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23 results on '"Lees, T"'

1. Deep learning for hydrological modelling: from benchmarking to concept formation

Author

Lees, T, Dadson, S, and Reece, S

Subjects
Deep learning (Machine learning), environmental modelling, Hydrology
Abstract

Hydrological modelling seeks to address the question: what happens to water once it falls on the land surface? Water can flow into river systems, it can pass through soils into the subsurface, it can be absorbed by the biosphere, or it can be released back into the atmosphere as evaporation. The ultimate purpose of hydrological modelling is twofold, to improve our predictions about the system of interest, and to understand how the system works. In recent decades, advances in science and technology have been made by using techniques from the field of Deep Learning, whereby flexible models are calibrated on large datasets to deduce relationships and make predictions. These techniques have begun to be applied across the environmental sciences. In this thesis I will explore a particular model architecture for deriving relationships between inputs and outputs from data, to provide accurate simulations of hydrological systems as well as to improve our understanding of the hydrological processes themselves. The Long Short-Term Memory (LSTM) is a neural network architecture from the field of Deep Learning which has shown promise for time-series modelling. This model architecture was chosen for its correspondence with our perceptual model of hydrology, whereby we consider the hydrological system to be characterised by a description of its state, and processes that govern the transfer of energy and materials from that state. This input-state-output architecture is similar in many ways to traditional process-based and conceptual models. However, unlike these models the LSTM is capable of searching a much wider range of possible functions that map inputs to outputs, capable of learning any process that can be deduced from the data, as opposed to being limited by the encoding in the traditional models. The chapters that make up this thesis first demonstrate that the LSTM is an appropriate architecture for rainfall-runoff modelling on the island of Great Britain. I trained the model using meteorological and catchment averaged attributes as input, and river discharge as outputs over a large sample of catchments. In comparison with often used conceptual model architectures, I show that the LSTM demonstrates state-of-the-art performance and justify further interrogation of what the model has learned. In a follow up study, I explore what the LSTM has learned about the hydrological system by taking the trained model weights and interpreting them with reference to intermediate stores of water that relate the meteorological inputs to the outputs of discharge. Despite the complexity of translating rainfall to discharge, hydrology is not limited to rainfall-runoff modelling. The final chapter in this thesis turns to the problem of forecasting a satellite-derived vegetation health metric which is used operationally as a proxy for drought conditions. Like rainfall-runoff modelling, the system being simulated is driven by the complex interaction of meteorological and land surface attributes, however, the target variable is now a store of water (vegetation) rather than a flux (discharge). This dissertation provides the hydrological community with three important outcomes. Firstly, the LSTM model results are provided as a benchmark for future work looking to develop a national rainfall runoff model for Great Britain. Secondly, this dissertation demonstrates a method used elsewhere in machine learning research that allows a scientist to diagnose what the LSTM has learned about the hydrological system. Finally, this dissertation demonstrates the utility of the LSTM in a drought monitoring context, forecasting a satellite derived vegetation health metric with the potential to improve the ability of national agencies to respond to drought events. Ultimately, this dissertation offers a demonstration of the power of Deep Learning models in hydrology, and calls on the community to interrogate these tools further to not only advance our predictive goals, but also our scientific ones.

Published
2023

2. Impact of acute stress on cortical electrical activity and cardiac autonomic coupling

Author

Chalmers, T, Maharaj, S, Lees, T, Lin, CT, Newton, P, Clifton-Bligh, R, McLachlan, CS, Gustin, SM, and Lal, S

Subjects
FOS: Psychology, 09 Engineering, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, Neurology & Neurosurgery, 170299 Cognitive Science not elsewhere classified
Abstract

Assessment of heart rate variability (reflective of the cardiac autonomic nervous system) has shown some predictive power for stress. Further, the predictive power of the distinct patterns of cortical brain activity and - cardiac autonomic interactions are yet to be explored in the context of acute stress, as assessed by an electrocardiogram and electroencephalogram. The present study identified distinct patterns of neural-cardiac autonomic coupling during both resting and acute stress states. In particular, during the stress task, frontal delta waves activity was positively associated with low-frequency heart rate variability and negatively associated with high-frequency heart rate variability. Low high-frequency power is associated with stress and anxiety and reduced vagal control. A positive association between resting high-frequency heart rate variability and frontocentral gamma activity was found, with a direct inverse relationship of low-frequency heart rate variability and gamma wave coupling at rest. During the stress task, low-frequency heart rate variability was positively associated with frontal delta activity. That is, the parasympathetic nervous system is reduced during a stress task, whereas frontal delta wave activity is increased. Our findings suggest an association between cardiac parasympathetic nervous system activity and frontocentral gamma and delta activity at rest and during acute stress. This suggests that parasympathetic activity is decreased during acute stress, and this is coupled with neuronal cortical prefrontal activity. The distinct patterns of neural-cardiac coupling identified in this study provide a unique insight into the dynamic associations between brain and heart function during both resting and acute stress states.

Published
2021
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3. Electroencephalographic prediction of global and domain specific cognitive performance of clinically active Australian Nurses

Author

Lees T, Maharaj S, Kalatzis G, Nassif NT, Newton PJ, and Lal S

Subjects
0903 Biomedical Engineering, 0906 Electrical and Electronic Engineering, 1116 Medical Physiology, Biomedical Engineering
Abstract

OBJECTIVE:To investigate the relationship between EEG activity and the global and domain specific cognitive performance of healthy nurses, and determine the predictive capabilities of these relationships. APPROACH:Sixty-four nurses were recruited for the present study, and data from 61 were utilised in the present analysis. Global and domain specific cognitive performance of each participant was assessed psychometrically using the Mini-mental state exam and the Cognistat, and a 32-lead monopolar EEG was recorded during a resting baseline phase and an active phase in which participants completed the Stroop test. MAIN RESULTS:Global cognitive performance was successfully predicted (81%-85% of variance) by a combination of fast wave activity variables in the alpha, beta and theta frequency bands. Interestingly, predicting domain specific performance had varying degrees of success (42%-99% of the variance predicted) and relied on combinations of both slow and fast wave activity, with delta and gamma activity predicting attention performance; delta, theta, and gamma activity predicting memory performance; and delta and beta variables predicting judgement performance. SIGNIFICANCE:Global and domain specific cognitive performance of Australian nurses may be predicted with varying degrees of success by a unique combination of EEG variables. These proposed models image transitory cognitive declines and as such may prove useful in the prediction of early cognitive impairment, and may enable better diagnosis, and management of cognitive impairment.

Published
2020

5. A sustained ocean observing system in the Indian Ocean for climate related scientific knowledge and societal needs

Author

Hermes, J. C., Masumoto, Y., Beal, L. M., Roxy, M. K., Vialard, Jérôme, Andres, M., Annamalai, H., Behera, S., D'Adamo, N., Doi, T., Peng, M., Han, W., Hardman-Mountford, N., Hendon, H., Hood, R., Kido, S., Lee, C., Lees, T., Lengaigne, Matthieu, Li, J., Lumpkin, R., Navaneeth, K. N., Milligan, B., McPhaden, M. J., Ravichandran, M., Shinoda, T., Singh, A., Sloyan, B., Strutton, P. G., Subramanian, A. C., Thurston, S., Tozuka, T., Ummenhofer, C. C., Unnikrishnan, A. S., Venkatesan, R., Wang, D., Wiggert, J., Yu, L., and Yu, W.

Subjects
end-user connections and application, data, regional observing system, interdisciplinary, IndOOS, integration, sustained observing system, Indian Ocean
Abstract

The Indian Ocean is warming faster than any of the global oceans and its climate is uniquely driven by the presence of a landmass at low latitudes, which causes monsoonal winds and reversing currents. The food, water, and energy security in the Indian Ocean rim countries and islands are intrinsically tied to its climate, with marine environmental goods and services, as well as trade within the basin, underpinning their economies. Hence, there are a range of societal needs for Indian Ocean observation arising from the influence of regional phenomena and climate change on, for instance, marine ecosystems, monsoon rains, and sea-level. The Indian Ocean Observing System (IndOOS), is a sustained observing system that monitors basin-scale ocean-atmosphere conditions, while providing flexibility in terms of emerging technologies and scientific and societal needs, and a framework for more regional and coastal monitoring. This paper reviews the societal and scientific motivations, current status, and future directions of IndOOS, while also discussing the need for enhanced coastal, shelf, and regional observations. The challenges of sustainability and implementation are also addressed, including capacity building, best practices, and integration of resources. The utility of IndOOS ultimately depends on the identification of, and engagement with, end-users and decision-makers and on the practical accessibility and transparency of data for a range of products and for decision-making processes. Therefore we highlight current progress, issues and challenges related to end user engagement with IndOOS, as well as the needs of the data assimilation and modeling communities. Knowledge of the status of the Indian Ocean climate and ecosystems and predictability of its future, depends on a wide range of socio-economic and environmental data, a significant part of which is provided by IndOOS.

Published
2019

6. Prevalence and risk factors of depression, anxiety, and stress in a cohort of Australian nurses

Author

Maharaj, S, Lees, T, and Lal, S

Subjects
Adult, Male, Depression, Australia, Nurses, Blood Pressure, Anxiety, Middle Aged, Toxicology, Job Satisfaction, Cohort Studies, Occupational Stress, Mental Health, Socioeconomic Factors, Risk Factors, Surveys and Questionnaires, Prevalence, Humans, Female, Life Style
Abstract

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Nurses remain at the forefront of patient care. However, their heavy workload as a career can leave them overworked and stressed. The demanding nature of the occupation exposes nurses to a higher risk of developing negative mental states such as depression, anxiety, and stress. Hence, the current study aimed to assess the prevalence and risk factors of these mental states in a representative sample of Australian nurses. The Depression Anxiety Stress Scale was administered to 102 nurses. Information about demographic and work characteristics were obtained using lifestyle and in-house designed questionnaires. Prevalence rates of depression, anxiety, and stress were found to be 32.4%, 41.2%, and 41.2% respectively. Binominal logistic regressions for depression and stress were significant (p = 0.007, p = 0.009). Job dissatisfaction significantly predicted a higher risk of nurses developing symptoms of depression and stress respectively (p = 0.009, p = 0.011). Poor mental health among nurses may not only be detrimental to the individual but may also hinder professional performance and in turn, the quality of patient care provided. Further research in the area is required to identify support strategies and interventions that may improve the health and wellbeing of nursing professionals and hence the quality of care delivered.

