Female and Obese Patients Might Have Higher Risk from Surgical Repair of Asymptomatic Carotid Artery Stenosis

Davidović, Lazar; Končar, Igor; Dragaš, Marko; Marković, Miroslav; Ilić, Nikola; Mutavdžic, Perica; Banzić, Igor; Ristanovic, Natasa

doi:10.1016/j.avsg.2015.03.032

Cited by 7 publications

(5 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to it the choice of shunting is also left to the discretion on the operating surgeon. On the other hand one of our studies did not find that the usage of shunt reduce the incidence of perioperative stroke occurrence 12) . Due to this we use the following strategy regarding the usage of shunt during CEA [25][26][27] .…”

Section: Comparison Of Eversion and Conven-tional Techniquescontrasting

confidence: 69%

“…Then new clamping follows, a common carotid artery is opened longitudinally, a shunt is placed and conventional CEA is performed. Thanks to previous strategy, we improved early results and significantly reduced the usage of carotid shunt from 37% at the period between 2000 and 2003, to only 7% during last years 12,21,[25][26][27] . Namely, beside well known advantages, the usage of carotid shunt also has some disadvantages.…”

Section: Comparison Of Eversion and Conven-tional Techniquesmentioning

confidence: 99%

See 1 more Smart Citation

Eversion Carotid Endarterectomy : A Short Review

Davidović

Tomić²

2020

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Carotid endarterectomy (CEA) is the main procedure in carotid surgery, as well as the most frequent vascular procedure. Two techniques of CEA are available : eversion and conventional plus patch angioplasty. Eversion CEA is anatomic procedure that reduces ischemic and total operative time. Simultaneous correction of the joined carotid kinking and coiling is possible, easy and safe, while the usage of patch is excluded. Thanks to oblique shape of anastomosis, eversion CEA is associated with low risk of long-term restenosis. The false anastomotic aneurysms occurrence is very rare, almost impossible after eversion CEA. However, the usage of carotid shunt during eversion CEA is not always simple, while proximal or distal extension of the carotid plaque can make eversion CEA more difficult and risky. Eversion CEA should be the first choice in carotid surgery. Conventional CEA is indicated in cases when carotid plaque is extended more than usual, as well as, if the usage of carotid shunt is necessary.

show abstract

Section: Comparison Of Eversion and Conven-tional Techniquescontrasting

confidence: 69%

Section: Comparison Of Eversion and Conven-tional Techniquesmentioning

confidence: 99%

Eversion Carotid Endarterectomy : A Short Review

Davidović

Tomić²

2020

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…If it is performed by an experienced surgeon, it is safe. 1,12,27) According to the present study, a preoperative color Doppler ultrasound image is a reliable preoperative estimator of the peripheral extension of the atherosclerotic plaque in the ICA.…”

Section: Discussionmentioning

confidence: 71%

“…It is well known that the most important technical problem in carotid endarterectomy is the distal extension of the atherosclerotic plaque, which is up to the skull base. 2 , 7 , 12 ) This could be an unpleasant revelation after having chosen to perform, in particular, an eversion endarterectomy and in front of an already divided ICA. At this point of no return, the procedure becomes more complicated, although there are several techniques that provide additional exposure of ICA and extensive exposure to the skull base.…”

Section: Discussionmentioning

confidence: 99%

Doppler is a Safe Criterion for Ensuring the Implementation of Eversion Carotid Endarterectomy

Christoforou

Bakoyiannis

Konidari

et al. 2021

Annals of Vascular Diseases

View full text Add to dashboard Cite

Objective: This is a prospective study concerning patients with symptomatic or asymptomatic significant carotid stenosis. Preoperative and intraoperative measurements of the peripheral extension of the carotid atherosclerotic plaque have been compared with postoperative measurements to identify a preoperative method that safely allows the performance of eversion carotid endarterectomy (ECEA). Materials and Methods: The study included 37 patients with symptomatic internal carotid stenosis greater than 70% and 43 patients with asymptomatic stenosis greater than 80%. Four methods were used for establishing criteria: preoperative Doppler examination, intraoperative measurement of the carotid atheroma before artery division, measurement of the removed plaque, and histological measurement of the plaque. Results: Preoperative Doppler examination is a method of estimating the actual distal extension of the internal carotid artery (ICA) atheroma, with correction as dictated by the following formula: In all cases, preoperative ultrasound measurements and intraoperative estimation confirmed the correct decision to proceed with the eversion technique. Conclusion: The peripheral extension of the atherosclerotic plaque of the ICA can be assessed with accuracy by preoperative Doppler study, which can be used with safety as a predicting criterion of the existence of healthy peripheral carotid tissue that allows the performance of the eversion endarterectomy technique.

show abstract

“…Therefore, it is necessary to identify patients with an increased risk of postoperative complications, which would enable adequate selection of those who will undergo surgery [3]. The available literature describes that risk factors for postoperative complications after CEA are most often related to age, sex, body mass index (BMI), the presence of other diseases, especially diabetes, the degree of stenosis and plaque characteristics, type of surgery, and anesthesia [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Body mass index and early outcomes after carotid endarterectomy

et al. 2022

View full text Add to dashboard Cite

As the existing data on the correlation of adiposity with adverse outcomes of carotid endarterectomy (CEA) are inconsistent, the aim of the present study is to examine the correlation of an increased body mass index with 30-day complications after carotid endarterectomy. The cohort study comprises 1586 CEAs, performed at the Clinic for Vascular Surgery in Belgrade, from 2012–2017. Out of them, 550 CEAs were performed in patients with normal body mass index (18.5–24.9), 750 in overweight (25.0–29.9), and 286 in obese (≥30) patients. The association of overweight and obesity with early outcomes of carotid endarterectomy was assessed using univariate and multivariate logistic regression analysis. Overweight patients, in whom CEAs were performed, were significantly more frequently males, compared to normal weight patients–Odds Ratio (OR) 1.51 (95% confidence interval– 1.19–1.89). Moreover, overweight patients significantly more frequently had non-insulin-dependent diabetes mellitus—OR 1.44 (1.09–1.90), and more frequently used ACEI in hospital discharge therapy—OR 1.41 (1.07–1.84) than normal weight patients. Additionally, the CEAs in them were less frequently followed by bleedings—OR 0.37 (0.16–0.83). Compared to normal weight patients, obese patients were significantly younger—OR 0.98 (0.96–0.99), and with insulin-dependent and non-insulin-dependent diabetes mellitus—OR 1.83 (1.09–3.06) and OR 2.13 (1.50–3.01) respectively. They also more frequently had increased triglyceride levels–OR 1.36 (1.01–1.83), and more frequently used oral anticoagulants in therapy before the surgery–OR 2.16 (1.11–4.19). According to the results obtained, overweight and obesity were not associated with an increased death rate, transient ischemic attack (TIA), stroke, myocardial infarction, or with minor complications, and the need for reoperation after carotid endarterectomy. The only exception was bleeding, which was significantly less frequent after CEA in overweight compared to normal weight patients.

show abstract

Female and Obese Patients Might Have Higher Risk from Surgical Repair of Asymptomatic Carotid Artery Stenosis

Cited by 7 publications

References 37 publications

Eversion Carotid Endarterectomy : A Short Review

Eversion Carotid Endarterectomy : A Short Review

Doppler is a Safe Criterion for Ensuring the Implementation of Eversion Carotid Endarterectomy

Body mass index and early outcomes after carotid endarterectomy

Contact Info

Product

Resources

About