Abstract:
OBJECTIVE:The baroreceptor at the carotid body plays an important role in hemodynamic autoregulation. Manipulation of the baroreceptor during carotid endarterectomy (CEA) or radial force from carotid artery angioplasty and/or stenting (CAS) may cause both intraoperative and postoperative hemodynamic instability. The purpose of this study is to evaluate the long-term effects of CEA and CAS on blood pressure (BP), heart rate (HR), and subsequent changes on antihypertensive medications. METHODS:A retrospective chart review was performed to identify patients who underwent CEA or CAS between 2009 and 2015 at a single tertiary care institution. Baseline demographics and comorbidities were recorded. Operative details of the carotid artery endarterectomy and the use of balloon angioplasty during the CAS were analyzed. Hemodynamic parameters such as BP, HR, and antihypertensive medication requirement were evaluated at 3, 6, 12, 24, and 36 months. RESULTS:A total of 289 patients were identified. The average age was 70.6 years old, and males constituted 64.0%. All patients had moderate (>50%) to severe (>70%) carotid stenosis. Of those, 111 (40.5%) patients were symptomatic. Systolic BP (mm Hg) of CAS and CEA were similar over the entire follow-up period. Heart rate (beats/min) remained stable postoperatively. A reduced number of antihypertensive medications was observed in the CAS cohort during the first postoperative year when compared to the preoperative baseline: 2.03 at preop, 1.77 ( P < .01) at 3 months, 1.78 ( P = .02) at 6 months, 1.77 ( P = .02) at 12 months, 1.86 ( P = .09) at 24 months, and 2.03 ( P = =.50) at 36 months. Logistic regression analysis identified that CAS (odds ratio [OR]: 2.52, confidence interval [CI]: 1.09-5.83) and multiple (>2) antihypertensive medication use at baseline (OR: 5.89, CI: 2.62-13.26) were predictors for a reduction in the number of antihypertensive medications following carotid revascularization. CONCLUSION:Surgical intervention for carotid stenosis poses a risk of postoperative hemodynamic dysregulation. Although postoperative BP and HR remained relatively stable after both CAS and CEA, the number of postoperative antihypertensive medications was reduced in the CAS cohort for the first postoperative year when compared to baseline. Patients with multiple antihypertensive agents undergoing CAS should have close postoperative BP monitoring and should be monitored for a possible reduction in their antihypertensive medication regimen.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Lim S,Javorski MJ,Nassoiy SP,Park Y,Halandras PM,Bechara CF,Aulivola B,Crisostomo PRdoi
10.1177/1538574419828088subject
Has Abstractpub_date
2019-05-01 00:00:00pages
297-302issue
4eissn
1538-5744issn
1938-9116journal_volume
53pub_type
杂志文章abstract::Postoperative carotid artery pseudoaneurysms are rare. The traditional treatment of choice has been operative repair, which can present a significant technical challenge owing to the reoperative neck inflammation and potential cranial nerve injuries. The authors report 3 cases of postoperative carotid pseudoaneurysms ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440303700308
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the immediate and long-term clinical outcomes after carotid artery stenting (CAS) with and without protection devices (PDs), compared with carotid endarterectomy (CEA). METHODS:A total of 116 patients with symptomatic carotid stenosis underwent CAS; 56 patients (48.3%) underwent CAS-PD; and 137 p...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412457471
更新日期:2012-10-01 00:00:00
abstract::Carotid body tumors are rare neoplasms, which typically present as a slow growing, painless neck mass found along the anterior border of the sternocleidomastoid muscle. These tumors are generally benign but possess aggressive local growth potential. Therefore, definitive treatment requires surgical resection. The auth...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440403800211
更新日期:2004-03-01 00:00:00
abstract::Pulmonary embolism remains an endemic challenge for public health care. The first line of treatment for venous thromboembolic disorder has been anticoagulation; however, in the absence of appropriate pharmacologic treatment, because of failure or contraindication, caval filter placement has been widely performed in th...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574409332000
更新日期:2009-08-01 00:00:00
abstract::Blowout syndrome caused by vascular invasion is a dreadful complication of late stage malignancies that carry high morbidity and poor overall prognosis in a compromised population. Endovascular management can offer minimally invasive and life-saving alternative for such acute conditions. We describe the case of a 62-y...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574419858821