Published
2018

7. Erratum to 'Choices of Stent and Cerebral Protection in the Ongoing ACST-2 Trial: A Descriptive Study' (European Journal of Vascular and Endovascular Surgery (2017) 53(5) (617–625) (S1078588417300424) (10.1016/j.ejvs.2016.12.034))

Author

de Waard, D. D., Halliday, A., de Borst, G. J., Bulbulia, R., Huibers, A., Casana, R., Bonati, L. H., Tolva, V., Fraedrich, G., Rantner, B., Gizewski, E., Gruber, I., Hendriks, J., Cras, P., Lauwers, P., van Scheil, P., Vermassen, F., Van Herzeele, I., Geenens, M., Hemelsoet, D., Lerut, P., Lambrecht, B., Saad, G., Peeters, A., Bosiers, M., da Silva, E., de Luccia, N., Sitrangulo, J. C., Estenssoro, A. E. V., Presti, C., Casella, I., Monteiro, J. A. T., Campos, W., Puech-Leao, P., Petrov, V., Bachvarov, C., Hill, M., Mitha, A., Wong, J., Liu, C. -W., Bao, L., Yu, C., Cvjetko, I., Vidjak, V., Fiedler, J., Ostry, S., Sterba, L., Kostal, P., Staffa, R., Vlachovsky, R., Privara, M., Kriz, Z., Vojtisek, B., Krupa, P., Reif, M., Benes, V., Buchvald, P., Endrych, L., Prochazka, V., Kuliha, M., Otahal, D., Hrbac, T., Netuka, D., Mohapl, M., Kramier, F., Eldessoki, M., Heshmat, H., Abd-Allah, F., Palmiste, V., Margus, S., Toomsoo, T., Becquemin, J. -P., Bergeron, P., Abdulamit, T., Cardon, J. -M., Debus, S., Thomalla, G., Fiehler, J., Gerloss, C., Grzyska, U., Storck, M., Lamacchia, E., Eckstein, H. H., Söllner, H., Berger, H., Kallmayer, M., Popert, H., Zimmermann, A., Guenther, A., Klingner, C., Mayer, T., Schubert, J., Zanow, J., Scheinert, D., Banning-Eichenseer, U., Bausback, Y., Branzan, D., Braünilch, S., Lenzer, J., Schidt, A., Staab, H., Ulirch, M., Barlinn, J., Haase, K., Abramyuk, A., Bodechtel, U., Gerber, J., Reeps, C., Pfeiffer, T., Torello, G., Cöster, A., Giannoukas, A., Spanos, K., Matsagkas, M., Koutias, S., Vasdekis, S., Kakisis, J., Moulakakis, K., Lazaris, A., Liapas, C., Brountzos, E., Lazarides, M., Ioannou, N., Polydorou, A., Fulop, B., Fako, E., Voros, E., Bodosi, M., Nemeth, T., Barzo, P., Pazdernyik, S., Entz, L., Szeberin, Z., Dosa, E., Nemes, B., Jaranyi, Z., Pazdernyia, S., Madhaban, P., Hoffman, A., Nikolsky, E., Beyar, R., Silingardi, R., Lauricella, A., Coppi, G., Nicoloci, E., Tusini, N., Strozzi, F., Vecchiati, E., Ferri, M., Ferrero, E., Psacharopulo, D., Gaggiano, A., Viazzo, A., Farchioni, L., Parlani, G., Caso, V., De Rangoy, P., Verzini, F., Castelli, P., Delodovici, M. L., Carrafiello, G., Ierardi, A. M., Piffaretti, G., Nano, G., Occhiuto, M. T., Malacrida, G., Tealdi, D., Steghter, S., Stella, A., Pini, R., Faggioli, G., Sacca, S., Negri, M. D., Palombo, M., Perfumo, M. C., Fadda, G. F., Kasemi, H., Cernetti, C., Tonello, D., Visonà, A., Mangialardi, N., Ronchey, S., Altavista, M. C., Michelagnoli, S., Chisci, E., Speziale, F., Capoccia, L., Veroux, P., Giaquinta, A., Patti, F., Pulli, R., Boggia, P., Angiletta, D., Amatucci, G., Spinetti, F., Mascoli, F., Tsolaki, E., Civilini, E., Reimers, B., Snoch-Ziólkiewicz, M., Gabriel, M., Odero, A., Accrocca, F., Bajardi, G., Takashi, I., Masayuki, E., Hidenori, E., Aidashova, B., Kospanov, N., Bakke, S., Skjelland, M., Czlonkowska, A., Kobayashi, A., Proczka, R., Dowzenko, A., Czepel, W., Polanski, J., Bialek, P., Ozkinis, G., Stanisic, M., Iwanowski, W., Andziak, P., Gonçalves, F. B., Starodubtsev, V., Ignatenko, P., Karpenko, A., Radak, D., Aleksic, N., Sagic, D., Davidovic, L., Koncar, I., Tomic, I., Colic, M., Bartkoy, D., Rusnak, F., Gaspirini, M., Praczek, P., Milosevic, Z., Flis, V., Bergauer, A., Kobilica, N., Miksic, K., Matela, J., Blanco, E., Guerra, M., Riambau, V., Gillgren, P., Skioldebrand, C., Nymen, N., Berg, B., Delle, M., Formgren, J., Kally, T. B., Qvarfordt, P., Plate, G., Pärson, H., Lindgren, H., Bjorses, K., Gottsäter, A., Warvsten, M., Kristmundsson, T., Forssell, C., Malina, M., Holst, J., Kuhme, T., Sonesson, B., Lindblad, B., Kolbel, T., Acosta, S., Bonati, L., Traenka, C., Mueller, M., Lattman, T., Wasner, M., Mujagic, E., Von Hessling, A., Isaak, A., Stierli, P., Eugster, T., Mariani, L., Stippich, C., Wolff, T., Kahles, T., Toorop, R., Moll, F., Lo, R., Meershoek, A., Jahrome, A. K., Vos, A. W. F., Schuiling, W., Keunen, R., Reijnen, M., Macsweeney, S., Mcconachie, N., Southam, A., Stansby, G., Lees, T., Lambert, D., Clarke, M., Wyatt, M., Kappadath, S., Wales, L., Jackson, R., Raudonaitis, A., Macdonald, S., Dunlop, P., Brown, A., Vetrivel, S., Bajoriene, M., Gopi, R., Mccollum, C., Wolowczyk, L., Ghosh, J., Seriki, D., Ashleigh, R., Butterfield, J., Welch, M., Smyth, J. V., Briley, D., Schulz, U., Perkins, J., Hands, L., Kuker, W., Darby, C., Handa, A., Sekaran, L., Poskitt, K., Morrison, J., Guyler, P., Grunwald, I., Brown, J., Jakeways, M., Tysoe, S., Hargroves, D., Gunathilagan, G., Insall, R., Senaratne, J., Beard, J., Cleveland, T., Nawaz, S., Lonsdale, R., Turner, D., Gaines, P., Nair, R., Chetter, I., Robinson, G., Akomolafe, B., Hatfield, J., Saastamoinen, K., Crinnion, J., Egun, A. A., Thomas, J., Drinkwater, S., D'Souza, S., Thomson, G., Gregory, B., Babu, S., Joseph, T., Gibbs, R., Tebit, G., Mehrzad, A., Enevoldson, P., Mendalow, D., Parry, A., Tervitt, G., Clifton, A., Nazzel, M., Peto, R., Pan, H., Potter, J., Bullbulia, R., Ashley, S., Flather, M., Mansfield, A., Simpson, D., Thomas, D., Gray, W., Farrell, B., Davies, C., Rahimi, K., Gough, M., Cao, P., Rothwell, P., Belli, A., Mafham, M., Herrington, W., Sandercock, P., Gray, R., Shearman, C., Molyneux, A., Gray, A., Clarke, A., Sneade, M., Tully, L., Brudlo, W., Lay, M., Munday, A., Berry, C., Tochlin, S., Mihaylova, B., Cox, J., Kurien, R., Chester, J. Giaquinta A., de Waard, D.D., Halliday, A., de Borst, G.J., Bulbulia, R., Huibers, A., Casana, R., Bonati, L.H., Tolva, V., Fraedrich, G., Rantner, B., Gizewski, E., Gruber, I., Hendriks, J., Cras, P., Lauwers, P., van Scheil, P., Vermassen, F., Van Herzeele, I., Geenens, M., Hemelsoet, D., Lerut, P., Lambrecht, B., Saad, G., Peeters, A., Bosiers, M., da Silva, E., de Luccia, N., Sitrangulo, J.C., Estenssoro, A.E.V., Presti, C., Casella, I., Monteiro, J.A.T., Campos, W., Puech-Leao, P., Petrov, V., Bachvarov, C., Hill, M., Mitha, A., Wong, J., Liu, C.-W., Bao, L., Yu, C., Cvjetko, I., Vidjak, V., Fiedler, J., Ostry, S., Sterba, L., Kostal, P., Staffa, R., Vlachovsky, R., Privara, M., Kriz, Z., Vojtisek, B., Krupa, P., Reif, M., Benes, V., Buchvald, P., Endrych, L., Prochazka, V., Kuliha, M., Otahal, D., Hrbac, T., Netuka, D., Mohapl, M., Kramier, F., Eldessoki, M., Heshmat, H., Abd-Allah, F., Palmiste, V., Margus, S., Toomsoo, T., Becquemin, J.-P., Bergeron, P., Abdulamit, T., Cardon, J.-M., Debus, S., Thomalla, G., Fiehler, J., Gerloss, C., Grzyska, U., Storck, M., LaMacchia, E., Eckstein, H.H., Söllner, H., Berger, H., Kallmayer, M., Popert, H., Zimmermann, A., Guenther, A., Klingner, C., Mayer, T., Schubert, J., Zanow, J., Scheinert, D., Banning-Eichenseer, U., Bausback, Y., Branzan, D., Braünilch, S., Lenzer, J., Schidt, A., Staab, H., Ulirch, M., Barlinn, J., Haase, K., Abramyuk, A., Bodechtel, U., Gerber, J., Reeps, C., Pfeiffer, T., Torello, G., Cöster, A., Giannoukas, A., Spanos, K., Matsagkas, M., Koutias, S., Vasdekis, S., Kakisis, J., Moulakakis, K., Lazaris, A., Liapas, C., Brountzos, E., Lazarides, M., Ioannou, N., Polydorou, A., Fulop, B., Fako, E., Voros, E., Bodosi, M., Nemeth, T., Barzo, P., Pazdernyik, S., Entz, L., Szeberin, Z., Dosa, E., Nemes, B., Jaranyi, Z., Pazdernyia, S., Madhaban, P., Hoffman, A., Nikolsky, E., Beyar, R., Silingardi, R., Lauricella, A., Coppi, G., Nicoloci, E., Tusini, N., Strozzi, F., Vecchiati, E., Ferri, M., Ferrero, E., Psacharopulo, D., Gaggiano, A., Viazzo, A., Farchioni, L., Parlani, G., Caso, V., De Rangoy, P., Verzini, F., Castelli, P., DeLodovici, M.L., Carrafiello, G., Ierardi, A.M., Piffaretti, G., Nano, G., Occhiuto, M.T., Malacrida, G., Tealdi, D., Steghter, S., Stella, A., Pini, R., Faggioli, G., Sacca, S., Negri, M.D., Palombo, M., Perfumo, M.C., Fadda, G.F., Kasemi, H., Cernetti, C., Tonello, D., Visonà, A., Mangialardi, N., Ronchey, S., Altavista, M.C., Michelagnoli, S., Chisci, E., Speziale, F., Capoccia, L., Veroux, P., Giaquinta, A., Patti, F., Pulli, R., Boggia, P., Angiletta, D., Amatucci, G., Spinetti, F., Mascoli, F., Tsolaki, E., Civilini, E., Reimers, B., Snoch-Ziólkiewicz, M., Gabriel, M., Odero, A., Accrocca, F., Bajardi, G., Takashi, I., Masayuki, E., Hidenori, E., Aidashova, B., Kospanov, N., Bakke, S., Skjelland, M., Czlonkowska, A., Kobayashi, A., Proczka, R., Dowzenko, A., Czepel, W., Polanski, J., Bialek, P., Ozkinis, G., Stanisic, M., Iwanowski, W., Andziak, P., Gonçalves, F.B., Starodubtsev, V., Ignatenko, P., Karpenko, A., Radak, D., Aleksic, N., Sagic, D., Davidovic, L., Koncar, I., Tomic, I., Colic, M., Bartkoy, D., Rusnak, F., Gaspirini, M., Praczek, P., Milosevic, Z., Flis, V., Bergauer, A., Kobilica, N., Miksic, K., Matela, J., Blanco, E., Guerra, M., Riambau, V., Gillgren, P., Skioldebrand, C., Nymen, N., Berg, B., Delle, M., Formgren, J., Kally, T.B., Qvarfordt, P., Plate, G., Pärson, H., Lindgren, H., Bjorses, K., Gottsäter, A., Warvsten, M., Kristmundsson, T., Forssell, C., Malina, M., Holst, J., Kuhme, T., Sonesson, B., Lindblad, B., Kolbel, T., Acosta, S., Bonati, L., Traenka, C., Mueller, M., Lattman, T., Wasner, M., Mujagic, E., Von Hessling, A., Isaak, A., Stierli, P., Eugster, T., Mariani, L., Stippich, C., Wolff, T., Kahles, T., Toorop, R., Moll, F., Lo, R., Meershoek, A., Jahrome, A.K., Vos, A.W.F., Schuiling, W., Keunen, R., Reijnen, M., Macsweeney, S., McConachie, N., Southam, A., Stansby, G., Lees, T., Lambert, D., Clarke, M., Wyatt, M., Kappadath, S., Wales, L., Jackson, R., Raudonaitis, A., MacDonald, S., Dunlop, P., Brown, A., Vetrivel, S., Bajoriene, M., Gopi, R., McCollum, C., Wolowczyk, L., Ghosh, J., Seriki, D., Ashleigh, R., Butterfield, J., Welch, M., Smyth, J.V., Briley, D., Schulz, U., Perkins, J., Hands, L., Kuker, W., Darby, C., Handa, A., Sekaran, L., Poskitt, K., Morrison, J., Guyler, P., Grunwald, I., Brown, J., Jakeways, M., Tysoe, S., Hargroves, D., Gunathilagan, G., Insall, R., Senaratne, J., Beard, J., Cleveland, T., Nawaz, S., Lonsdale, R., Turner, D., Gaines, P., Nair, R., Chetter, I., Robinson, G., Akomolafe, B., Hatfield, J., Saastamoinen, K., Crinnion, J., Egun, A.A., Thomas, J., Drinkwater, S., D'Souza, S., Thomson, G., Gregory, B., Babu, S., Joseph, T., Gibbs, R., Tebit, G., Mehrzad, A., Enevoldson, P., Mendalow, D., Parry, A., Tervitt, G., Clifton, A., Nazzel, M., Peto, R., Pan, H., Potter, J., Bullbulia, R., Ashley, S., Flather, M., Mansfield, A., Simpson, D., Thomas, D., Gray, W., Farrell, B., Davies, C., Rahimi, K., Gough, M., Cao, P., Rothwell, P., Belli, A., Mafham, M., Herrington, W., Sandercock, P., Gray, R., Shearman, C., Molyneux, A., Gray, A., Clarke, A., Sneade, M., Tully, L., Brudlo, W., Lay, M., Munday, A., Berry, C., Tochlin, S., Mihaylova, B., Cox, J., Kurien, R., and Chester, J.

