1,418 results match your criteria symptomatic cea


Evaluation of Factors Associated with, and Outcomes for Patients with Non-Home Discharge Destinations Following Carotid Endarterectomy.

Ann Vasc Surg 2021 Apr 7. Epub 2021 Apr 7.

Department of Surgery, Pennsylvania State University, College of Medicine, Hershey, PA. Electronic address:

Introduction: Following a carotid endarterectomy (CEA) procedure, patients are discharged to their homes or other locations than home such as an acute care facility or skilled nursing facility based on their functional status and level of medical attention needed. Decision-making for discharge destination following a CEA to home or non-home locations is important due to the differences in survival and post-operative complications. While primary outcomes such as mortality and occurrence of stroke following CEA have been extensively studied, there is a paucity of information characterizing outcomes of discharge destination and the factors associated. Read More

View Article and Full-Text PDF

THE IMPACT OF NEUTROPHIL-TOLYMPHOCYTE RATIO AND PLATELETTO- LYMPHOCYTE RATIO IN CAROTID ARTERY DISEASE.

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):45-51. Epub 2021 Apr 8.

Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal.

Introduction: Inflammation is a common underlying feature of atherosclerosis. Several inflammatory biomarkers have been reported to have prognostic value, in several areas, including in vascular surgery. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may permit to identify patients at greater risk for cerebrovascular events, tailor patient management, improve preoperative status and possibly develop target anti-atherosclerotic therapy. Read More

View Article and Full-Text PDF

Hybrid and Total Endovascular Approaches to Tandem Carotid Artery Lesions Have Similar Short- and Long-Term Outcomes.

Ann Vasc Surg 2021 Apr 5. Epub 2021 Apr 5.

Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.

Background: Addition of ipsilateral proximal endovascular intervention (PEI, common carotid/innominate) increases the risk of perioperative stroke/death for both carotid endarterectomy (CEA) and carotid stenting (CAS). However, these approaches have not been directly compared and is the subject of this study.

Methods: VQI (2005-2020) was queried for CEA and CAS with PEI, excluding emergent, bilateral, and repeat procedures, patients with prior ipsilateral CAS, ICA lesions with stenosis<50%, and transcarotid ICA stents. Read More

View Article and Full-Text PDF

Risk of Stroke before Revascularisation in Patients with Symptomatic Carotid Stenosis: A Pooled Analysis of Randomised Controlled Trials.

Eur J Vasc Endovasc Surg 2021 Apr 5. Epub 2021 Apr 5.

Department of Neurology and Stroke Centre, Department of Clinical Research, University Hospital, University of Basel, Basel, Switzerland; Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK. Electronic address:

Objective: Current guidelines recommending rapid revascularisation of symptomatic carotid stenosis are largely based on data from clinical trials performed at a time when best medical therapy was potentially less effective than today. The risk of stroke and its predictors among patients with symptomatic carotid stenosis awaiting revascularisation in recent randomised controlled trials (RCTs) and in medical arms of earlier RCTs was assessed.

Methods: The pooled data of individual patients with symptomatic carotid stenosis randomised to stenting (CAS) or endarterectomy (CEA) in four recent RCTs, and of patients randomised to medical therapy in three earlier RCTs comparing CEA vs. Read More

View Article and Full-Text PDF

Survival in stage IIB/C compared to stage IIIA rectal cancer: an Australian experience affirming that size does matter.

ANZ J Surg 2021 Apr 6. Epub 2021 Apr 6.

Department of Radiation Oncology, Illawarra Cancer Centre, Wollongong, New South Wales, Australia.

Background: Colorectal cancer (CRC) is one of the most commonly diagnosed malignancies globally; however, a survival paradox has been observed unique to this malignancy. The aim of this study was to review survival outcomes of patients diagnosed with stage II and stage III rectal cancer, to determine whether a survival paradox is present in our centre and assess for patient-related factors that can explain the observed paradox or were predictors of prognosis.

Methods: A retrospective review of data collected from 2006 to 2018 of patients diagnosed with rectal cancer in three separate centres was conducted. Read More

View Article and Full-Text PDF

Results of carotid artery stenting. Lessons learned in a belgian 'real world' practice.

