Search results for "Carotid endarterectomy"
showing 10 items of 30 documents
carotid endarterectomy versus stenting in patients with contralateral carotid artery occlusion
2009
General anaesthesia versus local anaesthesia for carotidsurgery (GALA): a multicentre, randomised controlled trial.
2008
Background The eff ect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is off set by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. Methods We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between J…
Operācijas rezultātu korelācija ar miega artērijas revaskularizācijas metodēm
2014
Anotācija Miega artēriju stenozes ķirurģiskai korekcijai karotīdu endarterectomijai ir būtiska nozīme insulta profilaksē. Promocijas darba mērķis: Izvērtēt miega artērijas endarterektomiju operāciju rezultātus, ņemot vērā intima-media slāņa biezumu un pacienta dzīves kvalitāti. Promocijas darbā autore veikusi pētījumu, kas atspoguļo karotīdu endarterektomijas operāciju rezultātus (komplikācijas, dzīves kvalitātes izmaiņas) un intīmas hiperplāzijas attīstību postoperatīvā periodā. Izveidota speciāla dzīves kvalitātes novērtēšanas anketa pacientiem ar miega artērijas sašaurinājumu. Pētījuma materiālu veido 104 pacienti, kuriem veiktas karotīdu endarterektomijas. Darbs veikts Latvijas Universi…
Interaction of cerebrovascular disease and contralateral carotid occlusion in prediction of shunt insertion during carotid endarterectomy
2012
INTRODUCTION To assess the possible role and the interaction of cerebrovascular disease and vascular stenosis on the necessity of shunt insertion during carotid endarterectomy (CEA). MATERIAL AND METHODS Eighty consecutive patients undergoing CEA under regional anaesthesia were prospectively enrolled. Patients were divided into two groups depending on whether they were shunted or not. The measured end-points were co-morbidities degree of contralateral and carotid stenosis and other intra- and postoperative outstanding parameters. ANOVA, Student's t and χ(2) tests were used (p<0.05). Variables differing significantly between groups and potential confounders were used in backward stepwise log…
Transverse Small Skin Incision for Carotid Endarterectomy
2015
The purpose of this report is to determine the feasibility of short transverse skin incision (STI4 cm) for eversion (EEA) and patch (PEA) endarterectomy with or without shunt by comparing it with the outcomes after long transverse skin incision (LTI 4-8 cm).Of 164 elective consecutive patients (71 ± 2.73% symptomatic) operated at one institution over 24 months, 81 were treated with STI, while 83 patients received LTI. The LTI and STI groups did not differ in terms of age, symptoms, or risk factors. EEA or PEA under locoregional (LRA) or general (GA) anesthesia were performed.STI was associated with shorter operation times (75.19 ± 15.33 vs. 94.87 ± 41 and 99.4 ± 27.36 vs. 132.66 ± 51.32, re…
IMPACT OF CAROTID ENDARTERECTOMY ON COGNITIVE PERFORMANCE AND DEPRESSIVE SYMPTOMS
2016
OBJECTIVES: This study aims to evaluate the impact of carotid endarterectomy (CEA) on cognitive performance in patients with severe carotid disease and depressive symptoms, and to explore the possible associations between certain demographics, clinical characteristics, and cognitive function and depression. MATERIALS AND METHODS: The study included 48 patients, who were referred for endarterectomy. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, while depressive symptoms were assessed using the patient health questionnaire(PHQ-9) scale. An assessment of cognitive and depressive symptoms was performed 1–3 days before surgery, and then six months after. R…
Plasma Testosterone Levels and Atherosclerotic Plaque Gene Expression in Men With Advanced Atherosclerosis
2021
Aims: Low plasma testosterone levels have been shown to predict worse outcome in men with severe atherosclerotic disease. We hypothesized that a low plasma testosterone level affects disease risk through changes in gene expression in atherosclerotic plaques. Therefore, we studied plasma testosterone levels in relation to gene expression levels in atherosclerotic plaque tissue of men with advanced atherosclerotic disease.Methods: Plasma testosterone levels were measured in 203 men undergoing carotid endarterectomy. The corresponding atherosclerotic plaque tissue was used for RNA sequencing. First, we assessed how often the androgen receptor gene was expressed in the plaque. Second, correlati…
Revacept, an Inhibitor of Platelet Adhesion in Symptomatic Carotid Artery Stenosis: Design and Rationale of a Randomized Phase II Clinical Trial
2020
AbstractPatients with stroke or transient ischemic attacks (TIAs) and internal carotid artery stenosis harbor an increased risk of recurrent stroke especially within 2 weeks after the first event. In addition, the revascularization procedure itself (carotid endarterectomy [CEA] or carotid artery stenting [CAS]) is associated with both clinically apparent and silent brain infarctions, mainly caused by the embolic nature of the ruptured carotid plaque. The glycoprotein VI (GPVI) fusion protein Revacept is a highly specific antithrombotic drug without direct inhibition of systemic platelet function that might reduce periprocedural distal embolization from the vulnerable ruptured plaque located…
Anesthetics and Cerebral Protection in Patients Undergoing Carotid Endarterectomy
2015
EREBRAL ISCHEMIA/HYPOXIA may occur in a vari-ety of perioperative circumstances. The main pathophy-siologic aspects involved in cerebral ischemia/reperfusion arecaused by adenosine triphosphate (ATP) consumption, theexcitotoxic actions of glutamate, changes in ionic homeostasis,and formation of free radicals (Fig 1). Outcomes from suchevents range from subclinical neurocognitive deficits to cata-strophic neurologic morbidity or death.
Evaluación de la desaturación regional cerebral de oxígeno monitorizada mediante oximetría cerebral INVOS como método de detección de isquemia cerebr…
2022
Hipótesis: La monitorización de la saturación cerebral regional de oxígeno con el oxímetro INVOS- 5100 es eficaz en la detección de la isquemia cerebral intraoperatoria en la endarterectomía carotídea. Objetivo principal: Evaluar la oximetría cerebral INVOS como método de detección de isquemia cerebral en la cirugía carotídea. Para ello, se comparará el descenso en la saturación cerebral regional de oxígeno INVOS en el grupo de pacientes que presente clínica neurológica en el clampaje carotídeo con el grupo que permanece sin clínica. Objetivos secundarios: 1. Establecer un valor crítico de desaturación cerebral INVOS, absoluto y porcentual, a partir del cual aparece clínica neurológica y es…