Subjects
Surgery, Cardiology and Cardiovascular Medicine, Settore MED/22 - Chirurgia Vascolare
Abstract

Due to a miscommunication during the production of this article, the members of the ACST-2 Collaborative Group were not properly indexed in PubMed. This has now been corrected online. We apologize for any confusion or inconvenience that this oversight might have caused.

Published
2017

8. Erratum to “Choices of Stent and Cerebral Protection in the Ongoing ACST-2 Trial: A Descriptive Study” (European Journal of Vascular and Endovascular Surgery (2017) 53(5) (617–625) (S1078588417300424) (10.1016/j.ejvs.2016.12.034))

Author

de Waard, D. D., Halliday, A., de Borst, G. J., Bulbulia, R., Huibers, A., Casana, R., Bonati, L. H., Tolva, V., Fraedrich, G., Rantner, B., Gizewski, E., Gruber, I., Hendriks, J., Cras, P., Lauwers, P., van Scheil, P., Vermassen, F., Van Herzeele, I., Geenens, M., Hemelsoet, D., Lerut, P., Lambrecht, B., SAAD, GEORGE SAFWAT YOUSSEF, Peeters, A., Bosiers, M., COSTA DA SILVA, AMELIA ELISABETE, de Luccia, N., Sitrangulo, J. C., Estenssoro, A. E. V., PRESTI, CHIARA, Casella, I., Monteiro, J. A. T., Campos, W., Puech-Leao, P., Petrov, V., Bachvarov, C., Hill, M., Mitha, A., Wong, J., Liu, C. -W., BAO, LIYING, Yu, C., Cvjetko, I., Vidjak, V., Fiedler, J., Ostry, S., Sterba, L., Kostal, P., Staffa, R., Vlachovsky, R., Privara, M., Kriz, Z., Vojtisek, B., Krupa, P., Reif, M., Benes, V., Buchvald, P., Endrych, L., Prochazka, V., Kuliha, M., Otahal, D., Hrbac, T., Netuka, D., Mohapl, M., Kramier, F., Eldessoki, M., Heshmat, H., Abd-Allah, F., Palmiste, V., Margus, S., Toomsoo, T., Becquemin, J. -P., Bergeron, P., Abdulamit, T., Cardon, J. -M., Debus, S., Thomalla, G., Fiehler, J., Gerloss, C., Grzyska, U., Storck, M., LaMacchia, E., Eckstein, H. H., Söllner, H., Berger, H., Kallmayer, M., Popert, H., Zimmermann, A., Guenther, A., Klingner, C., Mayer, T., Schubert, J., Zanow, J., Scheinert, D., Banning-Eichenseer, U., Bausback, Y., Branzan, D., Braünilch, S., Lenzer, J., Schidt, A., Staab, H., Ulirch, M., Barlinn, J., Haase, K., Abramyuk, A., Bodechtel, U., Gerber, J., Reeps, C., Pfeiffer, T., Torello, G., Cöster, A., Giannoukas, A., Spanos, K., Matsagkas, M., Koutias, S., VASDEKIS, VASSILIS G.S., Kakisis, J., Moulakakis, K., Lazaris, A., Liapas, C., Brountzos, E., Lazarides, M., Ioannou, N., Polydorou, A., Fulop, B., Fako, E., Voros, E., Bodosi, M., Nemeth, T., Barzo, P., Pazdernyik, S., Entz, L., Szeberin, Z., Dosa, E., Nemes, B., Jaranyi, Z., Pazdernyia, S., Madhaban, P., Hoffman, A., Nikolsky, E., Beyar, R., Silingardi, R., Lauricella, A., COPPI, GIOACHINO, Nicoloci, E., Tusini, N., Strozzi, F., Vecchiati, E., Ferri, M., FERRERO, ELISA, Psacharopulo, D., Gaggiano, A., Viazzo, A., Farchioni, L., Parlani, G., Caso, V., De Rangoy, P., Verzini, F., CASTELLI, PAOLO, DeLodovici, M. L., Carrafiello, G., Ierardi, A. M., Piffaretti, G., Nano, G., Occhiuto, M. T., Malacrida, G., Tealdi, D., Steghter, S., Stella, A., Pini, R., Faggioli, G., SACCA', SALVATORE, Negri, M. D., Palombo, M., Perfumo, M. C., Fadda, G. F., Kasemi, H., CERNETTI, MARIA CHIARA, Tonello, D., Visonà, A., Mangialardi, N., Ronchey, S., Altavista, M. C., Michelagnoli, S., Chisci, E., Speziale, F., Capoccia, L., Veroux, P., Giaquinta, A., Patti, F., Pulli, R., Boggia, P., Angiletta, D., Amatucci, G., Spinetti, F., Mascoli, F., TSOLAKI, ELPINIKI, Civilini, E., Reimers, B., Setacci, C., Pogany, G., ODERO, ANDREA, Accrocca, F., Bajardi, G., Takashi, I., Masayuki, E., Hidenori, E., Aidashova, B., Kospanov, N., Bakke, S., Skjelland, M., Czlonkowska, A., Kobayashi, A., Proczka, R., Dowzenko, A., Czepel, W., Polanski, J., Bialek, P., Ozkinis, G., Snoch-Ziólkiewicz, M., Gabriel, M., Stanisic, M., Iwanowski, W., Andziak, P., Gonçalves, F. B., Starodubtsev, V., Ignatenko, P., Karpenko, A., Radak, D., Aleksic, N., Sagic, D., Davidovic, L., Koncar, I., Tomic, I., ČOLIC, MINA, Bartkoy, D., Rusnak, F., Gaspirini, M., Praczek, P., Milosevic, Z., Flis, V., Bergauer, A., Kobilica, N., Miksic, K., Matela, J., Blanco, E., Guerra, M., Riambau, V., Gillgren, P., Skioldebrand, C., Nymen, N., Berg, B., DELLE VERGINI, ANNA RITA MARIA, Formgren, J., Kally, T. B., Qvarfordt, P., Plate, G., Pärson, H., Lindgren, H., Bjorses, K., Gottsäter, A., Warvsten, M., Kristmundsson, T., Forssell, C., Malina, M., Holst, J., Kuhme, T., Sonesson, B., Lindblad, B., Kolbel, T., Acosta, S., BONATI, LISA, Traenka, C., Mueller, M., Lattman, T., Wasner, M., Mujagic, E., Von Hessling, A., Isaak, A., Stierli, P., Eugster, T., Mariani, L., Stippich, C., Wolff, T., Kahles, T., Toorop, R., Moll, F., Lo, R., Meershoek, A., Jahrome, A. K., Vos, A. W. F., Schuiling, W., Keunen, R., Reijnen, M., Macsweeney, S., McConachie, N., Southam, A., Stansby, G., Lees, T., Lambert, D., Clarke, M., Wyatt, M., Kappadath, S., Wales, L., Jackson, R., Raudonaitis, A., MacDonald, S., Dunlop, P., Brown, A., Vetrivel, S., Bajoriene, M., Gopi, R., McCollum, C., Wolowczyk, L., Ghosh, J., Seriki, D., Ashleigh, R., Butterfield, J., WELCH, MICHAEL, Smyth, J. V., Briley, D., Schulz, U., Perkins, J., Hands, L., Kuker, W., Darby, C., Handa, A., Sekaran, L., Poskitt, K., Morrison, J., Guyler, P., Grunwald, I., Brown, J., Jakeways, M., Tysoe, S., Hargroves, D., Gunathilagan, G., Insall, R., Senaratne, J., Beard, J., Cleveland, T., Nawaz, S., Lonsdale, R., Turner, D., Gaines, P., Nair, R., Chetter, I., Robinson, G., Akomolafe, B., Hatfield, J., Saastamoinen, K., Crinnion, J., Egun, A. A., Thomas, J., Drinkwater, S., D'Souza, S., Thomson, G., Gregory, B., Babu, S., Ashley, S., Joseph, T., Gibbs, R., Tebit, G., Mehrzad, A., Enevoldson, P., Mendalow, D., Parry, A., Tervitt, G., Clifton, A., Nazzel, M., Peto, R., Pan, H., Potter, J., Bullbulia, R., Bonati, L., Mihaylova, B., Flather, M., Mansfield, A., Simpson, D., Thomas, D., Gray, W., Farrell, B., Davies, C., Rahimi, K., Gough, M., Cao, P., Rothwell, P., Belli, A., Mafham, M., Herrington, W., Sandercock, P., Gray, R., Shearman, C., Molyneux, A., Gray, A., Clarke, A., Sneade, M., Tully, L., Brudlo, W., Lay, M., MUNDAY, SARA