| A meta-analysis of combined endarterectomy and proximal balloon angioplasty for tandem disease of the arch vessels and carotid bifurcation. | |
| | |
MedLine Citation:
|
PMID: 21684709 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: High grade stenoses of both the innominate (IA) or common carotid artery (CCA) and the carotid bifurcation are rare and represent a therapeutic dilemma for the treating physician. A hybrid procedure with concomitant carotid endarterectomy (CEA) and retrograde angioplasty has been proposed as a less invasive treatment option. The aim of this study is to review the existing literature on such hybrid procedures. METHODS: An electronic search of the pertinent English literature was undertaken. A meta-analysis of all studies reporting on simultaneous carotid endarterectomy and retrograde angioplasty for the treatment of tandem internal carotid and proximal common carotid or innominate artery lesions was performed. RESULTS: Thirteen studies, including 133 patients were identified. Sixty-eight percent of the patients were male, 83% symptomatic. Proximal lesions were located in ipsilateral CCA in 85 cases and in IA in 48 cases. Reported technical success of the procedure was 97%. In 79 of the 129 successful operations, a stent was implanted, while the remaining 50 patients underwent simple balloon angioplasty. Thirty-day mortality and stroke rate were 0.7% and 1.5%, respectively. Combined 30-day mortality and stroke rate was 1.5%. During a mean follow-up of 12 to 36 months, five patients presented symptoms of cerebral ischemia and 17 died. Ten patients developed restenosis of the proximal lesion, (4 symptomatic, 7 in cases without stent) and 2 restenoses of the endarterectomy (all asymptomatic). Restenosis was treated in 7 cases (4 repeat angioplasty, 3 bypass grafts). CONCLUSIONS: This meta-analysis reports the largest collection of patients having undergone hybrid treatment of tandem disease of the arch vessels and carotid bifurcation. Results from this study show that the combined stroke and death rate with this approach is equal to or better than that for isolated endarterectomy. When possible, balloon angioplasty with stenting of the proximal component of this disease should be pursued to avoid restenosis. |
| | |
Authors:
|
Giorgos S Sfyroeras; Christos Karathanos; George A Antoniou; Vassileios Saleptsis; Athanasios D Giannoukas |
Related Documents
:
|
15224029 - Inhaled prostacyclin reduces cardiopulmonary bypass-induced pulmonary endothelial dysfu... 21616429 - Radiofrequency ablation of lung metastases close to large vessels during vascular occlu... 21906159 - Aneurysmal dilatation of the inferior vena cava. 10215259 - Coronary artery bypass grafting on the beating heart: a simple technique for subluxatin... 20338319 - Routine off-pump coronary artery bypass grafting is safe and feasible in high-risk pati... 21628319 - Discordance of aortic remodeling with clinical outcomes in patients treated with endova... 20853349 - The effect of cto recanalization on ffr of the donor artery. 17590809 - The spectrum of echocardiographic abnormalities in hypothyroidism and the effect of hor... 2352629 - Ectasia of arteries beyond the circle of willis. |
Publication Detail:
|
Type: Journal Article; Meta-Analysis; Review |
Journal Detail:
|
Title: Journal of vascular surgery Volume: 54 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2011 Aug |
Date Detail:
|
Created Date: 2011-08-08 Completed Date: 2011-10-24 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: 534-40 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
|
Department of Vascular Surgery, University Hospital of Larissa, Larissa, Greece. gsfyr@yahoo.gr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Angioplasty, Balloon* / adverse effects, instrumentation, mortality Arterial Occlusive Diseases / complications, mortality, therapy* Brachiocephalic Trunk* Carotid Artery, Common* Carotid Artery, Internal / surgery* Carotid Stenosis / complications, mortality, surgery, therapy* Combined Modality Therapy Constriction, Pathologic Endarterectomy, Carotid* / adverse effects, mortality Female Humans Male Middle Aged Recurrence Risk Assessment Risk Factors Stents Stroke / etiology Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception...
Next Document: Predictors of neck bleeding after eversion carotid endarterectomy.