Publications by authors named "B Radulescu"
Article Synopsis
- Carotid endarterectomy is a procedure used to prevent strokes in patients with narrowed carotid arteries, but it can lead to serious complications like severe hypotension, which increases the risk of stroke and heart issues.
- A study of 160 patients found that 30.6% experienced severe hypotension, with common risk factors including diabetes, heart valve issues, and longer surgery times.
- The use of a temporary shunt during surgery was specifically linked to an increased likelihood of severe hypotension, suggesting that selective shunting may be beneficial for patients with additional health concerns.
Multiple strategies for tandem severe carotid artery stenosis are reported: bilateral carotid artery endarterectomy (CEA), bilateral carotid artery stenting (CAS), and hybrid procedures (CEA and CAS). The management is controversial, considering the reported high risk of periprocedural stroke, hemodynamic distress, and cerebral hyperperfusion syndrome. We present the case of a 64-year-old patient with severe symptomatic bilateral internal carotid artery stenosis (95% stenosis on the left internal carotid artery with recent ipsilateral watershed anterior cerebral artery-medial cerebral artery (ACA-MCA) and medial cerebral artery-posterior cerebral artery (MCA-PCA) ischemic strokes and 90% stenosis on the right internal carotid artery with chronic ipsilateral frontal ischemic stroke) managed successfully with staged CEA within a 3-day interval.
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- * Key findings reveal that 27.5% of patients experienced new postoperative ischemic strokes, and obesity was associated with higher rates of complications such as in-hospital deaths, smoking, and hypertension.
- * Logistic regression indicated that selective bilateral cerebral perfusion lasting over 40 minutes significantly increased the risk of ischemic stroke in obese patients, suggesting the need for personalized strategies in managing cerebral perfusion for these individuals.
Coronary artery fistulas draining into the left ventricle is a rare finding. They can be associated with other congenital cardiac anomalies like ventricular septal defect or tetralogy of Fallot. While most of them are asymptomatic, they can lead to severe cardiac complications like infective endocarditis, heart failure, or myocardial ischemia.
View Article and Find Full Text PDF: Postoperative neurological complications (NCs) are an important cause of mortality in patients with acute type A aortic dissection (ATAAD). The aim of the study was to determine the association between intraoperative risk factors and newly developed postoperative NCs in patients after emergency surgery for ATAAD. : A total of 203 patients requiring emergency surgery were included in the study.
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