Extracorporeal life support for severe ARDS in adults is a successful therapeutic option in those patients who do not respond to conventional mechanical ventilator strategies.
Endovascular repair of isolated IAAs appears safe and effective, with initial results similar to those after endovascular abdominal aortic aneurysm repair.
PSV and ICA/CCA increase with stenosis to a greater extent in stented carotid arteries, necessitating revision of existing US criteria to follow CAS patients. To determine > or = 70% in-stent stenosis, PSV > or = 350 cm/s and ICA/CCA ratio > or = 4.75 are sensitive criteria. To determine > or = 50% stenosis, combining PSV > or = 225 cm/s and ICA/PCA ratio > or = 2.5 is optimal.
Octogenarians undergoing carotid artery stenting are at higher risk than nonoctogenarians for periprocedural complications, including neurologic events and death. Major event-free survival at 1 year is also significantly better in nonoctogenarians. These risks should be weighed when considering carotid stenting in elderly patients.
Patients considered a surgical high risk can undergo CEA without any worse outcome compared with those patients deemed low risk. The benefit of CAS will likely be marginal, and only controlled clinical trials will be able to determine if certain subgroups demonstrate improved outcome with CAS. Carotid endarterectomy remains the standard of care, even in high-risk surgical patients.
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