Carotid endarterectomy continues to be an operation that is widely employed and associated with excellent outcomes. Challenges to attain adequate field visualization do occur. A new retracting device is described that vastly improves operative field visualization, particularly in the upper area where high lesions and limited cervical mobility can restrict or hamper technical maneuvers. Complex maneuvers such as mandibular subluxation or osteotomy may be obviated.
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Emergency carotid endarterectomy with stent retrieval in a patient with stent migration following failed carotid artery stenting.
Indian J Thorac Cardiovasc Surg
February 2025
Department of CTVS, AIIMS, Jodhpur, 342005 India.
Carotid artery stenting (CAS) has become a favoured alternative to surgical carotid endarterectomy (CEA) in select cases of critical internal carotid artery (ICA) occlusion. However, complications such as stent migration or entrapment can occur, necessitating prompt diagnosis and intervention. We present a case of a 75-year-old diabetic male who underwent CAS for recurrent presyncope at a private hospital, and during the procedure of CAS the stent was migrated and its proximal part was impacted in the critically narrowed part of the ICA.
View Article and Find Full Text PDFTemporal changes and implications of diffusion tensor imaging metrics and cerebral white matter volume in patients undergoing carotid endarterectomy - a prospective study.
Neuroradiology
January 2025
Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Aims: To test utility of diffusion MRI-derived indices in carotid endarterectomy (CEA), change of diffusion tensor imaging (DTI) metrics, cerebral white matter (WM) volumes were evaluated and predictors of overall mortality determined.
Methods: Prospectively enrolled participants had preoperative, immediate and late postoperative DTI after CEA. WM volumes, DTI metrics (fractional anisotropy, FA; axial, radial, mean diffusivities; AD, RD, MD, respectively) were calculated for the index/contralateral hemispheres at all time points.
Advancing Vascular Surgery: The Role Of Artificial Intelligence And Machine Learning In Managing Carotid Stenosis.
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RISE@Health, Rua Dr. Plácido da Costa, Porto, Portugal; Department of Biomedicine - Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal.
Introduction: Cardiovascular diseases affect 17.7 million people annually, worldwide. Carotid degenerative disease, commonly described as atherosclerotic plaque accumulation, significantly contributes to this, posing a risk for cerebrovascular events and ischemic strokes.
View Article and Find Full Text PDFPrecision in Stroke Care: A Novel Model for Predicting Functional Independence in Urgent Carotid Intervention Patients.
J Am Coll Surg
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- The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA.
Background: Stroke requires timely intervention, with carotid endarterectomy (CEA) and carotid artery stenting (CAS) increasingly used in select acute carotid-related stroke patients. We aimed to build a model to predict neurologic functional independence (modified Rankin scale, mRS ≤ 2) in this high-risk group.
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January 2025
Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea. (K.-D.S.).
Background: Carotid artery stenting (CAS) is an alternative treatment for patients with carotid artery stenosis who are not eligible for carotid endarterectomy. Dual antiplatelet therapy (DAPT) after CAS aims to prevent ischemic stroke. However, its optimal duration remains unclear.
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