of treatment for ...
Nagaki Tomohito - - 2009
OBJECT: Several major randomized controlled trials of carotid endarterectomy (CEA) in patients with both symptomatic and asymptomatic carotid artery stenosis have addressed the net effects of CEA on the risk of stroke. However, because the risk of stroke among patients with asymptomatic carotid stenosis is relatively low, whether to treat ...
Zeebregts Clark J - - 2009
PURPOSE OF REVIEW: Carotid endarterectomy (CEA) is still considered the gold standard in the treatment of patients with significant carotid stenosis and has proven its value over the past decades. Endovascular techniques have evolved, and carotid artery stenting (CAS) is challenging CEA to become the better treatment. Various trends were ...
Illuminati Giulio - - 2009
We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained ...
Sylaja P N - - 2009
A 59-year old man developed perioperative stroke following left carotid endarterectomy seconday to thrombosis at the endarterectomy site. Transcranial Doppler ultrasonography revealed very frequent microembolization in the left middle cerebral artery territory. The patient was successfully treated with intravenous abciximab with complete neurological recovery.
Lal Brajesh K - - 2009
The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) completed randomization on July 18, 2008. Sponsored by the National Institute of Neurological Disorders and Stroke (NINDS), the trial has enrolled 2,522 participants across North America and is the largest randomized clinical trial (RCT) comparing the efficacy of carotid artery stenting (CAS) ...
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