Abstract：
BACKGROUND:Approximately 20% of strokes are attributable to carotid stenosis. However, the number of asymptomatic patients needed to prevent one stroke or death with endarterectomy is high at 17 to 32. There is a clear need to identify asymptomatic individuals at high risk of developing future ischemic events to improve the cost-effectiveness of surgery. Our aim was to examine the evidence for subclinical microembolization and silent brain infarction in the prediction of stroke in asymptomatic carotid stenosis using transcranial Doppler (TCD), computed tomography (CT), and magnetic resonance imaging (MRI). METHODS:The review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Articles regarding humans between 1966 and 2010 were identified through systematic searches of Pubmed, MEDLINE, and EMBASE electronic databases using a predetermined search algorithm. RESULTS:Fifty-eight full text articles met the inclusion criteria. A median of 28% of microemboli positive patients experienced a stroke or transient ischemic attack during follow-up compared with 2% of microemboli negative patients (P = .001). The same was true for the end point of stroke alone with a median of 10% of microemboli positive patients experiencing a stroke vs 1% of microemboli negative patients (P = .004). A specific pattern of silent CT infarctions was related to future stroke risk (odds ratio [OR] = 4.6; confidence interval [CI] = 3.0-7.2; P < .0001). There are no prospective MRI studies linking silent infarction and stroke risk. CONCLUSIONS:There is level 1 evidence for the use of TCD to detect microembolization as a risk stratification tool. However, this technique requires further investigation as a stroke prevention tool and would be complemented by improvements in carotid plaque imaging.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Jayasooriya G,Thapar A,Shalhoub J,Davies AHdoi
10.1016/j.jvs.2011.01.037subject
Has Abstractpub_date
2011-07-01 00:00:00pages
227-36issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(11)00193-5journal_volume
54pub_type
杂志文章,评审abstract：:Dissection of the internal carotid artery is an under-recognized cause of transient ischemic attack and cerebral vascular accident. Spontaneous dissections, in which no precipitating cause can be identified, occur infrequently. Endovascular intervention is an evolving treatment option in patients in whom anticoagulati...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2004.03.018
更新日期：2004-07-01 00:00:00
abstract：OBJECTIVE:The therapeutic strategy for extended aortic arch aneurysms remains controversial and has changed substantially since thoracic endovascular aortic repair was introduced. We applied single-stage hybrid (s-hybrid) total arch replacement (TAR), which involved ascending aorta replacement and debranching of arch v...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2018.08.184
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:We investigated the intraobserver and interobserver variability of using semiautomatic finite element analysis to calculate the von Mises stress and peak wall rupture risk (PWRR) in patients with an abdominal aortic aneurysm (AAA) in longitudinal studies. METHODS:Four independent observers made 3-dimensional...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2011.08.012
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to investigate changes in health-related quality of life (QOL) in patients treated for pararenal aortic aneurysms (PAAs) and thoracoabdominal aortic aneurysms (TAAAs) with fenestrated-branched endovascular aneurysm repair (F-BEVAR). METHODS:A total of 159 consecutive patients ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2018.07.060
更新日期：2019-05-01 00:00:00
abstract：PURPOSE:A recent overview indicated that although routine patching is safer than routine primary closure after carotid endarterectomy (CEA), there is no systematic evidence that patch type influences outcome. However, most surgeons still believe that prosthetic patches are probably more thrombogenic than vein patches. ...
journal_title：Journal of vascular surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1067/mva.2001.115005
更新日期：2001-05-01 00:00:00
abstract：OBJECTIVES:Increased utilization of computed tomography angiography (CTA) has increased the radiologic diagnosis of penetrating atherosclerotic ulcers (PAUs), which are defined as the ulceration of atherosclerotic plaque through the internal elastic lamina into the aortic media. However, the presentation, treatment ind...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2011.08.005
更新日期：2012-01-01 00:00:00
abstract：:Complications of medicine are like the sand traps in golf courses. They are regrettable, cannot be completely avoided even by the best, and the real skill lies in solving the problems they present. Dr Al Mighty told a resident to ignore a barely elevated temperature in a postoperative patient. "It is nothing worthy of...
