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153 records – page 1 of 16.

Age diffusion never stops? Carotid endarterectomy among the elderly.

https://arctichealth.org/en/permalink/ahliterature71208
Source
Appl Health Econ Health Policy. 2003;2(1):3-7
Publication Type
Article
Date
2003

[Analysis of remote results of eversion carotid endarterectomy].

https://arctichealth.org/en/permalink/ahliterature260751
Source
Angiol Sosud Khir. 2014;20(4):100-8
Publication Type
Article
Date
2014
Author
A V Pokrovskii
D F Beloiartsev
O L Talybly
Source
Angiol Sosud Khir. 2014;20(4):100-8
Date
2014
Language
Russian
Publication Type
Article
Keywords
Aged
Carotid Arteries - pathology
Carotid Stenosis - diagnosis - mortality - physiopathology - surgery
Endarterectomy, Carotid - adverse effects - methods - statistics & numerical data
Female
Hemodynamics
Humans
Male
Middle Aged
Moscow
Postoperative Complications - classification - epidemiology
Reproducibility of Results
Retrospective Studies
Risk assessment
Risk factors
Severity of Illness Index
Stroke - etiology - prevention & control
Survival Rate
Treatment Outcome
Vascular Patency
Abstract
Analysed herein are remote results of surgical management of patients presenting with atherosclerotic stenoses of carotid arteries by means of eversion carotid endarterectomy. Over the period from 2002 to 2007 specialists of the Department of Vascular Surgery of the Institute of Surgery named after A.V. Vishnevsky under the RF Ministry of Public Health carried out a total of 393 eversion carotid endarterectomies in 356 patients. We assessed the remote results of 338 (86%) operations in 303 (85%) patients, analysing survival, freedom from stroke, patency of the reconstructed internal carotid artery and effects of risk factors on these indices. The average duration of follow-up amounted to 84 ± 31 months (max - 146 mos). A total of 242 (71.2%) patients survived. The cumulative 5-year survival rate amounted to 84%, with 10-year survival equalling 63%. Severity of the initial atherosclerotic lesion of the arterial bed, progression of atherosclerosis, and control over risk factors for atherosclerosis exerted a statistically significant influence on total survival. Acute disorders of cerebral circulation (of any localization) at a median follow-up of 81 ± 33 months (max - 146 mos) developed in 38 (12.1%) patients, of whom in 15 (4.8%) it terminated with a lethal outcome. Five-year cumulative freedom from stroke amounted to 92%, equalling 80% 10 years after. The risk factors which influenced the freedom from stroke included a history of acute impairments of cerebral circulation, restenoses of the reconstructed ipsilateral internal carotid artery (>70%), and diabetes mellitus. Amongst the examined by means of ultrasonography 164 patients, patency of the reconstructed ipsilateral internal carotid artery at an average follow-up of 75 ± 28 months (max - 135 mos) amounted to 95%. Haemodynamically significant restenoses (= 70%) were revealed in eight (5%) cases. Of these, three (2%) patients had narrowing of 70-89% and the remaining five (3%) patients had narrowing of = 90% (including 2 occlusions of the reconstructed ipsilateral internal carotid artery). We revealed no risk factors influencing the development of restenosis of the reconstructed ipsilateral internal carotid artery after eversion carotid endarterectomy. The obtained findings give grounds to consider eversion carotid endarterectomy as a safe and reliable method for treatment of atherosclerotic lesions of carotid arteries and, consequently, for prevention of stroke. Control of risk factors may improve remote results of surgical treatment.
PubMed ID
25490364 View in PubMed
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[Antithrombotic therapy in operations on extracranial arteries].

https://arctichealth.org/en/permalink/ahliterature157737
Source
Vestn Khir Im I I Grek. 2008;167(1):11-3
Publication Type
Article
Date
2008
Author
G Iu Sokurenko
Iu V Luk'ianov
E V Parusova
L N Edovina
Source
Vestn Khir Im I I Grek. 2008;167(1):11-3
Date
2008
Language
Russian
Publication Type
Article
Keywords
Aged
Brain Ischemia - drug therapy - mortality - surgery
Combined Modality Therapy
Endarterectomy, Carotid - methods
Female
Fibrinolytic Agents - therapeutic use
Humans
Male
Middle Aged
Postoperative Complications - epidemiology
Russia - epidemiology
Ticlopidine - analogs & derivatives - therapeutic use
Abstract
Application of Clopidogrel in the postoperative period in patients after surgery on extracranial arteries was analyzed. The preparation was used in 56 patients. Uninterrupted intake of the drug took place during 5 to 12 months, 7+/-1.6 months on average. Stomach and duodenal ulcer was diagnosed in 11 patients (20%), 3 patients (5%) had chronic pancreatitis with periodical exacerbations and 2 patients (4%) had erythrocytemia. One bleeding requiring revision of the wound took place in the nearest postoperative period. During the whole period of observation there were no thrombotic or thromboembolic complication against the background of using plavix. In none of the patients granulocytopenia was revealed with continuous intake of plavix. An ultrasonic investigation of the operated arteries in the remote postoperative period failed to reveal hemodynamically significant restenoses of carotid arteries.
PubMed ID
18411659 View in PubMed
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An update on the treatment and management of stroke.

