scholarly journals Ocular Circulation and Chronic Ocular Ischemic Syndrome before and after Carotid Artery Revascularization Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Shoichiro Kawaguchi ◽  
Jun-ichi Iida ◽  
Yoshitomo Uchiyama
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Color Doppler ◽  
Artery Stenosis ◽  
Carotid Revascularization ◽  
Ocular Circulation ◽  
Ocular Ischemic Syndrome ◽  
Before And After ◽  
Revascularization Surgery ◽  
Ischemic Syndrome

Background. We evaluated the effect of carotid revascularization surgery on ocular circulation and chronic ocular ischemic syndrome (OIS).Methods. We examined ninety patients with carotid artery stenosis (more than 50% stenosis) at its origin treated with carotid endarterectomy (N=56) or carotid artery stenting (N=34). Twenty-five patients (28%) complained of chronic OIS. Ocular circulation was examined before and after revascularization surgery using ophthalmic artery (OphAr) and central retinal artery (CRA) color Doppler flow imaging.Results. (1) Ocular circulation: preoperatively, the average OphAr peak systolic flow velocity (Vs) was 0.05 m/sec, and the average CRA Vs was 0.07 m/sec. At 1 week after surgery, the average OphAr Vs significantly increased to 0.32 (P<0.05), and the average CRA Vs significantly increased to 0.11 m/sec (P<0.05). These significant improvements were sustained throughout the three months of the followup. (2) OIS: during the follow-up period (mean: 3.6 years), 15 patients (60%) showed visual acuity improvement, and no patients complained of amaurosis fugax or worsening of the chronic OIS.Conclusion. Carotid revascularization surgery was effective in improving the ocular circulation, and it was also useful for the chronic OIS due to the carotid artery stenosis.

Abstract TP126: Ocular Circulation in Carotid Artery Stenosis Treated by CEA or CAS

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shoichiro Kawaguchi ◽  
Hisanobu Kurioka
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Color Doppler ◽  
Artery Stenosis ◽  
Color Doppler Flow Imaging ◽  
Carotid Revascularization ◽  
Ocular Circulation ◽  
Before And After ◽  
Revascularization Surgery

Background: The authors evaluated the effect of carotid artery revascularization surgery for ocular circulation and chronic ocular ischemic syndrome (OIS). Methods: The authors examined ninety-3 patients with carotid artery stenosis (more than 50% stenosis) at its origin treated by carotid endarterectomy (N=58) or carotid artery stenting (N=34). Twenty-six patients (28%) complained of chronic OIS evaluated by the ophthalmic examination. Ocular circulation was examined before and after revascularization surgery using ophthalmic artery (OphAr) and central retinal artery (CRA) color Doppler flow imaging. Results: 1) Ocular circulation: Preoperatively, the average OphAr peak systolic flow velocity (Vs) was 0.05 m/sec, and the average CRA Vs was 0.07 m/sec. At 1 week after surgery, the average OphAr Vs significantly increased to 0.32 ( p < 0.05), and the average CRA Vs significantly increased to 0.11 m/sec ( p < 0.05). These significant improvements were sustained throughout the three months of the follow up.2) OIS: During the follow-up period (mean: 3.6 years), 16 patients (62%) showed visual acuity improvement, and no patients complained of amaurosis fugax or worsening of the chronic OIS. Conclusion: Carotid revascularization surgery was effective in improving the ocular circulation, and it was also useful for the chronic OIS due to the carotid artery stenosis.

