Clinical Results of Carotid Denervation by Adventitial Stripping in Carotid Sinus Syndrome

Toorop, Raechel J.; Scheltinga, Marc R.; Huige, M. C.; Moll, Frans L.

doi:10.1016/j.ejvs.2009.09.009

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…Thus, CB denervation became a procedure performed on patients in instances of carotid sinus syndrome, asthma or pulmonary disease. (For J Physiol 596.15 more details on benefits and risks see Holton & Wood, 1965;Marschke et al 1965;Wood et al 1965;Toorop et al 2010;Fitzgerald, 2014;Gourine & Funk, 2017;Iturriaga, 2018).…”

Section: Unravelling the Network Mechanisms Underlying Peripheral Andmentioning

confidence: 99%

Advances in cellular and integrative control of oxygen homeostasis within the central nervous system

Ramírez

Severs

Ramirez

et al. 2018

The Journal of Physiology

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Mammals must continuously regulate the levels of O and CO , which is particularly important for the brain. Failure to maintain adequate O /CO homeostasis has been associated with numerous disorders including sleep apnoea, Rett syndrome and sudden infant death syndrome. But, O /CO homeostasis poses major regulatory challenges, even in the healthy brain. Neuronal activities change in a differentiated, spatially and temporally complex manner, which is reflected in equally complex changes in O demand. This raises important questions: is oxygen sensing an emergent property, locally generated within all active neuronal networks, and/or the property of specialized O -sensitive CNS regions? Increasing evidence suggests that the regulation of the brain's redox state involves properties that are intrinsic to many networks, but that specialized regions in the brainstem orchestrate the integrated control of respiratory and cardiovascular functions. Although the levels of O in arterial blood and the CNS are very different, neuro-glial interactions and purinergic signalling are critical for both peripheral and CNS chemosensation. Indeed, the specificity of neuroglial interactions seems to determine the differential responses to O , CO and the changes in pH.

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Section: Unravelling the Network Mechanisms Underlying Peripheral Andmentioning

confidence: 99%

Advances in cellular and integrative control of oxygen homeostasis within the central nervous system

Ramírez

Severs

Ramirez

et al. 2018

The Journal of Physiology

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“…First, an exaggerated bradycardic response to eyeball pressure (oculo‐vagal reflex) and tilt‐induced syncope are often present in patients with CSH . Secondly, CSH is associated with other forms of reflex syncope such as swallowing, cough, micturition and defaecation syncope . According to this view, CSH is an indicator of a susceptibility to reflex syncope that can be triggered in various ways.…”

Section: Physiological Mechanisms Underlying Cshmentioning

confidence: 99%

“…A lack of reproduction of spontaneous symptoms of hypotension after atropine administration has also been applied . Others simply reported that atropine was used to abolish heart rate slowing and allow differentiation of pure cardioinhibitory, vasodepressor and mixed types of CSH . Furthermore, cardioinhibitory CSH was diagnosed by some without using atropine or pacing to quantify the vasodepressor response .…”

Section: Haemodynamic Consequences Of Cardioinhibition and Vasodepresmentioning

confidence: 99%

At the heart of the arterial baroreflex: a physiological basis for a new classification of carotid sinus hypersensitivity

et al. 2013

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The aim of this review is to provide an update of the current knowledge of the physiological mechanisms underlying reflex syncope. Carotid sinus syncope will be used as the classical example of an autonomic reflex with relatively well-established afferent, central and efferent pathways. These pathways, as well as the pathophysiology of carotid sinus hypersensitivity (CSH) and the haemodynamic effects of cardiac standstill and vasodilatation will be discussed. We will demonstrate that continuous recordings of arterial pressure provide a better understanding of the cardiovascular mechanisms mediating arterial hypotension and cerebral hypoperfusion in patients with reflex syncope. Finally we will demonstrate that the current criteria to diagnose CSH are too lenient and that the conventional classification of carotid sinus syncope as cardioinhibitory, mixed and vasodepressor subtypes should be revised because isolated cardioinhibitory CSH (asystole without a fall in arterial pressure) does not occur. Instead, we suggest that all patients with CSH should be thought of as being 'mixed', between cardioinhibition and vasodepression. The proposed stricter set of criteria for CSH should be evaluated in future studies.

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“…The data is very significant: it is demonstrated that patients remain asymptomatic and this is index that alternative therapeutic answers there are. May be they are more complex and more difficult to implement, less documented, but certainly no less reliable, than PM implantation [10][11][12][13]. However, what we need to discuss here is the pathophysiological significance of the surgical intervention.…”

Section: Chs and Brainmentioning

confidence: 99%

“…The experience is limited to two surgical groups and a few cases [10][11][12]. The more recent review [13] refers to 130 procedures.…”

Section: Chs and Brainmentioning

confidence: 99%

Carotid Sinus Hypersensibility: A Concept on the Way

Lagi¹

2013

IJCM

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This review examines the pathogenesis of Carotid Sinus Hypersensitivity (CSH) by describing the different hypotheses that exist in literature. One hypothesis is that CSH is not a disease of the heart but of the central and/or peripheral nervous system where the heart is the victim. CSH is associated with cognitive disturbance, vasovagal syncope and orthostatic hypotension. Another hypothesis is that the CSH is considered a syndrome or a symptom associated with different diseases so as to require a diagnostic framework. This Hypothesis is the basis of frequent recurrences that are associated with the pacemaker implant therapy only.

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Clinical Results of Carotid Denervation by Adventitial Stripping in Carotid Sinus Syndrome

Abstract: Carotid denervation by adventitial stripping of the proximal carotid internal artery is effective and safe and may offer a valid alternative for pacemaker treatment in patients with carotid sinus syndrome.

Cited by 11 publications

References 29 publications

Advances in cellular and integrative control of oxygen homeostasis within the central nervous system

Advances in cellular and integrative control of oxygen homeostasis within the central nervous system

At the heart of the arterial baroreflex: a physiological basis for a new classification of carotid sinus hypersensitivity

Carotid Sinus Hypersensibility: A Concept on the Way

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