ANN, Berry, C., Tochlin, S., Cox, J., Kurien, R., Chester, J., de Waard, D. D., Halliday, A., de Borst, G. J., Bulbulia, R., Huibers, A., Casana, R., Bonati, L. H., Tolva, V., Fraedrich, G., Rantner, B., Gizewski, E., Gruber, I., Hendriks, J., Cras, P., Lauwers, P., van Scheil, P., Vermassen, F., Van Herzeele, I., Geenens, M., Hemelsoet, D., Lerut, P., Lambrecht, B., Saad, G., Peeters, A., Bosiers, M., da Silva, E., de Luccia, N., Sitrangulo, J. C., Estenssoro, A. E. V., Presti, C., Casella, I., Monteiro, J. A. T., Campos, W., Puech-Leao, P., Petrov, V., Bachvarov, C., Hill, M., Mitha, A., Wong, J., Liu, C. -W., Bao, L., Yu, C., Cvjetko, I., Vidjak, V., Fiedler, J., Ostry, S., Sterba, L., Kostal, P., Staffa, R., Vlachovsky, R., Privara, M., Kriz, Z., Vojtisek, B., Krupa, P., Reif, M., Benes, V., Buchvald, P., Endrych, L., Prochazka, V., Kuliha, M., Otahal, D., Hrbac, T., Netuka, D., Mohapl, M., Kramier, F., Eldessoki, M., Heshmat, H., Abd-Allah, F., Palmiste, V., Margus, S., Toomsoo, T., Becquemin, J. -P., Bergeron, P., Abdulamit, T., Cardon, J. -M., Debus, S., Thomalla, G., Fiehler, J., Gerloss, C., Grzyska, U., Storck, M., Lamacchia, E., Eckstein, H. H., Söllner, H., Berger, H., Kallmayer, M., Popert, H., Zimmermann, A., Guenther, A., Klingner, C., Mayer, T., Schubert, J., Zanow, J., Scheinert, D., Banning-Eichenseer, U., Bausback, Y., Branzan, D., Braünilch, S., Lenzer, J., Schidt, A., Staab, H., Ulirch, M., Barlinn, J., Haase, K., Abramyuk, A., Bodechtel, U., Gerber, J., Reeps, C., Pfeiffer, T., Torello, G., Cöster, A., Giannoukas, A., Spanos, K., Matsagkas, M., Koutias, S., Vasdekis, S., Kakisis, J., Moulakakis, K., Lazaris, A., Liapas, C., Brountzos, E., Lazarides, M., Ioannou, N., Polydorou, A., Fulop, B., Fako, E., Voros, E., Bodosi, M., Nemeth, T., Barzo, P., Pazdernyik, S., Entz, L., Szeberin, Z., Dosa, E., Nemes, B., Jaranyi, Z., Pazdernyia, S., Madhaban, P., Hoffman, A., Nikolsky, E., Beyar, R., Silingardi, R., Lauricella, A., Coppi, G., Nicoloci, E., Tusini, N., Strozzi, F., Vecchiati, E., Ferri, M., Ferrero, E., Psacharopulo, D., Gaggiano, A., Viazzo, A., Farchioni, L., Parlani, G., Caso, V., De Rangoy, P., Verzini, F., Castelli, P., Delodovici, M. L., Carrafiello, G., Ierardi, A. M., Piffaretti, G., Nano, G., Occhiuto, M. T., Malacrida, G., Tealdi, D., Steghter, S., Stella, A., Pini, R., Faggioli, G., Sacca, S., Negri, M. D., Palombo, M., Perfumo, M. C., Fadda, G. F., Kasemi, H., Cernetti, C., Tonello, D., Visonà, A., Mangialardi, N., Ronchey, S., Altavista, M. C., Michelagnoli, S., Chisci, E., Speziale, F., Capoccia, L., Veroux, P., Giaquinta, A., Patti, F., Pulli, R., Boggia, P., Angiletta, D., Amatucci, G., Spinetti, F., Mascoli, F., Tsolaki, E., Civilini, E., Reimers, B., Setacci, C., Pogany, G., Odero, A., Accrocca, F., Bajardi, G., Takashi, I., Masayuki, E., Hidenori, E., Aidashova, B., Kospanov, N., Bakke, S., Skjelland, M., Czlonkowska, A., Kobayashi, A., Proczka, R., Dowzenko, A., Czepel, W., Polanski, J., Bialek, P., Ozkinis, G., Snoch-Ziólkiewicz, M., Gabriel, M., Stanisic, M., Iwanowski, W., Andziak, P., Gonçalves, F. B., Starodubtsev, V., Ignatenko, P., Karpenko, A., Radak, D., Aleksic, N., Sagic, D., Davidovic, L., Koncar, I., Tomic, I., Colic, M., Bartkoy, D., Rusnak, F., Gaspirini, M., Praczek, P., Milosevic, Z., Flis, V., Bergauer, A., Kobilica, N., Miksic, K., Matela, J., Blanco, E., Guerra, M., Riambau, V., Gillgren, P., Skioldebrand, C., Nymen, N., Berg, B., M., Delle, Formgren, J., Kally, T. B., Qvarfordt, P., Plate, G., Pärson, H., Lindgren, H., Bjorses, K., Gottsäter, A., Warvsten, M., Kristmundsson, T., Forssell, C., Malina, M., Holst, J., Kuhme, T., Sonesson, B., Lindblad, B., Kolbel, T., Acosta, S., Bonati, L., Traenka, C., Mueller, M., Lattman, T., Wasner, M., Mujagic, E., Von Hessling, A., Isaak, A., Stierli, P., Eugster, T., Mariani, L., Stippich, C., Wolff, T., Kahles, T., Toorop, R., Moll, F., R., Lo, Meershoek, A., Jahrome, A. K., Vos, A. W. F., Schuiling, W., Keunen, R., Reijnen, M., Macsweeney, S., Mcconachie, N., Southam, A., Stansby, G., Lees, T., Lambert, D., Clarke, M., Wyatt, M., Kappadath, S., Wales, L., Jackson, R., Raudonaitis, A., Macdonald, S., Dunlop, P., Brown, A., Vetrivel, S., Bajoriene, M., Gopi, R., Mccollum, C., Wolowczyk, L., Ghosh, J., Seriki, D., Ashleigh, R., Butterfield, J., Welch, M., Smyth, J. V., Briley, D., Schulz, U., Perkins, J., Hands, L., Kuker, W., Darby, C., Handa, A., Sekaran, L., Poskitt, K., Morrison, J., Guyler, P., Grunwald, I., Brown, J., Jakeways, M., Tysoe, S., Hargroves, D., Gunathilagan, G., Insall, R., Senaratne, J., Beard, J., Cleveland, T., Nawaz, S., Lonsdale, R., Turner, D., Gaines, P., Nair, R., Chetter, I., Robinson, G., Akomolafe, B., Hatfield, J., Saastamoinen, K., Crinnion, J., Egun, A. A., Thomas, J., Drinkwater, S., D'Souza, S., Thomson, G., Gregory, B., Babu, S., Ashley, S., Joseph, T., Gibbs, R., Tebit, G., Mehrzad, A., Enevoldson, P., Mendalow, D., Parry, A., Tervitt, G., Clifton, A., Nazzel, M., Peto, R., Pan, H., Potter, J., Bullbulia, R., Mihaylova, B., Flather, M., Mansfield, A., Simpson, D., Thomas, D., Gray, W., Farrell, B., Davies, C., Rahimi, K., Gough, M., Cao, P., Rothwell, P., Belli, A., Mafham, M., Herrington, W., Sandercock, P., Gray, R., Shearman, C., Molyneux, A., Gray, A., Clarke, A., Sneade, M., Tully, L., Brudlo, W., Lay, M., Munday, A., Berry, C., Tochlin, S., Cox, J., Kurien, R., and Chester, J.

Subjects
Surgery, Cardiology and Cardiovascular Medicine
Abstract

Due to a miscommunication during the production of this article, the members of the ACST-2 Collaborative Group were not properly indexed in PubMed. This has now been corrected online. We apologize for any confusion or inconvenience that this oversight might have caused.

