Suggested standards for reports dealing with cerebrovascular disease

Jd, Baker; Rb, Rutherford; Ef, Bernstein; R, Courbier; Cb, Ernst; Rf, Kempczinski; Ts, Riles; Ck, Zarins

doi:10.1067/mva.1988.avs0080721

Cited by 63 publications

(46 citation statements)

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“…Perioperative complications were defined as complications occurring within 30 days of the CEA. 14 Strokes were defined as ipsilateral territory permanent deficits and/or the presence of a new ipsilateral infarct on computed tomography (CT) or magnetic resonance imaging (MRI). Neck hematomas requiring surgical reexploration were included for analysis and comparison, whereas neck hematomas that required extension of hospitalization or required readmission were not included but were mentioned in the results section to aid in the description of such occurrences.…”

Section: Methodsmentioning

confidence: 99%

Prospective Randomized Trial of ACUSEAL Versus Vascu-Guard Patching in Carotid Endarterectomy

Stone

AbuRahma

Mousa

et al. 2014

Annals of Vascular Surgery

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Background Multiple studies have been conducted that demonstrate the superiority of patch angioplasty over primary closure for carotid endarterectomy (CEA). Patch angioplasty with poly-tetrafluorethylene patches (ACUSEAL) have shown results comparable to patch angioplasty with saphenous vein and polyester patches. This is a prospective randomized study to compare the clinical outcomes of CEA using ACUSEAL versus bovine pericardium patching (Vascu-Guard). Methods Two hundred patients were randomized (1:1) to either ACUSEAL or Vascu-Guard patching. Demographic data/clinical characteristics were collected. Intraoperative hemostasis times and the frequency of reexploration for neck hematoma were recorded. All patients received immediate and 1-month postoperative duplex ultrasound studies, which were repeated at 6-month intervals. A Kaplan–Meier analysis was used to estimate the risk of restenosis and the stroke-free survival rates. Results The demographics were similar in both groups, except for a higher incidence of current smokers in the ACUSEAL group and more patients with congestive heart failure in the Vascu-Guard group (P = 0.02 and 0.03, respectively). The mean operative internal carotid artery diameter and the mean arteriotomy length were similar in both groups. The mean hemostasis time was 4.90 min for ACUSEAL patching vs. 3.09 min for Vascu-Guard (P = 0.027); however, the mean operative times were similar for both groups (ACUSEAL 2.09 hr vs. Vascu-Guard 2.16 hr, P = 0.669). The incidence of reexploration for neck hematoma was higher in the Vascu-Guard group; 6.12% vs. 1.03% (P = 0.1183). The incidence of perioperative ipsilateral neurologic events was 3.09% for ACUSEAL patching vs. 1.02% for Vascu-Guard patching (P = 0.368). The mean follow-up period was 15 months. The respective freedom from ≥70% carotid restenosis at 1, 2, and 3 years were 100%, 100%, and 100% for ACUSEAL patching vs. 100%, 98%, and 98% for Vascu-Guard patching (P = 0.2478). The ipsilateral stroke-free rates at 1, 2, and 3 years were 96% for ACUSEAL and 99% for Vascu-Guard patching. Conclusions Although CEA patching with ACUSEAL versus Vascu-Guard differed in hemostasis time, the frequency of reexploration for neck hematomas was more frequent in the pericardial patch group; however, only 1 patient had documented suture line bleeding and the surgical reexploration rate is not likely to be patch related. There were not any significant differences in perioperative/late neurologic events and late restenosis in the 2 groups.

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Section: Methodsmentioning

confidence: 99%

Prospective Randomized Trial of ACUSEAL Versus Vascu-Guard Patching in Carotid Endarterectomy

Stone

AbuRahma

Mousa

et al. 2014

Annals of Vascular Surgery

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“…Comorbidities (cardiac, renal, and pulmonary) and cardiovascular risk factors (diabetes, tobacco use, hypertension, and hyperlipidemia) were graded using the scheme proposed by the Subcommittee on Reporting Standards for Cerebrovascular Disease (15). Height and weight were measured in patients in the standing position without shoes.…”

Section: Methodsmentioning

confidence: 99%

Endogenous sex hormone levels in postmenopausal women undergoing carotid artery endarterectomy

