Impact of diabetes mellitus on characteristics of carotid plaques and outcomes after carotid endarterectomy

Mizuhashi, Satomi; Kataoka, Hiroharu; Sano, Noritaka; Ideguchi, Minoru; Higashi, Masahiro; Miyamoto, Yoshihiro; Iihara, Koji

doi:10.1007/s00701-014-2040-x

Cited by 6 publications

(9 citation statements)

References 29 publications

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“…Study characteristics are summarized in Table I. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] All 14 finally selected studies were observational cohort studies published in English, with the majority (93%) being retrospective in design. Nine (64%) studies were from Europe, four (29%) from the United States, and one (7%) from Japan.…”

Section: Resultsmentioning

confidence: 99%

“…Sixth, stroke outcome reporting was variable across studies. Two of the 14 studies differentiated the rates of ipsilateral and contralateral stroke among diabetics vs nondiabetics in their outcome reporting, 11,17 whereas others reported only ipsilateral stroke or did not define the type of stroke reported. For the purposes of this meta-analysis, all strokes reported, regardless of whether they were ipsilateral or contralateral, were included to maintain a consistent outcome definition across studies.…”

Section: Table II Baseline Demographic and Clinical Characteristicsmentioning

confidence: 99%

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Impact of diabetes on carotid artery revascularization

Hussain

Bin-Ayeed

Saeed

et al. 2016

Journal of Vascular Surgery

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Diabetic patients are at an increased risk of perioperative stroke, death, and long-term mortality compared with nondiabetic patients who undergo carotid artery revascularization. This knowledge can help further risk stratify patients with carotid artery stenosis before treatment. Future studies should focus on evaluating which mode of revascularization (CEA or CAS) is more effective in diabetic patients with carotid artery stenosis.

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Section: Resultsmentioning

confidence: 99%

Section: Table II Baseline Demographic and Clinical Characteristicsmentioning

confidence: 99%

Impact of diabetes on carotid artery revascularization

Hussain

Bin-Ayeed

Saeed

et al. 2016

Journal of Vascular Surgery

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“…In the study by Liu et al including 572 patients, they compared 184 diabetic patients with nondiabetic patients and did not detect a statistically significant difference between the two groups in terms of carotid artery restenosis (diabetic 2.9% and nondiabetic 3.4%) compared to nondiabetic patients [ 15 ]. In the study Mizuhashi et al including 281 patients, they compared 136 diabetic patients with the remaining nondiabetic patients and found no significant difference between the two groups in terms of carotid artery restenosis [ 16 ]. As can be understood from these examples, there are conflicting results from the previous studies on carotid artery restenosis.…”

Section: Discussionmentioning

confidence: 99%

Do standard carotid artery endarterectomy and primary closure technique cause early restenosis in diabetic patients?

Kanber

Uğurlucan

Şahın

et al. 2017

Arch Med Sci Atheroscler Dis

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IntroductionWe aimed to investigate carotid restenosis in 2-year follow-up in diabetic and nondiabetic patients who underwent standard carotid endarterectomy with primary carotid closure and determine whether diabetes mellitus is a risk factor for early stenosis for this surgical procedure.Material and methodsWe retrospectively assessed the data of patients who underwent standard carotid endarterectomy with primary carotid closure from the hospital registry and outpatient clinic follow-up between January 2006 and January 2012. The study included 25 diabetics and 25 nondiabetics, in total 50 patients. The control carotid Doppler ultrasonographies and/or computed tomography angiographies of the patients at postoperative 1, 6, 12, and 24 months were examined and a stenosis rate between 70% and 99% was regarded as significant carotid restenosis.ResultsWhen the diabetic and nondiabetic group patients were compared for early carotid restenosis at 2 years, there were 3 (12%) patients in the diabetic group and 4 (16%) patients in the nondiabetic group with restenosis. A statistically significant difference in early carotid restenosis was not observed between the two groups (p > 0.05).ConclusionsStandard carotid endarterectomy and primary closure of the artery is a successfully performed surgical procedure in diabetic patients. We concluded that diabetes mellitus is not a risk factor for early restenosis in the diabetic patient population according to the results of our research.

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“…A total of 624 records were identified from 5 databases and 19 studies were included for final quantitative synthesis [Figure 1]. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Characteristics of the included studies Among the 19 studies in this meta-analysis, 122,003 patients undergoing CEA were included. All CEA procedures were performed after the year 2000, and studies were based on clinical registries, public medical databases, or single-center databases.…”

Section: Literature Search Processesmentioning

confidence: 99%

“…Compared to non-DM patients, DM patients had an increased risk of long-term MAEs after CEA (3 studies, 14,226 patients; ES: 1.24, 95% CI: 1.04-1.49, P = 0.018; prevalence in DM vs. non-DM:12.2% vs. 9.2%). [15,16,18] There was no significant association between DM and a higher long-term risk of stroke, [16,18,20,21] death/stroke, [16,18,20] death, [16,18,20,21] or MI 16,18 [Figure 3]. And the heterogeneity analysis shows that the I 2 values for all research indicators are less than 50%.…”

Section: Long-term Outcomesmentioning

confidence: 99%

Diabetes mellitus and adverse outcomes after carotid endarterectomy: A systematic review and meta-analysis

Zhang

et al. 2023

Chinese Medical Journal

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Background: There is still uncertainty regarding whether diabetes mellitus (DM) can adversely affect patients undergoing carotid endarterectomy (CEA) for carotid stenosis. The aim of the study was to assess the adverse impact of DM on patients with carotid stenosis treated by CEA. Methods: Eligible studies published between 1 January 2000 and 30 March 2023 were selected from the PubMed, EMBASE, Web of Science, CENTRAL, and ClinicalTrials databases. The short-term and long-term outcomes of major adverse events (MAEs), death, stroke, the composite outcomes of death/stroke, and myocardial infarction (MI) were collected to calculate the pooled effect sizes (ESs), 95% confidence intervals (CIs), and prevalence of adverse outcomes. Subgroup analysis by asymptomatic/symptomatic carotid stenosis and insulin/noninsulin-dependent DM was performed. Results: A total of 19 studies (n = 122,003) were included. Regarding the short-term outcomes, DM was associated with increased risks of MAEs (

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Impact of diabetes mellitus on characteristics of carotid plaques and outcomes after carotid endarterectomy

Abstract: DM does not increase the risk of perioperative complications and does not influence long-term outcomes after CEA if preexisting vascular risk factors and cardiac diseases are appropriately evaluated and treated before surgery.

Cited by 6 publications

References 29 publications

Impact of diabetes on carotid artery revascularization

Impact of diabetes on carotid artery revascularization

Do standard carotid artery endarterectomy and primary closure technique cause early restenosis in diabetic patients?

Diabetes mellitus and adverse outcomes after carotid endarterectomy: A systematic review and meta-analysis

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