Document Detail


Echolucent or predominantly echolucent femoral plaques predict early restenosis after eversion carotid endarterectomy.
MedLine Citation:
PMID:  20141957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although the association between vulnerable lesions and cardiovascular events is well established, little is known about their relationship to postsurgery restenosis. To address this issue, we initiated a prospective, nonrandomized study to examine the femoral plaques on both sides in patients who were undergoing eversion carotid endarterectomy (CEA) and were longitudinally followed-up for early restenosis development.
METHODS: The final analysis enrolled 321 patients (189 women) with a median age of 67.0 years (interquartile range, 59.0-73.0 years), who underwent eversion CEA (2005 to 2007). Using duplex ultrasound scanning, we evaluated 321 common femoral atherosclerotic lesions on the day before CEA. A quantitative scale was used to grade the size of plaques as grade 1, one or more small plaques (<20 mm2); grade 2, moderate to large plaques; and grade 3, plaques giving flow disturbances. The plaque morphology in terms of echogenicity was graded as echolucent, 1; predominantly echolucent, 2; predominantly echogenic, 3; echogenic 4; or calcified, 5. The plaque surface was categorized as smooth, irregular, or ulcerated. The patients underwent carotid duplex ultrasound imaging at 6 weeks and at 6, 12, and 24 months after CEA. Mann-Whitney U test, chi2 test, and multivariate logistic regression were used for statistical evaluation.
RESULTS: Internal carotid artery restenosis of > or = 50% was detected in 33 patients (10.28%) in the operated region. Neither the size (grade 1, P = .793; grade 2, P = .540; grade 3, P = .395) nor the surface characteristics of the femoral plaques (smooth, P = .278; irregular, P = .281; ulcerated, P = .934) were significantly different between the patients with and without carotid restenosis. Echolucent-predominantly echolucent femoral lesions were an independent predictor of recurrent carotid stenosis (adjusted odds ratio, 5.63; 95% confidence interval, 2.14-10.89; P < .001).
CONCLUSION: Ultrasound evaluation of femoral plaque morphology before CEA can be useful for identifying patients at higher risk for carotid restenosis.
Authors:
Edit Dósa; Kristóf Hirschberg; Astrid Apor; Zsuzsanna Járányi; László Entz; György Acsády; Kálmán Hüttl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  51     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-03-04     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  345-50     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, Faculty of Medicine, Semmelweis University, Budapest, Hungary. dosaedit@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Atherosclerosis / complications,  ultrasonography*
Carotid Artery, Internal / surgery*,  ultrasonography
Carotid Stenosis / complications,  surgery*,  ultrasonography
Endarterectomy, Carotid / adverse effects*
Female
Femoral Artery / ultrasonography*
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Prospective Studies
Recurrence
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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