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The PERFORMANCE II Trial: A Prospective Multicenter Investigation of a Novel Carotid Stent System.
JACC Cardiovasc Interv
December 2024
Department for Angiology, Brandenburg Medical School Theodor Fontane, Campus Clinic Brandenburg, Center for Internal Medicine I, Berlin, Germany; Department of Angiology, Sankt-Gertrauden-Krankenhaus, Berlin, Germany.
Background: Several randomized clinical trials have shown that the composite endpoint of death, stroke, and myocardial infarction (MI) is equivalent between carotid artery stenting and carotid endarterectomy. However, the risk of minor stroke has been consistently higher with carotid artery stenting.
Objectives: The authors sought to evaluate the safety and effectiveness of a novel carotid stent system comprised of a stent, an adjustable integrated embolic filter and a postdilation balloon, in patients at elevated risk for adverse events from carotid endarterectomy.
Evaluating Anesthesia Guidance for Rescue Analgesia in Awake Patients Undergoing Carotid Endarterectomy with Cervical Plexus Blocks: Preliminary Findings from a Randomized Controlled Trial.
J Clin Med
December 2024
Collegium Medicum, WSB University, 41-300 Dabrowa Gornicza, Poland.
Eversion carotid endarterectomy (CEA) in awake patients is performed using cervical plexus blocks (CPBs) with or without carotid artery sheath infiltration (CASI) under ultrasound guidance. Although adequacy of anesthesia (AoA) guidance monitors nociception/antinociception balance, its impact on intraoperative analgesia quality and perioperative outcomes in awake CEA remains unexplored. Existing literature lacks evidence on whether AoA-guided anesthesia enhances clinical outcomes over standard techniques.
View Article and Find Full Text PDFSeizures Following Carotid Endarterectomy: A Comprehensive Meta-Analysis of 69,479 Patients and Evidence-Based Recommendations for Perioperative Care.
Diagnostics (Basel)
December 2024
Global Health Neurology Lab, Sydney, NSW 2150, Australia.
Seizures are a rare but potentially serious complication following carotid endarterectomy (CEA). Understanding their prevalence and associated factors is crucial for optimizing perioperative care and improving patient outcomes. This meta-analysis aimed to estimate the pooled prevalence of seizures following CEA and explore clinical and procedural factors contributing to their occurrence.
View Article and Find Full Text PDFDefining Thresholds for Meaningful Health Status Changes Following Transfemoral Carotid Artery Stenting.
Catheter Cardiovasc Interv
January 2025
Department of Internal Medicine, Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Background: Evaluating health status changes following transfemoral carotid artery stenting (TF-CAS) is essential for assessing procedural success, but meaningful clinical changes are unknown. We aimed to determine minimal clinically important differences (MCIDs) and quantify health status improvement or worsening rates after TF-CAS using the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) registry data.
Methods: The SAPPHIRE registry included patients undergoing TF-CAS from 2010 to 2014 for both symptomatic and asymptomatic carotid stenosis.
The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review.
J Neurosurg Anesthesiol
January 2025
Stroke Medicine.
Processed electroencephalography (pEEG) is increasingly used to titrate the depth of anesthesia. Whether such intra-procedural pEEG monitoring can offer additional information on cerebral perfusion or acute focal or global cerebral ischemia is unknown. This scoping review aimed to provide a narrative analysis of the current literature reporting the potential role of pEEG in adults with acute cerebral ischemia.
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