journal_title：Journal of vascular surgery
pub_type： 社论
doi：10.1016/j.jvs.2013.10.068
更新日期：2013-12-01 00:00:00
abstract：PURPOSE:Though the peroneal artery (PA) often remains patent despite disease or occlusion of other infrapopliteal arteries, there is skepticism about using the terminal PA as the outflow tract in distal revascularizations for limb salvage, especially when a patent inframalleolar artery is available. We analyzed our exp...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2008.01.002
更新日期：2008-05-01 00:00:00
abstract：INTRODUCTION:Despite its presumed effectiveness and clinical use, the physiology of selective visceral perfusion combined with distal aortic perfusion during open thoracoabdominal aortic surgery has not been characterized. Thus, the aim of this study was to establish a translatable model of thoracic aortic-clamping to ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2011.11.126
更新日期：2012-07-01 00:00:00
abstract：:Urologic complications related to vascular surgery involving the ureter have been well recognized. These include ureteral compression from aneurysms, congenital anomalies such as retrocaval ureter, obstruction from retroperitoneal fibrosis, iatrogenic injury, and ureteric fistulas. Complications involving the bladder ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jvs.2010.02.261
更新日期：2010-08-01 00:00:00
abstract：OBJECTIVE:To assess the effect of extremity vascular complications (EVCs, including ischemia or vessel trauma) on the outcomes of patients receiving cardiac support devices (CSDs, including ventricular assist device [VAD] and extracorporeal membrane oxygenation [ECMO]). METHODS:Institutional Review Board-approved, ret...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2013.12.014
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVE:Wounding patterns, methods of repair, and outcomes from femoropopliteal injury have been documented in recent civilian literature. In Operation Iraqi Freedom, as in past conflicts, these injuries continue to be a therapeutic challenge. Therefore, the objective of the current study is to document the pattern o...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2008.01.052
更新日期：2008-06-01 00:00:00
abstract：OBJECTIVE:In 2007, Medicare established ultrasound screening guidelines to identify patients at risk for abdominal aortic aneurysm (AAA). The purpose of this study was to evaluate AAA diagnosis rates and compliance with screening during 10 years (2007-2016) of the Screen for Abdominal Aortic Aneurysms Very Efficiently ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.01.053
更新日期：2019-10-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to identify whether revascularization by percutaneous transluminal angioplasty (PTA) for patients with intermittent claudication improved measures of functional performance including balance. METHODS:A prospective observational study was performed at a single tertiary vascular cente...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2013.05.106
更新日期：2013-12-01 00:00:00
abstract：OBJECTIVE:Heart rate (HR) parameters are known indicators of cardiovascular complications after cardiac surgery, but there is little evidence of their role in predicting outcome after major vascular surgery. The purpose of this study was to determine whether arrival HR (AHR) and highest intraoperative HR are associated...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jvs.2015.03.071
更新日期：2015-09-01 00:00:00
abstract：OBJECTIVE:In peripheral arterial disease (PAD) patients, a limiting factor in the success of percutaneous transluminal angioplasty (PTA) is the development of restenosis secondary to vascular smooth muscle cell (SMC) proliferation. Following endothelial damage and platelet activation, there is release of factors and ad...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jvs.2009.06.017
更新日期：2009-10-01 00:00:00
abstract：PURPOSE:The incidence, time-of-onset, and anatomical distribution of recurrent stenoses after remote endarterectomy in superficial femoral artery (SFA) occlusive disease were studied. METHODS:Patients undergoing SFA remote endarterectomy procedures were examined with duplex surveillance. Patients were examined at 6 we...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(99)70182-5
更新日期：1999-07-01 00:00:00
abstract：:Over a 12-year period, 160 transmetatarsal amputations were performed in patients with peripheral vascular occlusive disease. The following groups were defined: group 1 - nonreconstructable disease (n = 40); group 2 - transmetatarsal amputation in conjunction with distal revascularization (n = 99); group 3 - reconstru...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：OBJECTIVE:Approximately 10% of infrainguinal bypass surgeries are complicated by early conduit failure. The cause is unclear in most cases. A prospective study was conducted to monitor the development and function of platelet factor 4 (PF4)/heparin antibodies after infrainguinal bypass procedures and to evaluate their ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2008.03.028