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:Radial artery access is widely utilized in coronary angiography with reported lower rates of vascular complications and better patient comfort. There is limited data in the literature regarding radial access in peripheral endovascular procedures. We hypothesize that radial access is safe and feasible for per...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574420906942
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES::To evaluate the effects on aortoiliac fluid dynamics after the implantation of an endograft based on endovascular aneurysm sealing (EVAS) versus endovascular aneurysm repair (EVAR) strategy. METHODS::An adaptive geometrical deformable model was used for aortic lumen segmentation in 8 patients before and af...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574418791059
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:A 24-hour venous duplex ultrasound (VDU) for suspected deep vein thrombosis (DVT) imposes significant resource burdens on a hospital. We hypothesize that termination of after-hours services increases empiric therapy without affecting clinical outcomes. METHODS:A retrospective review of patients evaluated by ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574410365731
更新日期:2010-07-01 00:00:00
abstract:PURPOSE:When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. Th...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574417744085
更新日期:2018-02-01 00:00:00
abstract::Recent reports have documented poor long-term results following endovascular aneurysm repair (EVAR) of large abdominal aortic aneurysms (AAA). EVAR of small AAAs may result in improved long-term results compared to large AAAs. It is not known whether the frequency of anatomic suitability for EVAR is increased for smal...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440503900502
更新日期:2005-09-01 00:00:00
abstract::Aortocaval fistula is uncommon and often associated with a ruptured iliac or abdominal aortic aneurysm. It has a high mortality secondary to the aneurysmal rupture but also to a high output heart failure. Open surgery has been the standard; however, endovascular management has emerged with lower mortality. We present ...
journal_title:Vascular and endovascular surgery
pub_type:
doi:10.1177/1538574420939724
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to investigate the blood transfusion practice in patients operated for abdominal aortic aneurysm (AAA) with special emphasis on massive transfusion in cases with rupture. MATERIAL AND METHODS:From a database, 504 patients operated for AAA were stratified into 2 groups; an ea...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412467860
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Lymphaticovenular anastomosis (LVA) is becoming a treatment option for lymphedema. It is challenging to perform LVA when a lymphatic vessel is too far from a vein to anastomose directly. METHODS:We applied vein grafting for simultaneous multisite LVA (SM-LVA), when there was a considerable distance between ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574415614402
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To survey the Society for Vascular Surgery (SVS) membership with regard to type of practice, employment status, work effort, and productivity criteria. METHODS:A survey questionnaire was developed to gather information about member demographics, academic versus private practice, employment status, time in pr...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412457474
更新日期:2012-10-01 00:00:00
abstract:PURPOSE:To evaluate the effectiveness of endovascular management of steno-oclusive disease in liver transplants. METHODS:Retrospective review of liver transplant recipients with hepatic artery stenosis (HAS) or thrombosis (HAT) was performed. The HAS group was treated with balloon angioplasty with selective stent plac...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411407088
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The optimal antithrombotic regimen in peripheral arterial disease (PAD) is not known, leading to significant variations in antithrombotic treatment protocols in randomized trials and clinical practice. In device trials, antithrombotic regimens in patients receiving peripheral vascular interventions have not b...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574419836316
更新日期:2019-05-01 00:00:00
abstract::One of the most feared complications following vascular reconstruction is infection due to the attendant risks of limb loss, sepsis, or death. The reported incidence of infection following infrainguinal prosthetic graft infection is 2.5% with associated mortality rates and amputation rates of 18% and 41%, respectively...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574408326265
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To assess the first results of hybrid operations in chronic venous obstructions of iliofemoral segments in patients with postthrombotic syndrome (PTS). METHODS:Hybrid operations (open endovenectomy from the common femoral vein with arteriovenous fistula creation and iliac vein stenting) were performed in 12 ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574417717609
更新日期:2017-10-01 00:00:00