Acta Chir Belg 2021 Apr 5:1-18. Epub 2021 Apr 5.

Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Belgium.

Methods: In our department 45 CAS were performed from January 2006 until May 2018. Patient characteristics, indication for treatment and choice of treatment, minor stroke, major stroke and death rates were analyzed retrospectively.

Results: Of these patients 8/45 (18%) had a symptomatic carotid artery stenosis and 37/45 (82%) had an asymptomatic stenosis. Read More

View Article and Full-Text PDF

Quantification and mapping of cerebral hemodynamics before and after carotid endarterectomy, using 4D flow MRI.

J Vasc Surg 2021 Mar 31. Epub 2021 Mar 31.

Department of Clinical Sciences, Neuroscience, Umeå University, Umeå, SWEDEN.

Background And Purpose: Carotid stenosis can profoundly impact cerebral hemodynamics that cannot simply be inferred from the degree of stenosis. We quantified and mapped the distribution of blood flow rate in cerebral arteries before and after carotid endarterectomy using four-dimensional phase-contrast magnetic resonance imaging (4D flow MRI).

Methods: Nineteen patients (71 ± 6 years, 2 women) with symptomatic carotid stenosis (≥ 50%) undergoing carotid endarterectomy (CEA) were investigated using 4D flow MRI before and after surgery. Read More

View Article and Full-Text PDF

Early Outcomes of Carotid Revascularization in Retrospective Case Series.

J Clin Med 2021 Mar 1;10(5). Epub 2021 Mar 1.

Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece.

Background: Most data in carotid stenosis treatment arise from randomized control trials (RCTs) and cohort studies. The aim of this meta-analysis was to compare 30-day outcomes in real-world practice from centers providing both modalities.

Methods: A data search of the English literature was conducted, using PubMed, EMBASE and CENTRAL databases, until December 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA) guidelines. Read More

View Article and Full-Text PDF

Prior infection by seasonal coronaviruses, as assessed by serology, does not prevent SARS-CoV-2 infection and disease in children, France, April to June 2020.

Euro Surveill 2021 04;26(13)

Ecole Nationale Vétérinaire d'Alfort, Maisons Alfort, France.

BackgroundChildren have a low rate of COVID-19 and secondary severe multisystem inflammatory syndrome (MIS) but present a high prevalence of symptomatic seasonal coronavirus infections.AimWe tested if prior infections by seasonal coronaviruses (HCoV) NL63, HKU1, 229E or OC43 as assessed by serology, provide cross-protective immunity against SARS-CoV-2 infection.MethodsWe set a cross-sectional observational multicentric study in pauci- or asymptomatic children hospitalised in Paris during the first wave for reasons other than COVID (hospitalised children (HOS), n = 739) plus children presenting with MIS (n = 36). Read More

View Article and Full-Text PDF

Human leukocyte antigen (HLA)-F and -G gene polymorphisms and haplotypes are associated with malaria susceptibility in the Beninese Toffin children.

Infect Genet Evol 2021 Mar 27;92:104828. Epub 2021 Mar 27.

Post-graduate Program in Basic and Applied Immunology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, 14049-900 Ribeirão Preto, SP, Brazil. Electronic address:

Background: Little attention has been devoted to the role of the immunoregulatory HLA-E/-F/-G genes in malaria. We evaluated the entire HLA-E/-F/-G variability in Beninese children highly exposed to Plasmodium falciparum (P.f. Read More

View Article and Full-Text PDF

Early and Long-Term Outcomes of Carotid Stenting and Carotid Endarterectomy in Women.

Front Surg 2021 8;8:646204. Epub 2021 Mar 8.

Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy.

The role of carotid revascularization in women remains intensely debated because of the lower benefit and higher perioperative risks concerning the male counterpart. Carotid artery endarterectomy (CEA) and stenting (CAS) represent the two most valuable stroke prevention techniques due to large vessel disease. This study investigates the early and late outcomes in female sex in a real-world everyday clinical practice. Read More

View Article and Full-Text PDF

Trends and outcomes in Australian carotid artery revascularization surgery: 2010-2017.

