scholarly journals Hemodynamic changes in different types of carotid endarterectomy in the short- and long-term postoperative periods in patients with carotid artery stenosis

2020 ◽  
Vol 19 (5) ◽  
pp. 2381
Author(s):  
P. V. Ignatenko ◽  
A. A. Gostev ◽  
O. A. Novikova ◽  
Sh. B. Saaya ◽  
A. A. Rabtsun ◽  
...  
2020 ◽  
Author(s):  
Yanhua Wan ◽  
Yiran Li ◽  
Jiasheng Xu ◽  
Shasha Wan ◽  
Riwei Wang ◽  
...  

Abstract Objective: To explore the mid-and long-term clinical efficacy analysis of carotid artery stenosis treated with carotid endarterectomy.Methods: Retrospective analysis of 89 cases of patients with carotid artery stenosisundergoing carotid endarterectomy from our center from Jan,2013 to June,2017. To gather the hospitalization data of patients including the general information, the past medical history, preoperative conditions, the situation during surgery, postoperative situations. All the patients were followed up from 16 months to 63 months, and to make survival analysis on the follow-up status.Results:Among the 89 cases, 22cases of mild stenosis ,67cases of severe stenosis. 5 cases had postoperation wound hemorrhage or hematoma, 2 cases of cranial nerve injury, 2cases of cerebral stroke. Among the 62 cases of symptomatic carotid artery stenosis,48cases have been improved in term of their clinical symptoms with improvement rate of 77.4%. The Nonparametric test of mRS scores before and after surgery showed that there was significant difference in the preoperative and postoperative scores(P<0.05).Conclusion: The mid-and long-term clinical efficacy of carotid artery stenosis treated with carotid endarterectomy is good. The previous history of coronary heart disease and peripheral vascular diseases are the influence factors for the mid- and long-term adverse outcomes after carotid endarterectomy.


2015 ◽  
Vol 55 (11) ◽  
pp. 830-837 ◽  
Author(s):  
Taichi ISHIGURO ◽  
Taku YONEYAMA ◽  
Tatsuya ISHIKAWA ◽  
Koji YAMAGUCHI ◽  
Akitsugu KAWASHIMA ◽  
...  

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 183-189 ◽  
Author(s):  
Kosmas I. Paraskevas ◽  
Dimitri P. Mikhailidis ◽  
Frank J. Veith

Carotid artery stenting (CAS) has emerged as a potential alternative to carotid endarterectomy (CEA) for the management of carotid artery stenosis. The purpose of this article is to provide an evaluation and critical overview of the trials comparing the early and later results of CAS with CEA for symptomatic carotid stenosis. The Cochrane Controlled Trials Register, PubMed/Medline, and EMBASE databases were searched up to February 1, 2009, to identify trials comparing the long-term outcomes of CAS with CEA. The MeSH terms used were “carotid artery stenting,” “carotid endarterectomy,” “symptomatic carotid artery stenosis,” “treatment,” “clinical trial,” “randomized,” and “long-term results,” in various combinations. One single-center and three multicenter randomized studies reporting their long-term results from the comparison of CAS with CEA for symptomatic carotid stenosis were identified. All four studies independently reached the conclusion that CAS may not provide results equivalent to those of CEA for the management of symptomatic carotid stenosis. A higher incidence of recurrent stenosis and peri- and postprocedural events accounted for the inferior results reported for CAS compared with CEA. Current data from randomized studies indicate that CAS provides inferior long-term results compared with CEA for the management of symptomatic carotid artery stenosis. However, it can be argued that all of these trials were performed when both CAS equipment and CAS operators had not evolved to their current status. Given that current equipment and mature experience are required for CAS before comparing it with the current “gold standard” procedure (CEA), the results of soon-to-be reported trials (Carotid Revascularization Endarterectomy vs Stenting Trial [CREST], International Carotid Stenting Study [ICSS], or others) may alter the current impression that CAS is inferior to CEA for the treatment of symptomatic carotid stenosis.


1990 ◽  
Vol 4 (4) ◽  
pp. 323-327 ◽  
Author(s):  
Frank Vermassen ◽  
Albert Flamme ◽  
Joseph De Roose ◽  
Guyla Berszenyi ◽  
Fritz Derom

2019 ◽  
Vol 53 (3) ◽  
pp. 216-223 ◽  
Author(s):  
Muhammad Rizwan ◽  
Hanaa Dakour Aridi ◽  
Tru Dang ◽  
Widian Alshwaily ◽  
Besma Nejim ◽  
...  

Objectives: Carotid artery endarterectomy (CEA) and carotid artery stenting (CAS) are 2 effective treatment options for carotid revascularization and stroke prevention. The long-term outcomes of Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) reported similar stroke and death rate between the 2 procedures. This study presents the short- and long-term outcomes of CEA and CAS of all risk patients performed by a single vascular surgeon in a real-world setting. Methods: We retrospectively reviewed all patients who underwent CEA and CAS from September 2005 to June 2017 at our institute. Student t test, χ2, and Fisher exact tests were used to compare patient’s characteristics. Multivariate logistic, cox regression models and survival analysis were used to compare postoperative and long-term outcomes between the 2 groups. Results: Over 2000 patients were evaluated for carotid artery stenosis during the study period, and 313 revascularization procedures were performed (CEA: 47%, CAS: 53%). Patients’ age (Mean [95% confidence interval, CI] 68.8 [67.2-70.4] vs 69.7 [68.2-71.3], P = .40) was similar between CEA and CAS. Patients who underwent CAS had significantly higher comorbidities (chronic obstructive pulmonary disease [COPD], chronic heart failure [CHF], hyperlipidemia, and prior ipsilateral intervention, all P < .05). No difference was found in 30-day complications after CEA versus CAS including stroke (2.0% vs 1.2%), myocardial infarction (MI; 0.7% vs 1.2%), death (0% vs 1.2%) as well as combined major adverse events (stroke/death/MI; 2.7% vs 3.0%; all P > .05). Overall 7-year survival, stroke-free survival and restenosis-free survival were similar between the 2 groups ( P > .5). Significant predictors of mortality were diabetes (hazard ratio, HR [95% CI]: 2.41 [1.15-5.08]), chronic kidney disease (HR [95% CI]: 4.89 [1.97-12.13]), and COPD (HR [95% CI]: 3.31 [1.43-7.71]; all P values <.05). Statin use was protective with 71% reduction in risk of mortality (HR [95% CI]: 0.29 [0.12-0.67], P = .004). Conclusion: Our experience showed comparable short- and long-term outcomes of CAS and CEA performed for carotid artery stenosis by vascular surgeon. There was no difference between single institutional long-term outcomes and CREST outcomes following CEA and CAS.


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