https://arctichealth.org/en/permalink/ahliterature169776
Source
CANNT J. 2006 Jan-Mar;16(1):30-3, 36-9; quiz 34-5, 40-1
Publication Type
Article
Author
Séadna Ledger
Author Affiliation
London Health Sciences Centre, Ontario. Seadna.Ledger@lhsc.on.ca
Source
CANNT J. 2006 Jan-Mar;16(1):30-3, 36-9; quiz 34-5, 40-1
Language
English
French
Publication Type
Article
Keywords
Anticoagulants - therapeutic use
Canada - epidemiology
Endarterectomy, Carotid
Fibrinolytic Agents - therapeutic use
Humans
Hypertension - complications - prevention & control
Kidney Failure, Chronic - complications - therapy
Primary Prevention
Renal Dialysis - adverse effects
Risk factors
Smoking - adverse effects - prevention & control
Stroke - diagnosis - epidemiology - etiology - therapy
Tissue Plasminogen Activator - therapeutic use
Abstract
There have been huge advancements in the prophylaxis and treatment of stroke. The majority of patients who have a stroke are asymptomatic prior to the event. This makes it extremely important to identify high-risk patients and administer prophylaxis where appropriate. However, risk factors, prophylaxis and treatment strategies are less clear in dialysis patients due to the lack of studies. Patients with chronic kidney disease have a higher risk of experiencing a stroke and dying from it. More studies need to be done in this area. For now, modifiable risk factors such as blood pressure and nutrition, should be promoted and prophylaxis and treatment administered with extra vigilance due to these patients' increased bleeding risk.
PubMed ID
16615704 View in PubMed
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Are adverse events after carotid endarterectomy reported comparable in different registries?

https://arctichealth.org/en/permalink/ahliterature159468
Source
Eur J Vasc Endovasc Surg. 2008 Mar;35(3):280-5
Publication Type
Article
Date
Mar-2008
Author
A G Taha
P. Vikatmaa
A. Albäck
P S Aho
M. Railo
M. Lepäntalo
Author Affiliation
Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland; Department of Vascular Surgery, Assiut University Hospitals, Assiut, Egypt.
Source
Eur J Vasc Endovasc Surg. 2008 Mar;35(3):280-5
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Endarterectomy, Carotid - adverse effects - mortality
Finland - epidemiology
Humans
Outcome Assessment (Health Care)
Registries
Reproducibility of Results
Risk assessment
Abstract
To assess the extent of discrepancies between different vascular registries, at various levels of validation, and to investigate whether such differences might alter the morbidity and mortality rates obtained from the gold standard dataset for carotid endarterectomy (CEA).
All CEA operations in Helsinki University Central Hospital from 2000-2005 were retrieved from the local vascular registry (HUSVASC) and the Hospital Discharge Registry (HILMO). Both registries were validated at different levels to form the final dataset. Total and indication-specific perioperative morbidity and mortality rates were estimated from each level of validation and compared with those from the final dataset and with pooled rates from systematic reviews.
Initial search provided 675 and 681 CEAs from HUSVASC and HILMO, respectively, decreasing to 636 (94%) and 614 (90%) when using the specific operative codes for thrombendarterectomy and patch angioplasty. Manual verification of initial HUSVASC results proved that 655 (97%) operations were true CEAs. 18 further proven CEAs, registered only in HILMO, were added to form the final CEA dataset (n=673). The peri-operative morbidity and combined morbidity and mortality rates were 2.23% and 2.67%, respectively. Comparable rates were obtained from both registries, irrespective the level of verification.
Registry data do not appear to be biased by random loss of some operations and thus they are reliable for decision-making. However, further research is still needed to estimate the permissible volume of omissions in a registry for the data-base to remain trustworthy.
Notes
Comment In: Eur J Vasc Endovasc Surg. 2008 Mar;35(3):286-718171626
PubMed ID
18178115 View in PubMed
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[Assessing efficacy and risk factors of carotid endarterectomy and carotid stenting in patients with symptomatic stenoses of internal carotid arteries in early postoperative period].

