scholarly journals The relationship between preoperative serum cortisol level and the stability of plaque in carotid artery stenosis patients undergoing carotid endarterectomy

2016 ◽  
Vol 8 (7) ◽  
pp. 1611-1617
Author(s):  
Feng Qin ◽  
Yudong Sun ◽  
Wenping Hu ◽  
Xiaolong Wei ◽  
Zhenjiang Li ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Cortisol Level ◽  
Carotid Artery Stenosis ◽  
Serum Cortisol ◽  
Artery Stenosis ◽  
Serum Cortisol Level ◽  
Preoperative Serum ◽  
The Stability ◽  
The Relationship

Transcarotid Artery Revascularization and Advances in Vascular Surgery for Carotid Artery Disease

2021 ◽  
Author(s):  
James Hu ◽  
◽  
Andy Sohn ◽  
Justin George ◽  
Rajesh Malik ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Vascular Surgery ◽  
Carotid Endarterectomy ◽  
Surgical Management ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
Cerebrovascular Accidents ◽  
Artery Disease

Carotid artery atherosclerotic disease impacts over 2 million Americans annually. Since the advent of the carotid endarterectomy by Debakey in 1953, the surgical management of carotid artery stenosis has prevented cerebrovascular accidents. The technology utilized to manage carotid artery stenosis continued to evolve with the utilization of carotid artery stenting in 1989 and more recently transcarotid artery revascularization (TCAR). This review discusses the modern management of carotid artery stenosis with an emphasis on transcarotid artery revascularization (TCAR) and reversal of flow for reversal of flow for embolic protection.

Abstract 113: Platelet and Monocyte Activity in Carotid Artery Stenosis Treated with Carotid Endarterectomy

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Arvind Reddy Devanabanda ◽  
Caron Rockman ◽  
Nicole Allen ◽  
Maya Rubin ◽  
Binita Shah ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Healthy Subjects ◽  
Artery Stenosis ◽  
Monocyte Subsets ◽  
Platelet Activity ◽  
Platelet Surface ◽  
Inflammatory Monocytes ◽  
Anti Inflammatory

Background: Carotid artery stenosis (CAS) is a marker of atherosclerosis, a disease mediated by abnormalities in platelet and monocyte function, and a significant cause of stroke. Moreover, the effect of carotid artery revascularization via carotid endarterectomy (CEA) on platelet and monocyte markers is unknown. Objective: This study aims to investigate platelet activity, monocyte subsets and monocyte platelet aggregates (MPA) in CAS and changes with CEA. Methods: This prospective cohort study evaluated 48 patients who underwent non emergent CEA. Peripheral venous blood samples were obtained before, immediately postoperative and at 24 hours postoperative. Twenty healthy subjects served as controls. Platelet surface expression of P-selectin and PAC-1, monocyte subsets, and MPA were assessed using flow cytometry. Three distinct monocyte subsets were measured: anti-inflammatory (i.e. classical CD14 ++ CD16 - ) and pro-inflammatory (i.e. intermediate CD14 ++ CD16 + and nonclassical CD14 + CD16 ++ ) monocytes. Differences between two matched samples and between the study and control groups were statistically analyzed. Results: Compared to healthy subjects, CAS subjects had significantly greater markers of platelet activity (P-selectin [p=0.003] and PAC-1 [p=0.01]), pro-inflammatory monocytes (intermediate [p<0.0001] and nonclassical [p=0.009]) and MPA (p=0.0002). Following CEA, anti-inflammatory monocytes increased and pro-inflammatory monocytes decreased (Figure 1A). Platelet expression of P-selectin and MPA did not change, while PAC-1 transiently increased but then returned to baseline by 24 hours postoperative (Figure 1B &C). Conclusions: Subjects with CAS have elevated markers of thrombosis, inflammation, and their interface. However, only the pro-inflammatory monocytes are significantly reduced following CEA. Future studies investigating the clinical consequences of this reduction are warranted.

scholarly journals Concurrent Carotid Endarterectomy and Off-Pump Coronary Artery Bypass Graft Surgery in Bangladesh: A Prospective Cohort Study

2018 ◽  
Vol 13 (1) ◽  
pp. 2-7
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Heemel Saha ◽  
Sabita Mandal ◽  
Sanjoy Kumar Saha ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Early Postoperative Period ◽  
Artery Stenosis ◽  
Off Pump ◽  
Co Morbidity

A patient of ischemic heart disease (IHD) with additional carotid artery stenosis (CAS) has been distinguished as a high risk group for both heart and cerebral inconveniences following surgical intervention. We aimed to review the outcome of concurrent carotid endarterectomy (CEA) and off-pump coronary bypass graft (OPCABG)in a patient undergoing surgical revascularization for IHD and CAS at our institute.In the vicinity of 2014 and 2016, fifteen patients experienced OPCABG and CEA associatively in a single Surgeon's Practice. Six (40%) patients had a history of myocardial infarction (MI), four (26.66%) had unstable angina (USAP), and three (20%) had USAP together with MI, though two (13.33%) were asymptomatic. Nine (60%) patients demonstrated no neurological manifestations, three (20%) had transient ischemic assaults (TIAs), two (13.33%) experienced stroke, and 1 (6.66%) experienced both. Majority 7 (46.66%) patients had 75-90% carotid artery stenosis and 6(40%) patients experienced right though 8 (53.33%) experienced left CEA and only 1 (6.66%) had bilateral CEA. Five (33.33%) patients were found left main disease (>50% lesion) and 100% patients have had significant Left Anterior Descending (LAD) lesion in this study. Twelve (80%) patients show significant lesion in Right Coronary Artery (RCA) and ten (66.66%) patients had Obtuse marginal (OM) branch disease. CEA was performed before OPCABG in all cases. There were 15 patients (mean age 62.5±2.8 years; 80% were male), two (13.33%) had a perioperative stroke while one of them had TIAs (6.6%). Mean ICU stay was 36.6±4.5 h and patients were released in 10 days. There was no mortality in the early postoperative period and co-morbidity was less significant (6.6% myocardial ischemia, 13.33% atrial fibrillation, 6.66% TIA, 13.33% Stroke). There was 1 (6.66%) postoperative acute renal failure evidenced by raised serum creatinine level. Two (13.33%) patients showed respiratory complications; only 6.6% of them suffered from wound infection. A combined strategy by means of CEA with OPCABG is safe and savvy in view of the satisfactory consequences of morbidity and mortality rates and also short ICU and hospital stay status.Faridpur Med. Coll. J. Jan 2018;13(1): 2-7

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