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVE:Prior studies have suggested improved wound complication rates but decreased primary patency in lower extremity bypasses performed with endoscopic vein harvest (EVH) vs open vein harvest (OVH). We hypothesize that the inferior patency reflects the initial learning curve for EVH and that improved patency can b...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.02.043
更新日期：2019-11-01 00:00:00
abstract：:Aortobifemoral bypass (ABF) is the preferred operation for patients with bilateral aortoiliac occlusive disease, but for those with unilateral occlusion without significant stenosis of the contralateral iliac artery, alternative reconstructions, such as femorofemoral (FF) or iliofemoral (IF) bypass have been advocated...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1067/mva.1988.avs0080211
更新日期：1988-09-01 00:00:00
abstract：BACKGROUND:Treatment of chronic venous insufficiency (CVI) has largely focused on reflux. Minimally-invasive techniques to address superficial and perforator reflux have evolved, but correction of deep reflux continues to be challenging. The advent of intravascular ultrasound (IVUS) scan and minimally invasive venous s...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2009.08.032
更新日期：2010-02-01 00:00:00
abstract：PURPOSE:Intraoperative duplex scanning (IDS) after carotid endarterectomy (CEA) has been shown to reliably identify major defects either by significant changes in peak systolic velocities or by B-mode imaging. To evaluate whether IDS could also predict postoperative strokes in technically flawless CEAs, we analyzed sev...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2002.120044
更新日期：2002-03-01 00:00:00
abstract：OBJECTIVES:Worldwide, increasing proportions of aortic aneurysms are repaired electively via the endovascular route. The purpose of this study was to report the recent utilization of endovascular repair in Canada by reviewing a national administrative database. METHODS:The Canadian Institute for Health Information dat...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2005.05.043
更新日期：2005-09-01 00:00:00
abstract：:From 1995 through 1998, we encountered eight patients with infected Dacron patches after previous carotid endarterectomy. Two of the original operations had been done elsewhere, but the six patients who were collected from our own series represented 0.5% of the 1258 carotid endarterectomies we performed and 1.8% of th...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2000.107567
更新日期：2000-09-01 00:00:00
abstract：OBJECTIVE:Thrombus extension into a deep vein after superficial venous thermoablation remains a unique complication in the treatment of superficial reflux disease of the great saphenous vein (GSV). In this study, we evaluate if catheter tip positioning or vein diameter correlate with the length of proximal patent segme...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2011.06.115
更新日期：2011-12-01 00:00:00
abstract：OBJECTIVE:The use of cross-sectional area (CSA) measurements obtained from computed tomographic angiography (CTA) for the calculation of carotid artery stenosis has been suggested but not yet validated in a large population. The objective of this study was to determine whether CTA-derived CSA measurements were able to ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2013.02.031
更新日期：2013-09-01 00:00:00
abstract：:Cystic adventitial disease of veins is a rare condition. We report the case of a 28-year-old man who presented with a swollen leg secondary to obstruction of the common femoral vein as a result of this disease. He underwent excision of the cyst and made a full recovery. The presentation, investigation, treatment and p...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2006.05.034
更新日期：2006-10-01 00:00:00
abstract：PURPOSE:Many viruses have evolved mechanisms to evade detection by the host immune system. The herpes simplex gene ICP47 encodes a protein that binds to the host antigen-processing transporter, inhibiting the formation of major histocompatibility complex class I (MHC-I) antigens in infected cells. MHC-I antigen express...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：OBJECTIVE:Pivotal and comparative trial data are emerging for stent graft (SG) vs open repair of the thoracic aorta. We reviewed procedure-related perioperative morbidity, mortality, and mid-term outcomes in a contemporary series of patients treated with SG of the thoracic aorta. The data were compared with those of a ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2006.08.005
更新日期：2006-12-01 00:00:00
