scholarly journals Efficacy and safety of stenting for elderly patients with severe and symptomatic carotid artery stenosis: a critical meta-analysis of randomized controlled trials

2015 ◽  
pp. 1733
Author(s):  
Yugang Jiang ◽  
Yi-An Ouyang ◽  
Mengqiang Yu ◽  
Yunze Zhang ◽  
Hao Huang
Keyword(s):  
Carotid Artery ◽  
Elderly Patients ◽  
Randomized Controlled Trials ◽  
Carotid Artery Stenosis ◽  
Meta Analysis ◽  
Artery Stenosis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Symptomatic Carotid ◽  
Randomized Controlled

scholarly journals The efficacy and safety of desflurane versus sevoflurane in elderly patients during general anaesthesia: a meta-analysis randomized controlled trials

2019 ◽  
Author(s):  
Yiping Li ◽  
Ruiming Deng ◽  
Juan Zhou ◽  
Shifu Hu ◽  
Aiping Ouyang
Keyword(s):  
Elderly Patients ◽  
Randomized Controlled Trials ◽  
General Anaesthesia ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Pacu Stay ◽  
Postanesthetic Care Unit ◽  
Anesthesia Time

Abstract Background: The objective of the study was to systematically screen the literature and to identify of the results of randomized controlled trials (RCTs) comparing the efficacy and safety of desflurane versus sevoflurane in elderly patients during general anaesthesia. Methods: Databases including PUBMED, EMBASE, Web of Science and Cochrane Library were searched until July 2018 to identify relevant studies. Two authors independently reviewed each study. After literature screening and data extraction, a meta-analysis was conducted using the RevMan 5.2 software. Five RCTs, including 324 patients, met the inclusion criteria and were included in the final analysis. Results: Our pooled analysis showed that elderly patients during desflurane general anaesthesia could reduce time taken to open eyes (SMD, -0.63; 95% CI, -1.23 to -0.03; P=0.04), follow commands (SMD, -0.97; 95% CI, -1.76 to -0.19; P=0.01), extubation (SMD, -0.77; 95% CI, -1.35 to -0.19; P=0.009) and orientation (SMD, -1.49; 95% CI, -2.43 to -0.54). However, there was no difference between desflurane and sevoflurane groups with regard to anesthesia time (SMD, -0.10; 95% CI, -0.35 to 0.15; P=0.43) and the length of postanesthetic care unit (PACU) PACU stay (SMD, -4.65; 95% CI, -10.31 to 1; P=0.11). Conclusions: Our results show that elderly patients during desflurane general anaesthesia offers several potential advantages over anaesthesia in terms of the time to open the eyes, follow commands, extubation and orientation. However both anesthetics appear to be equivalent with regard to the anesthesia time and length of PACU stay. Keywords: Desflurane, sevoflurane, efficacy, safety, elderly patients, meta-analysis

Clinical considerations in the management of asymptomatic carotid artery stenosis

2011 ◽  
Vol 31 (6) ◽  
pp. E7 ◽  
Author(s):  
Philipp Taussky ◽  
Ricardo A. Hanel ◽  
Fredric B. Meyer
Keyword(s):  
Carotid Artery ◽  
Randomized Controlled Trials ◽  
Carotid Artery Stenosis ◽  
Risk Profile ◽  
Artery Stenosis ◽  
Controlled Trials ◽  
Asymptomatic Carotid ◽  
Randomized Controlled ◽  
Asymptomatic Carotid Artery Stenosis ◽  
Angioplasty And Stenting

Incidental findings pose considerable management dilemmas for the treating physician and psychological burden for the respective patient. With an aging population, more patients will be diagnosed with asymptomatic internal carotid artery stenosis. Patients will have to be counseled with regard to treatment options according to their individual risk profile and according to professionals' knowledge of evidence-based data derived from large randomized control trials. Treatment consensus has long been lacking for patients with asymptomatic carotid artery stenosis prior to any randomized controlled trials. Additionally, an individual's risk profile may be hard to assess according to knowledge gained from randomized controlled trials. Moreover, while earlier studies compared carotid endarterectomy and medical therapy, in the past years, a new therapeutic modality, carotid artery angioplasty and stenting, has emerged as a possible alternative. This has been evaluated in a recent randomized controlled trial, the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), which compared carotid endarterectomy with angioplasty and stenting in both symptomatic and asymptomatic patients. The following review summarizes current knowledge of the natural history, diagnosis, and treatment strategies to counsel patients with asymptomatic carotid artery stenosis.

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