Debing¹,

Peeters²,

Duquet³

et al. 2007

eur j endocrinol

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Objective: To study the endogenous sex hormone levels in natural postmenopausal women and their association with the presence of internal carotid artery (ICA) atherosclerosis. Design: Case-control study Methods: We compared 56 patients with severe ICA atherosclerosis referred for carotid artery endarterectomy (CEA) with 56 age-matched control subjects free of severe atherosclerotic disease. The presence of atherosclerosis was determined by high-resolution B-mode ultrasound. Metabolic parameters and sex hormones were measured or calculated: total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, quantitative insulin sensitivity check index, insulin resistance index, IGF-I, DHEA, DHEA sulfate (DHEA-S), free testosterone, total testosterone, estrone, estradiol, androstenedione, and sex hormone-binding globulin. Results: The cases had statistically significant lower levels of both total testosterone (0.23G0.12 vs 0.31G0.20 mg/l, PZ0.043) and free testosterone (3.42G1.94 vs 4.59G2.97 ng/l, PZ0.009) and significantly lower levels of androstenedione (625.3G168.7 vs 697.0G211.9 ng/l, PZ0.017) when compared with controls. Multivariate linear regression analysis, adjusted for traditional cardiovascular risk factors, baseline and physiologic characteristics, showed a significant inverse relationship between both serum free testosterone (bZK0.234, PZ0.028) and androstenedione (bZK0.241, PZ0.028) levels with the presence of severe atherosclerosis of ICA. Conclusions:The study provides evidence of a positive association between low serum androgen levels and severe ICA atherosclerosis in postmenopausal women. It suggests that higher, but physiological, levels of androgens in postmenopausal women have a protective role in the development of atherosclerosis of ICA.European Journal of Endocrinology 156 687-693

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“…Reportable complications including death, TIA, stroke, and asymptomatic occlusive events were determined in accordance with the North American Chapter of the International Society of Cardiovascular Surgery/Society for Vascular Surgery Ad Hoc Suggested Standard for Reports Dealing with Cerebrovascular Disease. 13 …”

Section: Postoperative Follow-up and Surveillance Protocolmentioning

confidence: 99%

Perioperative and Late Stroke Rates of Carotid Endarterectomy Contralateral to Carotid Artery Occlusion

AbuRahma

Robinson

Holt

et al. 2000

Stroke

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Background and Purpose-Several previous studies have reported the benefits of carotid endarterectomy (CEA) contralateral to carotid occlusion with mixed results, but none of these were randomized except for the North American Symptomatic Carotid Endarterectomy Trial. The purpose of this study was to analyze the results of surgery in patients with contralateral carotid artery occlusion in a randomized trial in which randomization was done according to the method of closure. Methods-In 399 CEAs (357 patients) that were randomized into primary closure versus patching, 49 had contralateral occlusion. Strokes were designated as ipsilateral if they arose from the same CEA side and contralateral if they arose from the occluded side. A Kaplan-Meier analysis was used to estimate perioperative strokes and stroke-free survival in patients with contralateral occlusion (group A) versus those without contralateral occlusion (group B). Results-Demographic characteristics and mean follow-up for both groups were similar (group A, 40 months; group B, 33 months). Group A had a higher incidence of contralateral transient ischemic attacks (TIAs) (12.2% versus 0.9%; PϽ0.0001), contralateral strokes (2% versus 0%; Pϭ0.025), and combined contralateral TIAs/strokes (14.3% versus 0.9%; PϽ0.0001). The rates for perioperative and all strokes (operative and late) were 2% and 4.1% (2% ipsilateral and 2% contralateral strokes) for group A and 2.9% and 3.4% (all ipsilateral) for group B (Pϭ0.60 and 0.85, respectively). The rates for perioperative and all TIAs were 0% and 14.3% for group A versus 2.6% and 6.3% for group B (Pϭ0.918 and Pϭ0.08, respectively). The rates for perioperative and all neurological events (TIA and stroke) were 2% and 18.4% for group A and 5.4% and 9.7% for group B (Pϭ0.27 and 0.113, respectively). The cumulative stroke-free survival rates at 5 years were 84% for group A and 77% for group B (PϾ0.1). The cumulative stroke-free survival rates at 5 years for symptomatic and asymptomatic patients in group A and group B were also similar. The perioperative and late deaths were similar for both groups (group A, 8%; group B, 14%). Conclusions-Group A had a higher incidence of contralateral TIAs and strokes than group B; however, the perioperative and all late stroke rates and survival rates of CEA were comparable in patients with and without contralateral occlusion.

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Suggested standards for reports dealing with cerebrovascular disease

Cited by 63 publications

References 0 publications

Prospective Randomized Trial of ACUSEAL Versus Vascu-Guard Patching in Carotid Endarterectomy

Prospective Randomized Trial of ACUSEAL Versus Vascu-Guard Patching in Carotid Endarterectomy

Endogenous sex hormone levels in postmenopausal women undergoing carotid artery endarterectomy

Perioperative and Late Stroke Rates of Carotid Endarterectomy Contralateral to Carotid Artery Occlusion

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