scholarly journals Re: “Systematic Review and Meta-Analysis of Very Urgent Carotid Intervention for Symptomatic Carotid Disease”

2019 ◽  
Vol 57 (5) ◽  
pp. 744
Author(s):  
Vladimir T. de Vasconcelos
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Carotid Disease ◽  
Symptomatic Carotid

scholarly journals Systematic Review and Meta-Analysis of Very Urgent Carotid Intervention for Symptomatic Carotid Disease

2018 ◽  
Vol 68 (6) ◽  
pp. 1959
Author(s):  
D. Milgrom ◽  
S. Hajibandeh ◽  
S. Hajibandeh ◽  
S.A. Antoniou ◽  
F. Torella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Carotid Disease ◽  
Symptomatic Carotid

scholarly journals Editor's Choice – Systematic Review and Meta-Analysis of Very Urgent Carotid Intervention for Symptomatic Carotid Disease

2018 ◽  
Vol 56 (5) ◽  
pp. 622-631 ◽  
Author(s):  
David Milgrom ◽  
Shahin Hajibandeh ◽  
Shahab Hajibandeh ◽  
Stavros A. Antoniou ◽  
Francesco Torella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Carotid Disease ◽  
Symptomatic Carotid

scholarly journals IP127. Urgent Carotid Endarterectomy in Symptomatic Carotid Stenosis: A Systematic Review and Meta-analysis

2017 ◽  
Vol 65 (6) ◽  
pp. 89S
Author(s):  
João Rocha-Neves ◽  
Marta Casal-Moura ◽  
Laura Capoccia ◽  
José Oliveira-Pinto ◽  
Armando Mansilha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Meta Analysis ◽  
Symptomatic Carotid ◽  
Symptomatic Carotid Stenosis

Abstract T P180: Ultrasound Characteristics of Symptomatic Carotid Plaques: A Systematic Review and Meta-analysis

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Waleed Brinjikji ◽  
Deena M Nasr ◽  
Alejandro A Rabinstein ◽  
Giuseppe Lanzino ◽  
Eric E Williamson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Carotid Plaque ◽  
Imaging Modality ◽  
Meta Analysis ◽  
Surface Irregularity ◽  
Carotid Plaques ◽  
Symptomatic Carotid ◽  
Plaque Ulceration

Background and Purpose: Ultrasound is the most commonly used imaging modality for assessment of carotid artery stenosis. A number of studies have demonstrated that surface irregularities, heterogeneous echotexture and hypoechoic plaques are risk factors for acute ischemic stroke. We performed a systematic review and meta-analysis of the literature to better define the risk of stroke based off of the sonographic characteristics of carotid plaques. Materials and Methods: We performed a comprehensive literature search evaluating the association of carotid plaque characteristics on ultrasound with ischemic outcomes. We included both case-control and cohort studies examining the relationship between complex plaque and acute ischemic stroke. Complex plaque was defined as plaque that had any of the following characteristics: heterogeneous plaque echogenicity, hypoechoic plaque, plaque neovascularization, plaque surface irregularity, plaque ulceration, and intraplaque motion. Meta-analyses using the random-effects model were performed for complex plaque and each of the individual complex plaque characteristics. Results: A total of 1013 articles were screened and 30 studies with 11528 patients (3054 symptomatic and 8474 asymptomatic) were included. The odds ratios for the association between complex plaque and ischemic symptoms was 5.18 (95%CI=4.63-5.79). Heterogeneous echotexture (OR=11.72, 95%CI=9.82-13.98), intraplaque motion (OR=1.57, 95%CI=1.02-2.41), plaque echolucency (OR=3.23, 95%CI=2.72-3.84), plaque neovascularity (OR=5.66, 95%CI=3.15-10.16) and plaque ulceration (OR=2.65, 95%CI=1.89-3.73) were all associated with ischemic symptoms. Surface irregularity without frank ulceration was not associated with ischemic symptoms (OR=1.35, 95%CI=0.98-1.86). Conclusions: Complex plaque, heterogeneous plaque echogenicity, hypoechoic plaque, plaque neovascularization, plaque ulceration and intraplaque motion are associated with ischemic symptoms. Assessment of carotid plaque on ultrasound provides stroke risk information beyond measurement of luminal stenosis.

Timing of Carotid Endarterectomy for Symptomatic Carotid Stenosis: A Snapshot of Current Trends and Systematic Review of Literature on Changing Paradigm towards Early Surgery

Neurosurgery ◽  
2019 ◽  
Vol 85 (2) ◽  
pp. E214-E225 ◽  
Author(s):  
Amey R Savardekar ◽  
Vinayak Narayan ◽  
Devi P Patra ◽  
Robert F Spetzler ◽  
Hai Sun
Keyword(s):  
Systematic Review ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Current Literature ◽  
Meta Analysis ◽  
Review Of Literature ◽  
Carotid Revascularization ◽  
Symptomatic Carotid ◽  
Index Event ◽  
Symptomatic Carotid Stenosis

Abstract Carotid revascularization has been recommended as the maximally beneficial treatment for stroke prevention in patients with recently symptomatic carotid stenosis (SCS). The appropriate timing for performing carotid endarterectomy (CEA) within the first 14 d after the occurrence of the index event remains controversial. We aim to provide a snapshot of the pertinent current literature related to the timing of CEA for patients with SCS. A systematic review of literature was conducted to study the timing of CEA for SCS. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were followed. A total of 63 articles were identified as relevant to this topic. A summary of 15 articles favoring urgent CEA (within 48 h) for SCS within 48 h of index event and 9 articles not favoring urgent CEA is presented. A consensus is still to be achieved on the ideal timing of CEA for SCS within the 14-d window presently prescribed. The current literature suggests that patients who undergo urgent CEA (within 48 h) after nondisabling stroke as the index event have an increased periprocedural risk as compared to those who had transient ischemic attack (TIA) as the index event. Further prospective studies and clinical trials studying this question with separate groups classified as per the index event are required to shed more light on the subject. The current literature points to a changing paradigm towards early carotid surgery, specifically targeted within 48 h if the index event is TIA, and within 7 d if the index event is stroke.

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