Published
2017

9. Electroencephalography as a predictor of self-report fatigue/sleepiness during monotonous driving in train drivers

Author

Lees, T, Chalmers, T, Burton, D, Zilberg, E, Penzel, T, and Lal, S

Subjects
Adult, Male, Sleepiness, Biomedical Engineering, Brain, Electroencephalography, Transportation, Signal Processing, Computer-Assisted, Middle Aged, Young Adult, Diagnostic Self Evaluation, Boredom, Humans, Female, Diagnosis, Computer-Assisted, Self Report, Fatigue, Aged
Abstract

© 2018 Institute of Physics and Engineering in Medicine. Objective: In this study, electroencephalography activity recorded during monotonous driving was investigated to examine the predictive capability of monopolar EEG analysis for fatigue/sleepiness in a cohort of train drivers. Approach: Sixty-three train drivers participated in the study, where 32- lead monopolar EEG data was recorded during a monotonous driving task. Participant sleepiness was assessed using the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Karolinksa sleepiness scale (KSS) and the checklist of individual strength 20 (CIS20). Main results: Self-reported fatigue/sleepiness scores of the train driver cohort were primarily associated with EEG delta, theta, and alpha variables; however, some beta and gamma associations were also implicated. Furthermore, general linear models informed by these EEG variables were able to predict self-reported scores with varying degrees of success, representing between 48% and 54% of variance in fatigue scores. Significance: Self-reported fatigue/sleepiness scores of train drivers were predicted with varying degrees of success (dependent upon the self-reported fatigue/sleepiness measure) by alterations to monopolar delta, theta, and alpha band activity variables, indicating EEG as a potential indicator for fatigue/sleepiness in train drivers.

Published
2018

10. THE NEUROCOGNITIVE RELATIONSHIP BETWEEN STRESS AND ANXIETY, AND MEMORY AND DECISION MAKING PERFORMANCE OF AUSTRALIAN NURSES

Author

Lees, T, Maharaj, S, Kalatzis, G, Nassif, N, Newton, P, and Lal, S

Subjects
06 Biological Sciences, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, Experimental Psychology
Abstract

Stress and anxiety have been consistently linked with impaired memory and decision making ability which can reduce workplace performance. While such impairments pose a risk to nurse performance, hence quality of patient care, research examining the cognitive impact of stress and anxiety in nurses is limited. The present study analysed data from 61 nurses and 51 non‐health professionals. The Depression, Anxiety, Stress Scale (DASS) measured state stress and anxiety levels. Global and domain specific cognitive performance was assessed using the Mini‐mental state exam and Cognistat, respectively. Additionally, a 32 lead electroencephalogram (EEG) montage was also captured as a physiological measure of cognitive performance. Stress was found to be associated with facilitated decision‐making in non‐health professionals (r = 0.37, p = 0.01), and impaired memory performance in nurses (r = ‐0.28, p < 0.05). Anxiety was associated with impaired memory in nurses (r = ‐0.39, p < 0.01) but no such association was observed in non‐health professionals. Analysis of EEG data revealed associations between stress and anxiety, and delta, beta and gamma activity variations, mostly localised to frontotemporal and frontoparietal brain regions. Overall, stress and anxiety are experienced by both non‐health professionals and nurses alike, and may influence cognitive performance in a unique manner for each group. Findings suggest that development and implementation of countermeasure strategies may help preserve nurse performance, and potentially reduce adverse medical events.

Published
2018

12. Choices of Stent and Cerebral Protection in the Ongoing ACST-2 Trial: A Descriptive Study (vol 53, pg 617, 2017)

Author

de Waard, D. D., Halliday, A., de Borst, G. J., Bulbulia, R., Huibers, A., Casana, R., Bonati, L. H., Tolva, V., Fraedrich, G., Rantner, B., Gizewski, E., Gruber, I., Hendriks, J., Cras, P., Lauwers, P., van Scheil, P., Vermassen, F., Van Herzeele, I., Geenens, M., Hemelsoet, D., Lerut, P., Lambrecht, B., Saad, G., Peeters, A., Bosiers, M., da Silva, E., de Luccia, N., Sitrangulo, J. C., Estenssoro, A. E. V., Presti, C., Casella, I., Monteiro, J. A. T., Campos, W., Puech-Leao, P., Petrov, V., Bachvarov, C., Hill, M., Mitha, A., Wong, J., Liu, C. -W., Bao, L., Yu, C., Cvjetko, I., Vidjak, V., Fiedler, J., Ostry, S., Sterba, L., Kostal, P., Staffa, R., Vlachovsky, R., Privara, M., Kriz, Z., Vojtisek, B., Krupa, P., Reif, M., Benes, V., Buchvald, P., Endrych, L., Prochazka, V., Kuliha, M., Otahal, D., Hrbac, T., Netuka, D., Mohapl, M., Kramier, F., Eldessoki, M., Heshmat, H., Abd-Allah, F., Palmiste, V., Margus, S., Toomsoo, T., Becquemin, J. -P., Bergeron, P., Abdulamit, T., Cardon, J. -M., Debus, S., Thomalla, G., Fiehler, J., Gerloss, C., Grzyska, U., Storck, M., Lamacchia, E., Eckstein, H. H., Söllner, H., Berger, H., Kallmayer, M., Popert, H., Zimmermann, A., Guenther, A., Klingner, C., Mayer, T., Schubert, J., Zanow, J., Scheinert, D., Banning-Eichenseer, U., Bausback, Y., Branzan, D., Braünilch, S., Lenzer, J., Schidt, A., Staab, H., Ulirch, M., Barlinn, J., Haase, K., Abramyuk, A., Bodechtel, U., Gerber, J., Reeps, C., Pfeiffer, T., Torello, G., Cöster, A., Giannoukas, A., Spanos, K., Matsagkas, M., Koutias, S., Vasdekis, S., Kakisis, J., Moulakakis, K., Lazaris, A., Liapas, C., Brountzos, E., Lazarides, M., Ioannou, N., Polydorou, A., Fulop, B., Fako, E., Voros, E., Bodosi, M., Nemeth, T., Barzo, P., Pazdernyik, S., Entz, L., Szeberin, Z., Dosa, E., Nemes, B., Jaranyi, Z., Pazdernyia, S., Madhaban, P., Hoffman, A., Nikolsky, E., Beyar, R., Silingardi, R., Lauricella, A., Coppi, G., Nicoloci, E., Tusini, N., Strozzi, F., Vecchiati, E., Ferri, M., Ferrero, E., Psacharopulo, D., Gaggiano, A., Viazzo, A., Farchioni, L., Parlani, G., Caso, V., De Rangoy, P., Verzini, F., Castelli, P., Delodovici, M. L., Carrafiello, G., Ierardi, A. M., Piffaretti, G., Nano, G., Occhiuto, M. T., Malacrida, G., Tealdi, D., Steghter, S., Stella, A., Pini, R., Faggioli, G., Sacca, S., Negri, M. D., Palombo, M., Perfumo, M. C., Fadda, G. F., Kasemi, H., Cernetti, C., Tonello, D., Visonà, A., Mangialardi, N., Ronchey, S., Altavista, M. C., Michelagnoli, S., Chisci, E., Speziale, F., Capoccia, L., Veroux, P., Giaquinta, A., Patti, F., Pulli, R., Boggia, P., Angiletta, D., Amatucci, G., Spinetti, F., Mascoli, F., Tsolaki, E., Civilini, E., Reimers, B., Snoch-Ziólkiewicz, M., Gabriel, M., Odero, A., Accrocca, F., Bajardi, G., Takashi, I., Masayuki, E., Hidenori, E., Aidashova, B., Kospanov, N., Bakke, S., Skjelland, M., Czlonkowska, A., Kobayashi, A., Proczka, R., Dowzenko, A., Czepel, W., Polanski, J., Bialek, P., Ozkinis, G., Stanisic, M., Iwanowski, W., Andziak, P., Gonçalves, F. B., Starodubtsev, V., Ignatenko, P., Karpenko, A., Radak, D., Aleksic, N., Sagic, D., Davidovic, L., Koncar, I., Tomic, I., Colic, M., Bartkoy, D., Rusnak, F., Gaspirini, M., Praczek, P., Milosevic, Z., Flis, V., Bergauer, A., Kobilica, N., Miksic, K., Matela, J., Blanco, E., Guerra, M., Riambau, V., Gillgren, P., Skioldebrand, C., Nymen, N., Berg, B., Delle, M., Formgren, J., Kally, T. B., Qvarfordt, P., Plate, G., Pärson, H., Lindgren, H., Bjorses, K., Gottsäter, A., Warvsten, M., Kristmundsson, T., Forssell, C., Malina, M., Holst, J., Kuhme, T., Sonesson, B., Lindblad, B., Kolbel, T., Acosta, S., Bonati, L., Traenka, C., Mueller, M., Lattman, T., Wasner, M., Mujagic, E., Von Hessling, A., Isaak, A., Stierli, P., Eugster, T., Mariani, L., Stippich, C., Wolff, T., Kahles, T., Toorop, R., Moll, F., Lo, R., Meershoek, A., Jahrome, A. K., Vos, A. W. F., Schuiling, W., Keunen, R., Reijnen, M., Macsweeney, S., Mcconachie, N., Southam, A., Stansby, G., Lees, T., Lambert, D., Clarke, M., Wyatt, M., Kappadath, S., Wales, L., Jackson, R., Raudonaitis, A., Macdonald, S., Dunlop, P., Brown, A., Vetrivel, S., Bajoriene, M., Gopi, R., Mccollum, C., Wolowczyk, L., Ghosh, J., Seriki, D., Ashleigh, R., Butterfield, J., Welch, M., Smyth, J. V., Briley, D., Schulz, U., Perkins, J., Hands, L., Kuker, W., Darby, C., Handa, A., Sekaran, L., Poskitt, K., Morrison, J., Guyler, P., Grunwald, I., Brown, J., Jakeways, M., Tysoe, S., Hargroves, D., Gunathilagan, G., Insall, R., Senaratne, J., Beard, J., Cleveland, T., Nawaz, S., Lonsdale, R., Turner, D., Gaines, P., Nair, R., Chetter, I., Robinson, G., Akomolafe, B., Hatfield, J., Saastamoinen, K., Crinnion, J., Egun, A. A., Thomas, J., Drinkwater, S., D'Souza, S., Thomson, G., Gregory, B., Babu, S., Joseph, T., Gibbs, R., Tebit, G., Mehrzad, A., Enevoldson, P., Mendalow, D., Parry, A., Tervitt, G., Clifton, A., Nazzel, M., Peto, R., Pan, H., Potter, J., Bullbulia, R., Ashley, S., Flather, M., Mansfield, A., Simpson, D., Thomas, D., Gray, W., Farrell, B., Davies, C., Rahimi, K., Gough, M., Cao, P., Rothwell, P., Belli, A., Mafham, M., Herrington, W., Sandercock, P., Gray, R., Shearman, C., Molyneux, A., Gray, A., Clarke, A., Sneade, M., Tully, L., Brudlo, W., Lay, M., Munday, A., Berry, C., Tochlin, S., Mihaylova, B., Cox, J., Kurien, R., and Chester, J.