https://arctichealth.org/en/permalink/ahliterature146432
Source
Angiol Sosud Khir. 2010;16(4):125-9
Publication Type
Article
Date
2010
Author
A V Gavrilenko
V A Ivanov
A V Piven'
A V Kuklin
G I Antonov
Iu A Bobkov
I V Trunin
S A Abugov
Source
Angiol Sosud Khir. 2010;16(4):125-9
Date
2010
Language
Russian
Publication Type
Article
Keywords
Aged
Carotid Stenosis - surgery
Endarterectomy, Carotid - adverse effects
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Postoperative Complications
Postoperative Period
Prognosis
Risk Assessment - methods
Risk factors
Russia - epidemiology
Stents - adverse effects
Stroke - epidemiology - etiology
Survival Rate - trends
Abstract
The present work was aimed at comparative assessment of efficacy and risk factors of carotid endarterectomy and carotid stenting in patients suffering from symptomatic stenoses of the internal carotid arteries, with due regard for the degree of the accompanying cardiac pathology, the presence of contralateral occlusion, and severity of chronic cerebrovascular insufficiency. We examined and treated a total of 142 patients diagnosed with stenoses of the internal carotid arteries and symptoms of chronic cerebrovascular insufficiency. In the cohort of those subjected to carotid endarterectomy we performed a total of 76 operations in 73 patients, and in the group of carotid stenting 71 operations of stenting of the internal carotid artery with cerebral protection in 69 patients. Postoperatively we assessed the following parameters: «stroke+lethality», incidence of transitory ischaemi? attacks, incidence rate of cerebrovascular neuropathy, and acute myocardial infarction. In the carotid endarterectomy group, we revealed increased risk for the development of neuropathy of the craniocerebral nerves (OR=0.0564, 95% CI 0.9953, P=0.049). In the group of stenting, we revealed increased risk for the development of transitory ischaemia.
PubMed ID
21389955 View in PubMed
Less detail

Association of ultrasonic texture and echodensity features between sides in patients with bilateral carotid atherosclerosis.

https://arctichealth.org/en/permalink/ahliterature108739
Source
Eur J Vasc Endovasc Surg. 2013 Sep;46(3):299-305
Publication Type
Article
Date
Sep-2013
Author
R J Doonan
A J Dawson
E. Kyriacou
A N Nicolaides
M M Corriveau
O K Steinmetz
K S Mackenzie
D I Obrand
M E Daskalopoulos
S S Daskalopoulou
Author Affiliation
Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Source
Eur J Vasc Endovasc Surg. 2013 Sep;46(3):299-305
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Aged
Algorithms
Carotid Artery Diseases - surgery - ultrasonography
Chi-Square Distribution
Cross-Sectional Studies
Endarterectomy, Carotid
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Image Processing, Computer-Assisted
Male
Principal Component Analysis
Quebec
Reproducibility of Results
Software
Abstract
Our objective was to estimate the correlation of echodensity and textural features, using ultrasound and digital image analysis, between plaques in patients with bilateral carotid stenosis.
Cross-sectional observational study.
Patients undergoing carotid endarterectomy were recruited from Vascular Surgery at the Royal Victoria and Jewish General hospitals in Montreal, Canada. Bilateral pre-operative carotid ultrasound and digital image analysis was performed to extract echodensity and textural features using a commercially available Plaque Texture Analysis software (LifeQMedical Ltd). Principal component analysis (PCA) was performed. Partial correlation coefficients for PCA and individual imaging variables between surgical and contralateral plaques were calculated with adjustment for age, sex, contralateral stenosis, and statin use.
In the whole group (n = 104), the six identified PCA variables and 42/50 individual imaging variables were moderately correlated (r = .211-.641). Correlations between sides were increased in patients with =50% contralateral stenosis and symptomatic patients.
Textural and echodensity features of carotid plaques were similar between two sides in patients with bilateral stenosis, supporting the notion that plaque instability is determined by systemic factors. Patients with unstable features of one plaque should perhaps be monitored more closely or treated more aggressively for their contralateral stenosis, particularly if this is hemodynamically significant.
PubMed ID
23849798 View in PubMed
Less detail

Asymptomatic stenoses of carotid arteries.