ANZ J Surg 2021 Mar 22. Epub 2021 Mar 22.

Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Background: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce the risk of stroke in patients with severe carotid stenosis. The aim was to compare contemporary treatment trends and outcomes after CEA and CAS between states of Australia.

Methods: A retrospective analysis was conducted on data from the Australasian Vascular Audit between 2010 and 2017. Read More

View Article and Full-Text PDF

Effect of osimertinib in treating patients with first-generation EGFR-TKI-resistant advanced non-small cell lung cancer and prognostic analysis.

J BUON 2021 Jan-Feb;26(1):51-57

Department of Respiration, Shanxi Provincial Cancer Hospital, No. 3 Zhigongxinjie, Xinghualing District, Taiyuan, Shanxi, 030001, China.

Purpose: To explore the efficacy and safety of the third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) Osimertinib in the treatment of patients with first-generation EGFR-TKI-resistant advanced non-small cell lung cancer (NSCLC).

Methods: The clinical data of 84 patients with advanced NSCLC treated in our hospital from September 2016 to March 2018 were retrospectively analyzed. All patients had progressive disease (PD) after treatment with first-generation EGFR-TKI, and then they were treated with Osimertinib. Read More

View Article and Full-Text PDF

Endarterectomy versus stenting for the prevention of periprocedural stroke or death in patients with symptomatic or asymptomatic carotid stenosis: a meta-analysis of 10 randomized trials.

Ann Transl Med 2021 Feb;9(3):256

Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.

Background: The incidence of stroke or death in carotid endarterectomy (CEA) versus carotid artery stenting (CAS) cannot be estimated accurately. We aimed to compare periprocedural stroke or death in patients with symptomatic or asymptomatic carotid artery stenosis (CS) treated with CEA versus CAS.

Methods: Ten randomized trials (with ≥100 randomized patients per trial) compared the relative effectiveness of CAS and CEA for the prevention of stroke or death. Read More

View Article and Full-Text PDF
February 2021

Combined risk modelling approach to identify the optimal carotid revascularisation approach.

Stroke Vasc Neurol 2021 Mar 8. Epub 2021 Mar 8.

Internal Medicine, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA.

Background: Carotid endarterectomy (CEA) results in fewer perioperative strokes, but more myocardial infarctions (MI) than carotid artery stenting (CAS). We explored a combined modelling approach that stratifies patients by baseline stroke and MI.

Methods: Baseline registry-based risk models for perioperative stroke and MI were identified via literature search. Read More

View Article and Full-Text PDF

Early and Late Outcomes after Transcarotid Revascularisation for Internal Carotid Artery Stenosis: A Systematic Review and Meta-Analysis.

Eur J Vasc Endovasc Surg 2021 Mar 2. Epub 2021 Mar 2.

Vascular Surgery Department, Sismanogleio General Hospital, Athens, Greece.

Objective: Transcarotid/transcervical revascularisation (TCAR) is an alternative to carotid endarterectomy (CEA) and transfemoral carotid stenting (tfCAS). This review aimed to evaluate pooled data on patients undergoing TCAR.

Data Sources: Medline, Embase, Scopus, and Cochrane Library databases were used. Read More

View Article and Full-Text PDF

Management of carotid stenosis for primary and secondary prevention of stroke: state-of-the-art 2020: a critical review.

Eur Heart J Suppl 2020 Nov 6;22(Suppl M):M35-M42. Epub 2020 Dec 6.

Department of Cardiology, Dupuytren University Hospital, INSERM 1094 & IRD, Limoges, France.

Carotid atherosclerotic plaque is encountered frequently in patients at high cardiovascular risk, especially in the elderly. When plaque reaches 50% of carotid lumen, it induces haemodynamically significant carotid stenosis, for which management is currently at a turning point. Improved control of blood pressure, smoking ban campaigns, and the widespread use of statins have reduced the risk of cerebral infarction to <1% per year. Read More

View Article and Full-Text PDF
November 2020

Use of immune checkpoint inhibitors in cancer patients with pre-existing sarcoidosis.

Immunotherapy 2021 Apr 1;13(6):465-475. Epub 2021 Mar 1.

Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

To evaluate adverse events in cancer patients with pre-existing sarcoidosis receiving immune checkpoint inhibitors (ICIs). We retrospectively reviewed cancer patients with sarcoidosis who underwent treatment with ICI to determine frequency of sarcoidosis flares. 32 patients with sarcoidosis received ICIs The median time to ICI initiation was 7 years (range: 1 month to 51 years). Read More

View Article and Full-Text PDF

Clinical Impact of Contralateral Carotid Occlusion in Patients Undergoing Carotid Artery Revascularization.

J Am Coll Cardiol 2021 Feb;77(7):835-844

Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Electronic address:

Background: The presence of a contralateral carotid occlusion (CCO) is an established high-risk feature for patients undergoing carotid endarterectomy (CEA) and is traditionally an indication for carotid artery stenting (CAS). Recent observational data have called into question whether CCO remains a high-risk feature for CEA.

Objectives: The purpose of this study was to determine the clinical impact of CCO among patients undergoing CEA and CAS in a contemporary nationwide registry. Read More

View Article and Full-Text PDF
February 2021

Outcomes of Carotid Revascularization in Patients with Contralateral Carotid Artery Occlusion.

J Am Coll Surg 2021 Feb 15. Epub 2021 Feb 15.

Division of Vascular and Endovascular Surgery, University of California San Diego, La Jolla, CA. Electronic address:

Background: Little is known about the best revascularization procedure for patients with contralateral carotid artery occlusion (CCO). We aim to compare the outcomes of transcarotid artery revascularization (TCAR), carotid endarterectomy (CEA), and transfemoral carotid artery stenting (TFCAS) in patients with CCO.

Study Design: Patients in the Vascular Quality Initiative dataset who underwent CEA, TFCAS, or TCAR, and had CCO between September 2016 and April 2020, were included. Read More

View Article and Full-Text PDF
February 2021

Overestimation of carotid stenosis on CTA - Real world experience.

J Clin Neurosci 2021 Mar 8;85:36-40. Epub 2021 Jan 8.

Neurology Department, Hadassah University Medical Center, Jerusalem, Israel.

Background: Symptomatic carotid stenosis is responsible for 10% of all strokes. Currently, CT angiography (CTA) is the main diagnostic tool for carotid stenosis. It is frequently the only diagnostic test preceding recommendations for carotid angioplasty and stenting (CAS) or carotid endarterectomy (CEA). Read More

View Article and Full-Text PDF

The Carotid Endarterectomy Cadaveric Investigation for Cranial Nerve Injuries: Anatomical Study.

Brain Sci 2021 Feb 10;11(2). Epub 2021 Feb 10.

Department of Neurosurgery, Acıbadem Mehmet Ali Aydinlar University, 34662 Istanbul, Turkey.

Cerebral stroke continues to be one of the leading causes of mortality and long-term morbidity; therefore, carotid endarterectomy (CEA) remains to be a popular treatment for both symptomatic and asymptomatic patients with carotid stenosis. Cranial nerve injuries remain one of the major contributor to the postoperative morbidities. Anatomical dissections were carried out on 44 sides of 22 cadaveric heads following the classical CEA procedure to investigate the variations of the local anatomy as a contributing factor to cranial nerve injuries. Read More

View Article and Full-Text PDF
February 2021

Carotid Endarterectomy: A Single Institutional Experience of 28 Years From Pakistan.

Ann Vasc Surg 2021 Feb 5. Epub 2021 Feb 5.

Department of General and Vascular Surgery, Shifa International Hospital, Islamabad, Pakistan.

Background: Cerebrovascular event is the most common reason of acute neurological injury in the western world. There is an extensive literature and data available on its prognosis, outcomes and complications rates from the west, yet still, data regarding its safety and efficacy is scarce from the South Asian belt.

Objective: To elucidate the role of carotid endarterectomy in patients with carotid stenosis regarding prevention of stroke and safety of the procedure. Read More

View Article and Full-Text PDF
February 2021

Diagnosis, Treatment and Follow-up in Extracranial Carotid Stenosis.