Subjects
Surgery, Cardiology and Cardiovascular Medicine
Published
2017

13. Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS)

Author

Writing Committee Null, Björck, M., Koelemay, M., Acosta, S., Bastos Goncalves, F., Kölbel, T., Kolkman, J. J., Lees, T., Lefevre, J. H., Menyhei, G., Oderich, G., ESVS Guidelines Committee Null, Kolh, P., de Borst, G. J., Chakfe, N., Debus, S., Hinchliffe, R., Kakkos, S., Koncar, I., Sanddal Lindholt, J., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers Null, Geelkerken, B., Gloviczki, P., Huber, T., and Naylor, R.

Subjects
Mesenteric arterial aneurysms, Acute mesenteric ischaemia, Arterial thrombosis, Guidelines, Chronic mesenteric ischaemia, Non-occlusive mesenteric ischaemia, Arterial embolism, Isolated dissections of the mesenteric arteries, Mesenteric venous thrombosis, Venous mesenteric ischaemia, Surgery, Cardiology and Cardiovascular Medicine
Published
2017

14. Status update and interim results from the asymptomatic carotid surgery trial-2 (ACST-2)

Author

Bulbulia, R, Gray, W, Naughten, A, den Hartog, A, Delmestri, A, Wallis, C, le Conte, S, Macdonald, S, Radak, D, Nessi, F, Torsello, G, Hendriks, J, Bjorses, K, Davidovic, L, Tusini, N, Gillgren, P, Casana, R, Tolva, V, Bausback, Y, Mehrzad, A, Gottsäter, A, Esisi, B, Cras, P, Hendriks, Jm, Lauwers, P, Hertoghs, M, Van Schil, P, De Jaegher, L, Peeters, P, Verbist, J, Dendooven, D, De Letter, J, Vanhooren, G, Astarci, P, Capron, I, Choghari, C, Hammer, F, Lacroix, V, Peeters, A, Verhelst, R, Bosiers, M, De Meester, K, Deloose, K, Van Buggenhout, E, Vinck, E, Geenens, M, Hemelsoet, D, Van Herzeele, I, Vermassen, F, De Koster, G, Desiron, Q, Maertens de Noordhout, A, Malmendier, D, Massoz, M, Saad, G, Cirelli, S, Dormal, P, Lerut, P, Thues, E, Coutts, S, Demchuk, A, Hill, M, Hudon, M, Klein, G, Mcclelland, M, Morrish, W, Samis, G, Sutherland, G, Watson, T, Wong, J, Liu, B, Liu, Cw, Barankova, L, Chlouba, V, Fiedler, J, Priban, V, Sterba, L, Kalabova, L, Kriz, Z, Krupa, P, Privara, M, Reif, M, Souckova, L, Staffa, R, Vlachovsky, R, Vojtisek, B, Hrbac, T, Kuliha, M, Prochazka, V, Roubec, M, Skoloudik, D, Abd Allah, F, Eldessoki, Mh, Kassem, Hh, Gharieb, Hs, Cardon, Jm, Le Gallou Wittenberg, A, Allaire, E, Becquemin, Jp, Cochennec, F, Desgranges, P, Hosseini, H, Kobeiter, H, Marzelle, J, Bergeron, P, Padovani, R, Trastour, Jc, Biermaier, B, Gissler, Hm, Klotzsch, C, Pfeiffer, T, Schneider, R, Soehl, L, Wennrih, M, Botsios, S, Branzan, D, Braunlich, S, Holzer, H, Lenzer, J, Reichenbecher, C, Piorkowski, C, Schuster, J, Scheinert, D, Schmidt, A, Ulrich, M, Werner, M, Coster, A, Engelhardt, A, Ratusinski, Cm, Berekoven, B, Frerker, K, Gordon, V, Bellenis, I, Polydorou, A, Polydorou, V, Tavernarakis, A, Ioannou, N, Terzoudi, M, Chatzinikou, E, Giannoukas, A, Hadjigeorgiou, G, Koutsias, S, Ralli, S, Rousas, N, Nemes, B, Jàrànyi, Z, Szabo, A, Varga, D, Barzo, P, Bodosi, M, Fako, E, Fulop, B, Kuncz, A, Nagy, E, Nemeth, T, Pazdernyik, S, Skoba, K, Voros, E, Haider, Sn, Harbison, J, Madhavan, P, Moore, D, Beyar, R, Hoffman, A, Karram, T, Kerner, A, Nikolsky, E, Nitecki, S, Amatucci, G, Vittorio, P, Frederico, Marinazzo, D, Regina, G, Giaquinta, A, Patti, F, Veroux, M, Veroux, P, Adobbati, L, Bertoni, G, Bianchi, P, Cireni, L, Martello, L, Arcuri, L, Casoni, F, Coppi, G, Moratto, R, Veronesi, J, Bajardi, G, Savettieri, G, Corbetta, R, Odero, A, Quaretti, P, Thyrion, Z, Cao, P, Caso, V, Derango, P, Farchioni, L, Parlani, G, Malferrari, G, Strozzi, F, Vecchiati, E, Biello, Antonella, Capoccia, Laura, Menna, Danilo, Rizzo, ANNA RITA, Sbarigia, Enrico, Speziale, Francesco, Toni, D, Giovanni, M, Meola, G, Nano, G, Occiuto, Mt, Stegher, S, Tealdi, D, Accrocca, F, Ambrogi, C, Barbazza, R, Marcucci, G, Cappelli, A, de Donato, G, Palasciano, G, Pieragalli, D, Setacci, C, Settaci, F, Labate, C, Ferrero, E, Ferri, M, Viazzo, A, Castelli, P, Delodovici, Ml, Ferrario, M, Piffaretti, G, Tomei, G, Furui, E, Inoue, T, Kondo, R, Matsumoto, Y, Shimizu, H, Aidashova, B, Kospanov, N, Lyssenko, R, Mussagaliev, D, De Borst GJ, Den Hartog AG, Lo, R, Moll, F, Toorop, R, Van Der Worp HB, Vonken, Ej, Bakke, S, Krohg Sorensen, K, Skjelland, M, Andziak, P, Drelichowski, S, Dratwicki, M, Gil, R, Iwanowski, W, Koncewicz, K, Nowicki, M, Pniewski, J, Rzezak, J, Seweryniak, P, Bialek, P, Biejat, Z, Czepel, W, Czlonkowska, A, Dowzenko, A, Jedzrejewska, J, Kobayashi, A, Leszezyuski, J, Malek, A, Polanski, J, Proczka, R, Skorski, M, Szostek, M, Aleksic, N, Babic, S, Kolar, J, Sagic, D, Tanaskovic, S, Colic, M, Jovanovic, D, Koncar, I, Bartko, D, Beno, P, Rusnak, F, Zelenak, K, Gasparini, M, Grad, A, Kompara, I, Milosevic, Z, Flis, V, Matela, J, Miksic, K, Milotic, F, Mrdja, B, Stirn, B, Tetickovic, E, Chamorro, A, Obach, V, Riambau, V, Roman, S, Blanco, E, Izquierdo, Ay, Guerra, M, Campbell, E, Lindgren, H, Nyberg, J, Plate, G, Parsson, H, Qvarfordt, P, Acosta, S, Brandt, K, Dias, N, Gottsater, A, Holst, J, Kristmundsson, T, Kuhme, T, Kolbel, T, Lindblad, B, Lindh, M, Malina, M, Ohrlander, T, Resch, T, Rönnle, V, Sonesson, B, Warvsten, M, Zdanowski, Z, Bengt, B, Delle, M, Formgren, J, Jarl, L, Kall, Tb, Konrad, P, Nyman, N, Skioldebrand, C, Steuer, J, Takolander, R, Ahlhelm, Fj, Bonati, L, Engelter, Ss, Eugster, T, Gensicke, H, Lyrer, P, Mariani, L, Stierli, P, Stippich, C, Wolff, T, Brown, E, Butler, N, Day, Dj, Hayes, P, Higgins, N, Jumilla, E, Martin, P, Mitchell, J, Varty, K, Birt, A, Davies, P, George, J, Graham, A, Jonker, L, Joseph, T, Kelsall, N, Potts, C, Wilson, T, Davey, P, Hayman, R, Tervitt, G, Abdul Hamiq, A, Bryce, J, Chetter, I, Ettles, D, Lakshminarayan, R, Mitchelsonm, K, Rhymes, C, Robinson, G, Scott, P, Vickers, A, Baht, H, Balogun, I, Burger, I, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, Jones, S, Rudenko, H, Senaratne, J, Thomas, G, Thomson, A, Enevoldson, P, Nahser, H, O'Brian, I, Torella, F, Watling, D, White, R, Clifton, A, Eley, C, Khanom, N, O'Reilly, J, Pereira, A, Bicknell, C, Cheshire, N, Gibbs, R, Hamady, M, James, A, Jenkins, M, Lacey, A, Mireskandari, M, Sachs, T, Wolfe, J, Hardy, D, Justin, F, Phiri, L, Sekaran, L, Sethuraman, S, Tate, L, Akyea Mensah, J, Chrisopoulou, A, Smyth, Jv, Nichol, I, Parry, A, Young, G, Clarke, M, Davis, M, Dixit, A, Dyker, A, Ford, G, Jackson, R, Kappadath, S, Lambert, D, Lees, T, Louw, S, Parr, N, Stansby, G, Wales, L, Wealleans, V, Wilson, L, Wyatt, M, Dorman, P, Hughes, A, Jones, D, Mendelow, Ad, Rodgers, H, Macsweeney, S, Mcconachie, N, Southam, A, Sunman, W, Briley, D, Darby, C, Handa, A, Hands, L, Kuker, W, Michael, K, Perkins, J, Schulz, U, Smith, D, Teal, R, Donnelly, M, D'Souza, S, Asehosem Egun, A, Gregory, B, Kelly, C, Punekar, S, Raj, S, Seriki, D, Thomson, G, Beard, J, Cleveland, T, Humphreys, J, Jenkins, A, King, C, Lonsdale, R, Nair, R, Nawaz, S, Okhuoya, F, Turner, D, Venables, G, Brown, J, Durairajan, R, Guyler, P, Harman, P, Jakeways, M, Khuoge, C, Kundu, A, Loganathan, T, Sinha, D, Thompson, V, Tysoe, S, Barer, Brown, A, Crawford, S, Dunlop, P, Majmudar, Mitchell, D, O'Brien, O'Connell, Scott, Vetrivel, S, Ashleigh, R, Butterfield, S, Gamble, G, Ghosh, J, Mccollum, C, Welch, M, Welsh, S, Kazan, V, Nazzal, M, Ramsey Williams, V, Halliday, A, Davies, C, Peto, R, Gray, A, Mihaylova, B, Potter, J, Flather, M, Mansfield, A, Farrell, B, Rahimi, K, Simpson, D, Thomas, D, Gough, M, Rothwell, P, Giles, M, Leopold, P, Belli, A, Sandercock, P, Gray, R, Shearman, C, Molyneux, A, Hayter, E, Lay, M, Munday, A, Young, A, Delmestri, A., Halliday, A, Bulbulia, R, Gray, W, Naughten, A, den Hartog, A, Delmestri, A, Wallis, C, le Conte, S, Macdonald, S, Tolva, V, Cras, Patrick, Hendriks, Jeroen, Lauwers, Patrick, van Schil, Paul, ACST-2 Collaborative Group, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, UCL - (SLuc) Service de radiologie, and UCL - (SLuc) Service de neurologie