https://arctichealth.org/en/permalink/ahliterature117203
Source
Angiol Sosud Khir. 2012;18(4):72-84
Publication Type
Article
Date
2012
Author
I M Ignat'ev
Source
Angiol Sosud Khir. 2012;18(4):72-84
Date
2012
Language
English
Russian
Publication Type
Article
Keywords
Aged
Asymptomatic Diseases
Brain Ischemia - etiology
Carotid Arteries - surgery - ultrasonography
Carotid Stenosis - complications - diagnosis - epidemiology - surgery
Data Interpretation, Statistical
Early Diagnosis
Early Medical Intervention
Endarterectomy, Carotid - adverse effects - methods - statistics & numerical data
Female
Humans
Male
Mass Screening - methods
Middle Aged
Outcome Assessment (Health Care) - statistics & numerical data
Postoperative Complications - epidemiology
Practice Guidelines as Topic
Prevalence
Randomized Controlled Trials as Topic
Risk factors
Russia - epidemiology
Ultrasonography, Doppler, Duplex - methods
Abstract
The study was aimed at determining the prevalence of carotid artery stenoses while carrying out a screening population examination and at specifying the indications for endarterectomy in symptom-free patients. We carried out a screening examination by means of duplex scanning of 624 people (495 men and 129 women) aged over 50 years old and having no transient or persistent neurological symptoms or a history of an endured ischaemic stroke. The patients' average age amounted to 58.8±8.7 years. The examined patients were subdivided into two groups. Group One was composed of 485 patients presenting with various risk factors for the development of stroke: arterial hypertension, CAD, diabetes mellitus, hereditary predisposition. Group Two consisted of 139 subjects with no evident manifesting signs of cardiovascular diseases. The frequency of revealing ICA stenoses > 50% in the group comprising patients with risk factors (14.8%) was significantly higher (p = 0.002) than that (4.5%) in the group of apparently healthy people. From 2009 to 2011 the operation of carotid endarterectomy (CEA) was performed in 89 (15.9% of the total number of CEA) patients with asymptomatic stenoses of carotid arteries (ASCA), ICA stenting was performed in 15 patients. CEA in patients with asymptomatic lesions was carried out in ICA stenoses from 70 to 99%, and in a series of patients with unstable and ulcerated plaques with a high degree of embolization according to the findings of TCDG in stenoses from 60% and more. There were neither strokes nor lethal outcomes after the operations. Also given is a brief review of the literature covering contemporary problems concerning ASCA.
PubMed ID
23324635 View in PubMed
Less detail

Atheromatous plaque reflects serum total cholesterol levels: a comparative morphologic study of endarterectomy coronary atherosclerotic plaques removed from patients from the southern part of India and Caucasians from Ottawa, Canada.

https://arctichealth.org/en/permalink/ahliterature205639
Source
Clin Cardiol. 1998 May;21(5):335-40
Publication Type
Article
Date
May-1998
Author
P J Varghese
S B Arumugam
K M Cherian
V. Walley
A. Farb
R. Virmani
Author Affiliation
Division of Cardiology, George Washington University Medical Center, Washington, D.C. 20037, USA.
Source
Clin Cardiol. 1998 May;21(5):335-40
Date
May-1998
Language
English
Publication Type
Article
Keywords
Adult
Cholesterol - blood
Coronary Artery Disease - epidemiology - ethnology - pathology
Endarterectomy
Humans
Incidence
India - epidemiology
Middle Aged
Ontario - epidemiology
Risk factors
Abstract
Natives of South India have a very high incidence of coronary artery disease, despite low calorie and fat intake.
This study was undertaken to determine whether morphologic features of atheromatous plaque reflect the serum total cholesterol.
Fifty-three endarterectomy specimens from patients (mean age 47 +/- 9 years, mean cholesterol 203 +/- 47 mg/dl) obtained from one cardiac surgeon working in a single institution in South India were evaluated. Morphologic findings were compared with 40 endoarterectomy specimens obtained from age-matched Caucasians from Ottawa, Canada, with a reported mean cholesterol of 262 +/- 47 mg/dl. Morphometric measurements of the vessel size, percent stenosis, and the various components of the atherosclerotic plaque were determined by computerized planimetry.
The vessel size was smaller in the Indian than in the Canadian population (4.6 +/- 2.9 vs. 5.6 +/- 3.0 mm2, p = 0.07), the plaque area was less (4.3 +/- 2.3 vs. 5.3 +/- 2.8 mm2, p = 0.055) and the calculated percent stenosis was significantly less (93 vs. 96%, p = 0.028). Of all the parameters evaluated, only necrotic core in the Indian population (7.1 +/- 10.9% vs. Canadian 16.7 +/- 19.7%, p
Notes
Comment In: Clin Cardiol. 1998 Sep;21(9):699-7009755391
PubMed ID
9595216 View in PubMed
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153 records – page 1 of 16.