abstract::Because of its extremely powerful sclerosing effect, in our experience, ethanol can be considered the most efficacious agent in the percutaneous treatment of peripheral venous malformations. To reduce the risk of ethanol reflux into the superficial veins or the central venous system, we developed a simple but very eff...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574410362117
更新日期:2010-05-01 00:00:00
abstract::Vascular abnormalities in neurofibromatosis type 1 (NF-1) are rare but sometimes fatal. We report a case of spontaneous rupture of a left renal artery aneurysm in a patient with NF-1. A 41-year-old nonpregnant normotensive woman known to have NF-1 presented to our emergency department with left flank pain. Computed to...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574413495465
更新日期:2013-10-01 00:00:00
abstract::Acute arterial disruptions of the thoracic aorta are rare and often lethal. They are most often due to blunt trauma and occur most commonly just distal to the left subclavian artery origin in the setting of multisystem injuries. The very proximal nature of the lesion in survivors makes open surgical repair hazardous, ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440403800404
更新日期:2004-07-01 00:00:00
abstract::Inadvertent complications of jugular vein catheterization are not uncommon, however, a persistent symptomatic carotid-jugular fistula has been rarely reported. A 72-year-old male with infected surgical wound after coxofemoral disarticulation for sarcoma presented with symptoms of acute right heart failure. A fistula b...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574416675675
更新日期:2016-11-01 00:00:00
abstract::A 26-year-old male soldier was clinically characterized by transient fever, persistent right upper quadrant pain, hypertension, and elevated inflammatory biomarkers associated with bacterial infection. On the fifteenth day after the onset of symptoms, he had typical CT findings in polyarteritis nodosa involving only t...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574420968682
更新日期:2020-10-21 00:00:00
abstract::Efficacy of duplex ultrasound (DU) surveillance of complex EVAR such as FEVAR and ChEVAR has not been studied. All patients undergoing FEVAR or ChEVAR at a single multihospital institution were retrospectively reviewed. Postoperative surveillance included DU at 1 month and CTA at 3 months. 82 patients met inclusion cr...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574420980605
更新日期:2020-12-15 00:00:00
abstract::This study evaluated the efficacy of an exercise program after arterial bypass surgery. Patients undergoing bypass surgery were randomized to a control group (group I), with standard preoperative and postoperative care, or the intervention group (group II) with a supervised exercise program of twice-weekly treadmill a...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1177/1538574406296209
更新日期:2007-02-01 00:00:00
abstract::Arterio-hepatic venous fistula (AHVF) is an exceedingly rare phenomenon compared to arterio-portal venous fistula with only 8 cases reported in world literature. Many listed causes can be attributed to the development of there are no reported cases of AHVF following a core-needle biopsy. We report a case of 38 year-ol...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574420954300
更新日期:2021-02-01 00:00:00
abstract::Although uncommon, hoarseness can be a presenting symptom of a thoracic aneurysm. We present a case of a 67-year-old man with hoarseness, subsequently found to have left vocal paralysis. On workup, a computed tomography scan demonstrated a saccular thoracic aneurysm compressing the recurrent laryngeal nerve at the aor...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574408324616
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:Type A acute aortic dissection is a surgical emergency, and supra-aortic trunk involvement may be complicated by stroke in 6% to 20% of cases. A 66-year-old Caucasian female patient underwent a composite repair of the ascending aorta for type A aortic dissection. Postoperative period was complicated by episodes...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411414301
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Remote ischemic preconditioning (RIPC) involves the phenomenon whereby transient episodes of limb ischemia induced by cuff inflation provide cardioprotection. The effectiveness of RIPC in vascular surgery is uncertain. This randomized, controlled trial was designed to investigate the potential of two episode...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1177/1538574416639150
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Regression of the residual sac is indicative of successful endovascular aortic aneurysm (EVAR) repair. Using color duplex ultrasound (CDU), we monitored the residual aneurysm sac following EVAR and correlated sac behavior with perioperative risk factors. METHODS:Of 145 patients with EVAR, 106 (73.1%) patien...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574413513846
更新日期:2014-02-01 00:00:00