Subjects
Male, Time Factors, Carotid artery stenosis, Carotid artery stenting, Carotid endarterectomy, Randomized controlled trial, Stroke, medicine.medical_treatment, Myocardial Infarction, Severity of Illness Index, law.invention, law, Risk Factors, MED/22 - CHIRURGIA VASCOLARE, Carotid Stenosis, Endarterectomy, Endarterectomy, Carotid, Middle Aged, Treatment Outcome, Female, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Aged, Angioplasty, Asymptomatic Diseases, Cardiovascular Agents, Humans, Patient Selection, Risk Assessment, Asymptomatic, medicine, Carotid, business.industry, Vascular surgery, medicine.disease, Surgery, Cardiovascular agent, Human medicine, business
Abstract

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Published
2016

15. Stress and its Impact on the Neurocognitive Performance of Australian Nurses

Author

Lees, T and Lal, S

Subjects
Psychiatry, Adult, Male, Nurses, Electroencephalography, Middle Aged, Brain Waves, Occupational Diseases, Executive Function, Cognition, Humans, Female, New South Wales, Life Style, Stress, Psychological
Abstract

Copyright © 2016 John Wiley & Sons, Ltd. Nurses function inside a particularly stressful occupation that requires the provision of continuous care to individuals who are often in great need. Stress has been shown to impair performance and specifically shown to impair nursing quality. However, we do not yet know how stress influences the cognitive performance of nurses, and hence, the present study investigated the associations between stress and cognitive performance in nurses using electroencephalography and administered cognitive assessments. Thirty-six nurses (34 women) of mean age 37.77 ± 11.40 years were recruited. Stress was examined using the Lifestyle Appraisal Questionnaire. Broad spectrum electroencephalogram activity at positions Fp1, Fp2, C3 and C4 was recorded for a 5-min baseline and active phase to physiologically assess cognitive performance. Additionally, the Mini-Mental State Exam and Cognistat were also used to measure cognitive performance. Assessed cognitive performance was not associated to stress, however, lifestyle factors, as well as a number of the examined cognitive electroencephalographic variables including changes in theta, alpha activity and gamma reactivity were. Definitively determining how stress affects the cognitive performance of nurses requires additional research; the present study forms a foundation from which future research can further expand the examination of stress exposure in nurses. Copyright © 2016 John Wiley & Sons, Ltd.

Published
2016

17. Quality Improvement in Vascular Surgery:The Role of Comparative Audit and Vascunet

Author

Mitchell, D, Venermo, M, Mani, K, Bjorck, M, Troeng, T, Debus, S, Szeberin, Z, Hansen, A K, Beiles, B, Setacci, C, Bergqvist, D, Menyhei, G, Heller, G, Danielsson, G, Loftus, I, Thomson, I, Vogt, K, Jensen, L, Altreuther, M, Eldrup, N, Wigger, P, Moreno-Carriles, R, and Lees, T

Subjects
Europe, Medical Audit, Australia, Registries, Quality Improvement, Vascular Surgical Procedures, New Zealand
Published
2015

19. Current practice of carotid endarterectomy in the UK

Author

Rudarakanchana, N, Halliday, AW, Kamugasha, D, Grant, R, Waton, S, Horrocks, M, Naylor, AR, Rudd, AG, Cloud, GC, Mitchell, D, Lees, T, Hoffman, A, Rothwell, PM, and Potter, JF

Subjects
Male, Clinical audit, medicine.medical_specialty, Delayed Diagnosis, medicine.medical_treatment, Amaurosis Fugax, Carotid endarterectomy, Postoperative Complications, Preoperative Care, medicine, Humans, Carotid Stenosis, Prospective Studies, Prospective cohort study, Referral and Consultation, Stroke, Aged, Cause of death, Postoperative Care, Endarterectomy, Carotid, business.industry, Mortality rate, General surgery, Professional Practice, Amaurosis fugax, medicine.disease, Surgery, Stenosis, Ischemic Attack, Transient, Female, medicine.symptom, business, Platelet Aggregation Inhibitors
Abstract

Background Carotid endarterectomy (CEA) reduces the risk of stroke in patients with internal carotid stenosis of 50–99 per cent. This study assessed national surgical practice through audit of CEA procedures and outcomes. Methods This was a prospective cohort study of UK surgeons performing CEA, using clinical audit data collected continuously and reported in two rounds, covering operations from December 2005 to December 2007, and January 2008 to September 2009. Results Some 352 (92·6 per cent) of 380 eligible surgeons contributed data. Of 19 935 CEAs recorded by Hospital Episode Statistics, 12 496 (62·7 per cent) were submitted to the audit. A total of 10 452 operations (83·6 per cent) were performed for symptomatic carotid stenosis; among these patients, the presenting symptoms were transient ischaemic attack in 4507 (43·1 per cent), stroke in 3572 (34·2 per cent) and amaurosis fugax in 1965 (18·8 per cent). The 30-day mortality rate was 1·0 per cent (48 of 4944) in round 1 and 0·8 per cent (50 of 6151) in round 2; the most common cause of death was stroke, followed by myocardial infarction. The rate of death or stroke within 30 days of surgery was 2·5 per cent (124 of 4918) in round 1 and 1·8 per cent (112 of 6135) in round 2. Conclusion CEA is performed less commonly in the UK than in other European countries and probably remains underutilized in the prevention of stroke. Increasing the number of CEAs done in the UK, together with reducing surgical waiting times, could prevent more strokes.

Published
2012

20. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial

Author

Ederle, J., Dobson, J., Featherstone, R. L., Bonati, L. H., Worp, H. B., Borst, G. J., Lo, T. H., Gaines, P., Dorman, P. J., Macdonald, S., Lyrer, P. A., Hendriks, J. M., Mccollum, C., Nederkoorn, P. J., Brown, M. M., Algra, A., Bamford, J., Beard, J., Bland, M., Bradbury, A. W., Clifton, A., Hacke, W., Halliday, A., Malik, I., Mas, J. L., Mcguire, A. J., Sidhu, P., Venables, G., Bradbury, A., Collins, R., Molynewc, A., Naylor, R., Warlow, C., Ferro, J. M., Thomas, D., Coward, L., Featherstone, R. F., Tindall, H., Mccabe, D. J. H., Wallis, A., Brooks, M., Chambers, B., Chan, A., Chu, P., Clark, D., Dewey, H., Donnan, G., Fell, G., Hoare, M., Molan, M., Roberts, A., Roberts, N., Beiles, B., Bladin, C., Clifford, C., Grigg, M., New, G., Bell, R., Bower, S., Chong, W., Holt, M., Saunder, A., Than, P. G., Gett, S., Leggett, D., Mcgahan, T., Quinn, J., Ray, M., Wong, A., Woodruff, P., Foreman, R., Schultz, D., Scroop, R., Stanley, B., Allard, B., Atkinson, N., Cambell, W., Davies, S., Field, P., Milne, P., Mitchell, P., Tress, B., Yan, B., Beasley, A., Dunbabin, D., Stary, D., Walker, S., Cras, P., D Archambeau, O., Hendriks, J. M. H., Schil, P., Bosiers, M., Deloose, K., Buggenhout, E., Letter, J., Devos, V., Ghekiere, J., Vanhooren, G., Astarci, P., Hammer, F., Lacroix, V., Peters, A., Verhelst, R., Dejaegher, L., Peeters, A., Verbist, J., Blair, J. F., Caron, J. L., Daneault, M., Giroux, M. F., Guilbert, F., Lanthier, S., Lebrun, L. H., Oliva, V., Raymond, J., Roy, D., Soulez, G., Weill, A., Hill, M., Hu, W., Hudion, M., Morrish, W., Sutherland, G., Wong, J., Alback, A., Harno, H., Ijas, P., Kaste, M., Lepantalo, M., Mustanoja, S., Paananen, T., Porras, M., Puutala, J., Railo, M., Sairanen, T., Soinne, L., Vehmas, A., Vikatmaa, P., Goertler, M., Halloul, Z., Skalej, M., Brennan, P., Kelly, C., Leahy, A., Moroney, J., Thornton, J., Koelemay, M. J. W., Reekers, J. A. A., Roos, Y. B. W. E. M., Koudstaal, P. J., Pattynama, P. M. T., Lugt, A., Dijk, L. C., Sambeek, L. R. H. M., Urk, H., Verhargen, H. J. M., Bruininckx, C. M. A., Bruijn, S. F., Keunen, R., Knippenberg, B., Mosch, A., Treurniet, F., Dijk, L., Overhagen, H., Wever, J., Beer, F. C., Den Berg, J. S. P., Hasselt, B. A. A. M., Zeilstra, D. J., Boiten, J., Otterloo, J. C. A. D., Vries, A. C., Nieholt, G. J. L. A., Kallen, B. F. W., Blankensteijn, J. D., Leeuw, F. E., Kool, L. J. S., Vliet, J. A., Kort, G. A. P., Kapelle, L. J., Mali, W. P. T. M., Moll, F., Verhagen, H., Barber, P. A., Bourchier, R., Hill, A., Holden, A., Stewart, J., Bakke, S. J., Krohg-Sorensen, K., Skjelland, M., Tennoe, B., Bialek, P., Biejat, Z., Czepiel, W., Czlonkowska, A., Dowzenko, A., Jedrzejewska, J., Kobayashi, A., Lelek, M., Polanski, J., Kirbis, J., Milosevic, Z., Zvan, B., Vasco, J., Blasco, J., Chamorro, A., Macho, J., Obach, V., Riambau, V., San Roman, L., Branera, J., Canovas, D., Estela, J., Gaibar, A. G., Perendreu, J., Bjorses, K., Gottsater, A., Ivancev, K., Maetzsch, T., Sonesson, B., Berg, B., Delle, M., Formgren, J., Gillgren, P., Kall, T. B., Konrad, P., Nyman, N., Takolander, R., Andersson, T., Malmstedt, A., Soderman, M., Wahlgren, C., Wahlgren, N., Binaghi, S., Hirt, L., Michel, P., Ruchat, P., Engelter, S. T., Fluri, F., Guerke, L., Jacob, A. L., Kirsch, E., Radue, E. W., Stierli, P., Wasner, M., Wetznel, S., Bonvin, C., Kalangos, A., Lovblad, K., Murith, N., Ruefenacht, D., Sztajzel, R., Higgins, N., Kirkpatrick, P. J., Martin, P., Adam, D., Bell, J., Crowe, P., Gannon, M., Henderson, M. J., Sandler, D., Shinton, R. A., Scriven, J. M., Wilmink, T., D Souza, S., Egun, A., Guta, R., Punekar, S., Seriki, D. M., Thomson, G., Brennan, A., Enevoldson, T. P., Gilling-Smith, G., Gould, D. A., Harris, P. L., Mcwilliams, R. G., Nasser, H. C., White, R., Prakash, K. G., Serracino-Inglott, F., Subramanian, G., Smyth, J. V., Walker, M. G., Clarke, M., Davis, M., Dixit, S. A., Dolman, P., Dyker, A., Ford, G., Golkar, A., Jackson, R., Jayakrishnan, V., Lambert, D., Lees, T., Louw, S., Mendelow, A. D., Rodgers, H., Rose, J., Stansby, G., Wyatt, M., Baker, T., Baldwin, N., Jones, L., Mitchell, D., Munro, E., Thornton, M., Baker, D., Davis, N., Hamilton, G., Mccabe, D., Platts, A., Tibballs, J., Cleveland, T., Dodd, D., Lonsdale, R., Nair, R., Nassef, A., Nawaz, S., Belli, A., Cloud, G., Markus, H., Mcfarland, R., Morgan, R., Pereira, A., Thompson, A., Chataway, J., Cheshire, N., Gibbs, R., Hammady, M., Jenkins, M., Wolfe, J., Adiseshiah, M., Bishop, C., Brew, S., Brookes, J., Jager, R., Kitchen, N., Ashleigh, R., Butterfield, S., Gamble, G. E., Nasim, A., O Neill, P., Edwards, R. D., Lees, K. R., Mackay, A. J., Moss, J., Rogers, P., Developmental Genetics, International Carotid Stenting Study, ACS - Amsterdam Cardiovascular Sciences, Neurology, Surgery, Radiology and Nuclear Medicine, and ANS - Amsterdam Neuroscience

