Background and Purpose-Adipophilin is an adipose differentiation-related protein expressed in lipid-containing cells.Using DNA microarray analysis, we previously found the adipophilin gene (ADFP) to be overexpressed in symptomatic carotid plaques (CP
Objective: Few studies have been published on the safety of carotid endarterectomy (CEA) after intravenous thrombolysis (IVT). Registry reports have been recommended in order to gather large study groups.Design: A retrospective, registry based, case controlled study on prospectively gathered data from Sweden, the capital region of Finland, and from Denmark, including 30 days of follow up.Methods: The study group was a consecutive series of 5526 patients who had CEA for symptomatic carotid artery stenosis during a 4.5 year period. Among these, 202 (4%) had IVT prior to surgery, including 117 having CEA within 14 days, and 59 within 7 days of thrombolysis. IVT as well as CEA were performed following established guidelines. The median time from index symptom to CEA was 12 days (range 0e130, IQR 7e21).Results: The 30 day combined stroke and death rate was 3.5% (95% CI 1.69e6.99) for those having IVT + CEA, 4.1% (95% CI 3.46e4.39) for those having CEA without previous IVT (odds ratio 0.84 [95% CI 0.39e1.81]), 3.4% (95% CI 1.33e8.39) for those having IVT + CEA within 14 days, and 5.1% (95% CI 1.74e13.91) for those having IVT + CEA within 7 days.Conclusion: Data on the time from symptoms to CEA in patients not having IVT, Rankin score, degree of stenosis, and cerebral imaging were not available. Despite its weaknesses, this study reasserts that CEA can be performed within the recommended 2 weeks of the onset of symptoms and IVT without increasing the risk of peri-operative stroke or death. Centres and vascular registries are recommended to continue monitoring changes in patient characteristics, lead times, and major complications after CEA in general, with a special focus on those who have undergone a prior thrombolysis.
Purpose
Retinal vascular function was assessed in patients with carotid stenosis (CS) before and six months after carotid endarterectomy (CEA) and in controls at a six‐month interval.
Methods
We studied 68 patients (81% male, mean age 69) and 41 healthy non‐medicated controls (77%, 68) from March 2015 to December 2018. Our ophthalmological examination included flicker‐induced arteriolar and venular measurements with a Dynamic Vessel Analyser in both eyes.
Results
At baseline, flicker‐induced arteriolar and venular dilation was reduced in the ipsilateral eyes of the patients compared with dilation in the controls (arteriolar 1.0% versus 2.6%, p = 0.001 and venular 2.2% versus 2.8%, p = 0.049). These differences subsided after CEA. In patients' ipsilateral eyes, flicker‐induced arteriolar dilation was borderline postoperatively (preoperative 1.0% versus postoperative 1.6%, p = 0.06), whereas venular dilation increased (2.2% versus 2.8%, p = 0.025). We found various tentative associations with the change in flicker‐induced dilations after CEA, but not with the preoperative dilations.
Conclusions
Postoperative recovery of the reduced flicker‐induced arteriolar and venular dilatation in the ipsilateral eye shows that, after CEA, the activity‐dependent vascular reactivity of haemodynamically compromised retinal tissue can improve.
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