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Your search keyword '"Carotid Artery, Internal/surgery"' showing total 3 results
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3 results on '"Carotid Artery, Internal/surgery"'

1. Interposition Grafting of Large Extracranial Carotid Aneurysm.

Author

Huyzer, Marlous, Reijnen, Michel M. P. J., Sybrandy, Johannes E. M., Buth, Jacob, and Zeebregts, Clark J.

Subjects
*ANEURYSMS, *CAROTID artery diseases, *THROMBOEMBOLISM, *PARALYSIS, *SURGICAL complications
Abstract

Extracranial carotid aneurysms are a rare entity and carry an inherent risk of thromboembolic complications. Treatment options consist of endovascular and conventional surgical techniques. We describe the cases of 3 patients who were treated with an interposition graft for a large extracranial carotid aneurysm. The patients had presented with an extracranial carotid aneurysm with a diameter of 30 to 43 mm. In all cases, the aneurysm was excluded by means of an interposition graft, without major perioperative complications. There was 1 case of temporary paresis of the facial nerve and another of temporary paresis of the vocal cord. After a mean follow-up period of 14 months, all patients were alive, and there were no neurologic deficits. A retrospective analysis was performed of patients who had undergone conventional surgical treatment of extracranial carotid aneurysms. The patients' characteristics, symptoms, surgical interventions, complications, and deaths were all documented. Carotid aneurysms can safely be excluded by interposition grafting, and this treatment should still be considered for most patients, although endovascular repair might provide a valid alternative. [ABSTRACT FROM AUTHOR]

Published
2011

2. Meta-analysis of the outcomes of treatment of internal carotid artery near occlusion

Author

A J A Meershoek, E E Vries, D Veen, H M Ruijter, G J Borst, A Garcia-Pastor, A Gonzalez, E Johansson, Y Matsuda, T Ogata, F Oka, R Pulli, S Sakamoto, S Tanaskovic, D Radak, and S Son

Subjects
medicine.medical_specialty, Neurology, Systematic Reviews, Neurologi, medicine.medical_treatment, Endarterectomy, Kaplan-Meier Estimate, Stroke/epidemiology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine.artery, Internal medicine, Occlusion, medicine, Internal/surgery, Humans, Carotid Stenosis, Survival rate, Endarterectomy, Carotid, Cochrane collaboration, business.industry, Carotid/mortality, Endarterectomy, Carotid/mortality, Carotid Artery, Internal/surgery, Stroke, Survival Rate, Logistic Models, Treatment Outcome, Meta-analysis, Multivariate Analysis, Cardiology, Carotid Stenosis/complications, Surgery, Stents, Systematic Review, Internal carotid artery, Carotid Artery, business, Medical therapy, 030217 neurology & neurosurgery, Carotid Artery, Internal
Abstract

Background Guidelines recommend treating patients with an internal carotid artery near occlusion (ICANO) with best medical therapy (BMT) based on weak evidence. Consequently, patients with ICANO were excluded from randomized trials. The aim of this individual-patient data (IPD) meta-analysis was to determine the optimal treatment approach. Methods A systematic search was performed in MEDLINE, EMBASE and the Cochrane Library databases in January 2018. The primary outcome was the occurrence of any stroke or death within the first 30 days of treatment, analysed by multivariable mixed-effect logistic regression. The secondary outcome was the occurrence of any stroke or death beyond 30 days up to 1 year after treatment, evaluated by Kaplan–Meier survival analysis. Results The search yielded 1526 articles, of which 61 were retrieved for full-text review. Some 32 studies met the inclusion criteria and pooled IPD were available from 11 studies, including some 703 patients with ICANO. Within 30 days, any stroke or death was reported in six patients (1·8 per cent) in the carotid endarterectomy (CEA) group, five (2·2 per cent) in the carotid artery stenting (CAS) group and seven (4·9 per cent) in the BMT group. This resulted in a higher 30-day stroke or death rate after BMT than after CEA (odds ratio 5·63, 95 per cent c.i. 1·30 to 24·45; P = 0·021). No differences were found between CEA and CAS. The 1-year any stroke- or death-free survival rate was 96·1 per cent for CEA, 94·4 per cent for CAS and 81·2 per cent for BMT. Conclusion These data suggest that BMT alone is not superior to CEA or CAS with respect to 30-day or 1-year stroke or death prevention in patients with ICANO. These patients do not appear to constitute a high-risk group for surgery, and consideration should made to including them in future RCTs of internal carotid artery interventions.

Published
2019

3. Meta-analysis of the outcomes of treatment of internal carotid artery near occlusion

Author

NEON study group, Leerstoel Schoot, and Methodology and statistics for the behavioural and social sciences

Subjects
Survival Rate, Logistic Models, Treatment Outcome, Multivariate Analysis, Carotid Stenosis/complications, Humans, Stents, Endarterectomy, Carotid/mortality, Kaplan-Meier Estimate, Carotid Artery, Internal/surgery, Stroke/epidemiology
Abstract

BACKGROUND: Guidelines recommend treating patients with an internal carotid artery near occlusion (ICANO) with best medical therapy (BMT) based on weak evidence. Consequently, patients with ICANO were excluded from randomized trials. The aim of this individual-patient data (IPD) meta-analysis was to determine the optimal treatment approach. METHODS: A systematic search was performed in MEDLINE, EMBASE and the Cochrane Library databases in January 2018. The primary outcome was the occurrence of any stroke or death within the first 30 days of treatment, analysed by multivariable mixed-effect logistic regression. The secondary outcome was the occurrence of any stroke or death beyond 30 days up to 1 year after treatment, evaluated by Kaplan-Meier survival analysis. RESULTS: The search yielded 1526 articles, of which 61 were retrieved for full-text review. Some 32 studies met the inclusion criteria and pooled IPD were available from 11 studies, including some 703 patients with ICANO. Within 30 days, any stroke or death was reported in six patients (1·8 per cent) in the carotid endarterectomy (CEA) group, five (2·2 per cent) in the carotid artery stenting (CAS) group and seven (4·9 per cent) in the BMT group. This resulted in a higher 30-day stroke or death rate after BMT than after CEA (odds ratio 5·63, 95 per cent c.i. 1·30 to 24·45; P = 0·021). No differences were found between CEA and CAS. The 1-year any stroke- or death-free survival rate was 96·1 per cent for CEA, 94·4 per cent for CAS and 81·2 per cent for BMT. CONCLUSION: These data suggest that BMT alone is not superior to CEA or CAS with respect to 30-day or 1-year stroke or death prevention in patients with ICANO. These patients do not appear to constitute a high-risk group for surgery, and consideration should made to including them in future RCTs of internal carotid artery interventions.

Published
2019

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