Dtsch Arztebl Int 2020 Nov;117(47):801-807

Spokesman (HHE) and Secretary (AK) of the Steering Group, Department forf Vascular and Endovascular Surgery, University Hospital "rechts der Isar", Technical University of Munich; Member of the Steering Group, Institute for Neuroradiology, University Hospital Frankfurt; Member of the Steering Group, Ettlingen; Member of the Steering Group, Department of Vascular and Thoracic Surgery, Karlsruhe Municipal Hospital Member of the Steering Group, Department of Neurology and Stroke Unit, Benedictus Hospital Tutzing; German Vascular Society (DGG); German Society of Neuroradiology (DGNR); German Society for Angiology/Vascular Medicine (DGA); German Society of Surgery (DGCH); German Society of Neurology (DGN).

Background: Around 15% of cerebral ischemias are caused by lesions of the extracranial carotid artery. The goal of this guideline is to provide evidence- and consensus-based recommendations for the management of patients with extracranial carotid stenoses throughout Germany and Austria.

Methods: A systematic literature search (1990-2019) and methodical assessment of existing guidelines and systematic reviews; consensus-based answers to 37 key questions with evidence-based recommendations. Read More

View Article and Full-Text PDF
November 2020

Simultaneous treatment of common carotid lesions increases the risk of stroke and death after carotid artery stenting.

J Vasc Surg 2021 Feb 2. Epub 2021 Feb 2.

Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Background: Tandem carotid artery lesions that involve simultaneous internal carotid artery (ICA) and common carotid artery (CCA) stenoses present a complex clinical problem. Some studies have shown that the addition of a retrograde proximal intervention to treat a CCA lesion during a carotid endarterectomy (CEA) increases the risk of stroke and death. However, the stroke and death risks associated with a totally endovascular approach to tandem lesions is unknown and is the subject of this study. Read More

View Article and Full-Text PDF
February 2021

Safety and Efficacy of Early Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis: A Meta-Analysis.

Biomed Res Int 2021 8;2021:6623426. Epub 2021 Jan 8.

Shandong Taian City Central Hospital Branch, Taian City, Shandong Province, China.

Design: A systematic document retrieval of studies published in the past 10 years reporting periprocedural stroke/mortality/MI after carotid endarterectomy (CEA) related to the time between CEA and qualifying neurological symptoms. The application database has "PubMed, EMbase and Cochrane databases." RevMan5. Read More

View Article and Full-Text PDF
January 2021

Absence of Consistent Sex Differences in Outcomes From Symptomatic Carotid Endarterectomy and Stenting Randomized Trials.

Stroke 2021 Jan 25;52(2):416-423. Epub 2021 Jan 25.

Department of Neurology, Mayo Clinic, Jacksonville, FL (T.G.B.).

Background And Purpose: CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) reported a higher periprocedural risk for any stroke, death, or myocardial infarction for women randomized to carotid artery stenting (CAS) compared with women randomized to carotid endarterectomy (CEA). No difference in risk by treatment was detected for women relative to men in the 4-year primary outcome. We aimed to conduct a pooled analysis among symptomatic patients in large randomized trials to provide more precise estimates of sex differences in the CAS-to-CEA risk for any stroke or death during the 120-day periprocedural period and ipsilateral stroke thereafter. Read More

View Article and Full-Text PDF
January 2021

Combination of Single- and Paired-Pulse Somatosensory Evoked Potentials in Ischemic Monitoring: Preliminary Investigation in Carotid Endarterectomy.

Cureus 2020 Dec 21;12(12):e12206. Epub 2020 Dec 21.

Neurosurgery, Kanmon Medical Center, National Hospital Organization (NHO), Shimonoseki, JPN.

Introduction Severe ischemia induces cerebral excitability imbalance before completion of infarct. To investigate the clinical availability of this imbalance with ischemic monitoring, paired-pulse somatosensory evoked potentials (SEPs) were performed in conjunction with conventional SEPs during carotid endarterectomy. Methods For carotid endarterectomy patients with hemodynamic deficits of the middle cerebral artery area (n = 34), the excitability imbalances (Q) were measured by paired-pulse SEPs, wherein the second response (A) was divided by the first (A; Q = A/A). Read More

View Article and Full-Text PDF
December 2020