Abstract WP167: Changing Face of Carotid Revascularization Procedures in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Saqib A Chaudhry ◽  
Iqra N Akhtar ◽  
Wei Huang ◽  
Ameer E Hassan ◽  
Mohammad Rauf A Chaudhry ◽  
...  
Keyword(s):  
United States ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
The United States ◽  
Artery Stenosis ◽  
Teaching Hospitals ◽  
Trend Test ◽  
Carotid Revascularization ◽  
Asymptomatic Patients ◽  
Revascularization Procedures

Background: Carotid revascularization procedure, carotid endarterectomy (CEA) and carotid stent placement (CAS), are some of the most common procedures performed in United States and expected to change due to wider adoption of CAS. We performed this study to determine the changes in utilization of CEA and CAS in United States using nationally representative data. Methods: We used the National Inpatient Sample (NIS) from 2005 to 2014 to assess the changes in utilization of CEA and CAS over last 10 years in patients with symptomatic and asymptomatic carotid artery stenosis. NIS is the largest all payer dataset that includes diagnoses, admissions and discharge, demographics, and outcomes data of patients admitted to short stay non-Federal hospitals in the United States. We analyzed patterns of changes in utilization in various subsets of patients with carotid artery stenosis. Results: A total of 1,186,182 patients underwent carotid revascularization procedures during study period; 1,032,148 (87.1%) and 154,035 (12.9%) were CEA and CAS, respectively. The overall carotid revascularization procedures decreased over last 10 years (11.1% in 2005 to 8.4%in 2014, trend test p <.0001). Carotid revascularization in symptomatic patients increased (7.64% in 2005 to 11.01% in 2014, trend test p <.0001) while it decreased in asymptomatic patients (92.36% in 2006 to 88.99% in 2014, trend test p <.0001). There was an overall decrease in CEA (11.6% in 2005 to 8.3% in 2014, trend test <.0001) while in CAS remained unchanged (8.1% in 2005 to 8.9% in 2014, p=NS). There was an increase in carotid revascularization in teaching hospitals (40.9% in 2005 to 67.1% in 2014, trend test p <.0001) while decrease in non-teaching hospitals (50.9% in 2006 to 27.1% in 2014, trend test p <.0001). There was a decrease in carotid revascularization procedures in patients aged ≥80 years (19.8% in 2005 to 18.7% in 2014, trend test p <.0001) and CEA (19.6% in 2006 to 18.8% in 2014, trend test P<.0001) and CAS (21.2% in 2006 to 18.6% in 2014, trend test p=<.0001). Conclusion: Although CAS is increasing in a disproportionate manner within patient subgroups in United States, overall carotid revascularization procedures have decreased for unclear reasons.

Management of carotid artery stenosis in patients with coexistent unruptured intracranial aneurysms

2020 ◽  
Vol 132 (1) ◽  
pp. 94-97 ◽  
Author(s):  
Tiziano Tallarita ◽  
Thomas J. Sorenson ◽  
Lorenzo Rinaldo ◽  
Gustavo S. Oderich ◽  
Thomas C. Bower ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Intracranial Aneurysms ◽  
Early Period ◽  
Aneurysm Rupture ◽  
Artery Stenosis ◽  
Consecutive Series ◽  
Carotid Revascularization ◽  
Unruptured Intracranial Aneurysms ◽  
Risk Of Rupture

OBJECTIVEConcomitant unruptured intracranial aneurysms (UIAs) are present in patients with carotid artery stenosis not infrequently and result in unique management challenges. Thus, we investigated the risk of rupture of an aneurysm after revascularization of a carotid artery in a contemporary consecutive series of patients seen at our institution.METHODSData from patients who underwent a carotid revascularization in the presence of at least one concomitant UIA at our institution from 1991 to 2018 were retrospectively reviewed. Patients were evaluated for the incidence of aneurysm rupture within 30 days (early period) and after 30 days (late period) of carotid revascularization, as well as for the incidence of periprocedural complications from the treatment of carotid stenosis and/or UIA.RESULTSOur study included 53 patients with 63 concomitant UIAs. There was no rupture within 30 days of carotid revascularization. The overall risk of rupture was 0.87% per patient-year. Treatment (coiling or clipping) of a concomitant UIA, if pursued, could be performed successfully after carotid revascularization.CONCLUSIONSCarotid artery revascularization in the setting of a concomitant UIA can be performed safely without an increased 30-day or late-term risk of rupture. If indicated, treatment of the UIA can take place after the patient recovers from the carotid procedure.

Sign in / Sign up

Export Citation Format

Share Document