Tag Archives: carotid endarterectomy

Carotid Endarterectomy vs. Carotid Angioplasty in Symptomatic and Asymptomatic Patients: 30-Day Outcomes

Carotid Endarterectomy vs. Carotid Angioplasty in Symptomatic and Asymptomatic Patients: 30-Day Outcomes

Extracranial carotid artery disease represents 15 to 20% of all strokes. Carotid revascularization plays a role in primary and secondary prevention of cerebrovascular events. Outcomes of two common revascularization strategies, Carotid endarterectomy (CAE) and carotid artery stenting (CAS), have been studied and compared. In recent years, complications associated to CAS have dropped thanks to technical

tavi funcion cognitiva

Asymptomatic Carotid Lesions and Cognitive Impairment: Does Intervention Play a Role?

This study was designed to determine the effect of carotid endarterectomy/angioplasty on early (baseline vs. 3 months) and late (baseline vs. >5 months) cognitive function in patients with asymptomatic lesions. This systematic research included 31 non-randomized studies. Regarding the immediate post-operative period, 24 of these papers reported significant improvement in cognitive function; one study reported significant deterioration;

ESC 2021 | ACST-2: CAS vs endarterectomía en pacientes asintomáticos

ESC 2021 | ACST-2: CAS vs Endarterectomy in Asymptomatic Patients

The ACST-2 was designed to compare long-term outcomes of carotid artery stenting (CAS) vs carotid endarterectomy (CEA) in patients with asymptomatic stenosis.  Prior to this study we had the German registry including 18,000 patients undergoing CAS and 86,000 receiving CEA between 2014 and 2019. At 30 days, disabling stroke rate was 0.7% for both strategies.

La endarterectomía precoz parece superior a la angioplastia carotidea en pacientes sintomáticos

Contralateral Occluded Carotid Defines Revascularization Strategy

A significative lesion to the carotid artery in addition to contralateral carotid occlusion is an obvious factor of high risk for a revascularization procedure. However, this might be true for surgery but not for carotid artery stenting according to this recent publication in JACC. The presence of contralateral carotid occlusion has been established as high

Otro “escándalo” en la medicina basada en la evidencia ¿El monitoreo ambulatorio de presión puesto en duda?

Do We Need to See a Cardiologist before a Carotid Endarterectomy?

Cardiac complications are among the most frequent in patients undergoing carotid endarterectomy for asymptomatic lesions.  This excess of cardiac events in patients with no neurological symptoms of carotid stenosis is essential to balance the risk/benefit ratio of carotid endarterectomy.  A routine cardiology consultation prior surgery could reduce perioperative infarction rate, general complications and even mortality. 

Nuevo dispositivo para tener mayor protección en la angioplastia carotídea

Natural History of Severe and Asymptomatic Carotid Lesions

Deciding whether to intervene a severe (70-80%) carotid lesion in an asymptomatic patient is challenging. We know the margin of error is small and an excess of events caused by the intervention could tilt the scales. However, the updated information on the natural evolution of these lesions is scarce. This retrospective analysis included asymptomatic patients

Lesión de múltiples vasos y enfermedad carotidea severa ¿Cómo proceder?

Multivessel Disease and Severe Carotid Stenosis: How to Proceed

Myocardial revascularization surgery (CABG) is the most frequent of all cardiovascular surgeries and is still the gold standard to treat multivessel disease.  Between 6 and 8% of these patients present concomitant carotid stenosis and it is associated with increased peri and post procedural stroke rates during and after surgery. To prevent carotid stenosis, either PCI or endarterectomy

Pretratamiento con estatinas para prevenir eventos peri angioplastia carotidea

Statin Pre-Treatment for the Prevention of Peri-Procedural Events in Carotid Artery Stenting

Recent randomized studies have shown that the rates of combined peri-procedural events for carotid artery stenting and carotid endarterectomy are similar. While the final numbers are similar, the actual events are different: more infarction events for endarterectomy and more stroke (particularly minor stroke) events for carotid artery stenting. The reduction of these rates of stroke has been the aim of

La endarterectomía precoz parece superior a la angioplastia carotidea en pacientes sintomáticos

Early Endarterectomy Seems Superior to Carotid Stenting in Symptomatic Patients

Patients with symptomatic stenosis of the internal carotid artery benefit from early intervention. The challenge lies in what intervention to choose.  Most studies comparing endarterectomy to carotid stenting are fairly heterogeneous as regards timing of intervention. This element is key to comparing between procedures, since there is no doubt timing will directly affect results.  

enfermedad carotídea y coronaria severa

Best Revascularization Strategy for Severe Carotid and Coronary Artery Disease

Courtesy of Dr. Carlos Fava. Carotid artery disease is an important cause of stroke and is associated to coronary artery disease. When patients need myocardial revascularization surgery (Carotid Artery Bypass Graft) and cannot wait one month or more for carotid revascularization, the optimal management strategy is still controversial.   The aim of this study was