Subjects
Male, medicine.medical_specialty, SURGERY, medicine.medical_treatment, Carotid endarterectomy, 030204 cardiovascular system & hematology, Neuroinformatics [DCN 3], 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Angioplasty, medicine, Humans, Carotid Stenosis, cardiovascular diseases, ANGIOPLASTY, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, Intention-to-treat analysis, Cardiovascular diseases [NCEBP 14], business.industry, Stent, General Medicine, Interim analysis, medicine.disease, 3. Good health, Surgery, Female, Stents, Human medicine, Carotid stenting, business, 030217 neurology & neurosurgery, Angioplasty, Balloon
Abstract

Contains fulltext : 88112.pdf (Publisher’s version ) (Closed access) BACKGROUND: Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. METHODS: The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. FINDINGS: The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006). Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). INTERPRETATION: Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery. FUNDING: Medical Research Council, the Stroke Association, Sanofi-Synthelabo, European Union.

Published
2010

21. Waiting times for carotid endarterectomy in UK: observational study

Author

Halliday, AW, Lees, T, Kamugasha, D, Grant, R, Hoffman, A, Rothwell, PM, Potter, JF, Horrocks, M, Naylor, R, Rudd, AG, Carotid Endarterectomy Steering Group, Clinical Effectiveness and Evaluation Unit, Royal College of Phy, and Vascular Society of Great Britain and Ireland

Abstract

OBJECTIVES: To assess timeliness of carotid endarterectomy services in the United Kingdom.\ud \ud DESIGN: Observational study with follow-up to March 2008.\ud \ud SETTING: UK hospitals performing carotid endarterectomy.\ud \ud PARTICIPANTS: UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007.\ud \ud MAIN OUTCOME MEASURES: Provision and speed of delivery of appropriate assessments of patients; carotid endarterectomy and operative mortality; 30 day postoperative mortality. \ud \ud RESULTS: 240 (61% of those eligible) consultant surgeons took part from 102 (76%) hospitals and trusts. Of 9913 carotid endarterectomies recorded on hospital episode statistics, 5513 (56%) were included. Of the patients who underwent endarterectomy, 83% had a history of transient ischaemic attack or stroke. Of these recently symptomatic patients, 20% had their operation within two weeks of onset of symptoms and 30% waited more than 12 weeks. Operative mortality was 0.5% during the inpatient stay and 1.0% (95% confidence interval 0.7% to 1.3%) by 30 days.\ud \ud CONCLUSION: Only 20% of symptomatic patients had surgery within the two week target time set by the National Institute for Health and Clinical Excellence (NICE). Although operative mortality rates are comparable with those in other countries, some patients might experience disabling or fatal stroke while waiting for surgery and hence not be included in operative statistics. Major improvements in services are necessary to enable early surgery in appropriate patients in order to prevent strokes.

Published
2009

22. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author

Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy Baker, Amanda Colston, Bekky Eliot-Jones, Gita Gramizadeh, Catherine Lewis-Clarke, Laura McCafferty, Deborah Oliver, Debbie Palmer, Abhijeet Patil, Suzannah Pegler, Gopi Ramadurai, Aisling Roberts, Tracey Sargent, Shivaprasad Siddegowda, Ravi Singh-Ranger, Akintunde Williams, Lucy Williams, Steve Windebank, Tadas Zuromskis, Lanka Alwis, Jane Angus, Asaipillai Asokanathan, Caroline Fornolles, Diana Hardy, Sophy Hunte, Frances Justin, Duke Phiri, Marie Mitabouana-Kibou, Lakshmanan Sekaran, Sakthivel Sethuraman, Margaret L Tate, Joyce Akyea-Mensah, Stephen Ball, Angela Chrisopoulou, Elizabeth Keene, Alison Phair, Steven Rogers, John V Smyth, Colin Bicknell, Jeremy Chataway, Nicholas Cheshire, Andrew Clifton, Caroline Eley, Richard Gibbs, Mohammad Hamady, Beth Hazel, Alex James, Michael Jenkins, Nyma Khanom, Austin Lacey, Maz Mireskandari, Joanna O'Reilly, Antony Pereira, Tina Sachs, John Wolfe, Philip Davey, Gill Rogers, Gemma Smith, Gareth Tervit, Ian Nichol, Andrew Parry, Gavin Young, Simon Ashley, James Barwell, Francis Dix, Azlisham M Nor, Chris Parry, Angela Birt, Paul Davies, Jim George, Anne Graham, Leon Jonker, Nicci Kelsall, Caroline Potts, Toni Wilson, Jamie Crinnion, Larissa Cuenoud, Nikola Aleksic, Srdan Babic, Nenad Ilijevski, Đorde Radak, Dragan Sagic, Slobodan Tanaskovic, Momcilo Colic, Vladimir Cvetic, Lazar Davidovic, Dejana R Jovanovic, Igor Koncar, Perica Mutavdžic, Miloš Sladojevic, Ivan Tomic, Eike S Debus, Ulrich Grzyska, Dagmar Otto, Götz Thomalla, Jessica Barlinn, Johannes Gerber, Kathrin Haase, Christian Hartmann, Stefan Ludwig, Volker Pütz, Christian Reeps, Christine Schmidt, Norbert Weiss, Sebastian Werth, Simon Winzer, Janine Gemper, Albrecht Günther, Bianka Heiling, Elisabeth Jochmann, Panagiota Karvouniari, Carsten Klingner, Thomas Mayer, Julia Schubert, Friederike Schulze-Hartung, Jürgen Zanow, Yvonne Bausback, Franka Borger, Spiridon Botsios, Daniela Branzan, Sven Bräunlich, Henryk Hölzer, Janin Lenzer, Christopher Piorkowski, Nadine Richter, Johannes Schuster, Dierk Scheinert, Andrej Schmidt, Holger Staab, Matthias Ulrich, Martin Werner, Hermann Berger, Gábor Biró, Hans-Henning Eckstein, Michael Kallmayer, Kornelia Kreiser, Alexander Zimmermann, Bärbel Berekoven, Klaus Frerker, Vera Gordon, Giovanni Torsello, Sebastian Arnold, Cora Dienel, Martin Storck, Bernhard Biermaier, Hans Martin Gissler, Christof Klötzsch, Tomas Pfeiffer, Ralph Schneider, Leander Söhl, Michael Wennrich, Angelika Alonso, Michael Keese, Christoph Groden, Andreas Cöster, Andreas Engelhardt, Christoph-Maria Ratusinski, Bengt Berg, Martin Delle, Johan Formgren, Peter Gillgren, Lotta Jarl, Torbjörn B Kall, Peter Konrad, Niklas Nyman, Claes Skiöldebrand, Johnny Steuer, Rabbe Takolander, Jonas Malmstedt, Stefan Acosta, Katarina Björses, Kerstin Brandt, Nuno Dias, Anders Gottsäter, Jan Holst, Thorarinn Kristmundsson, Tobias Kühme, Tilo Kölbel, Bengt Lindblad, Mats Lindh, Martin Malina, Tomas Ohrlander, Tim Resch, Viola Rönnle, Björn Sonesson, Margareta Warvsten, Zbigniew Zdanowski, Erik Campbell, Per Kjellin, Hans Lindgren, Johan Nyberg, Björn Petersen, Gunnar Plate, Håkan Pärsson, Peter Qvarfordt, Pavel Ignatenko, Andrey Karpenko, Vladimir Starodubtsev, Mikhail A Chernyavsky, Maria S Golovkova, Boris B Komakha, Nikolay N Zherdev, Andrey Belyasnik, Pavel Chechulov, Dmitry Kandyba, Igor Stepanishchev, Csaba Csobay-Novák, Edit Dósa, László Entz, Balázs Nemes, Zoltán Szeberin, Pál Barzó, Mihaly Bodosi, Eniko Fákó, Béla Fülöp, Tamás Németh, Szilárd Pazdernyik, Krisztina Skoba, Erika Vörös, Eleni Chatzinikou, Athanasios Giannoukas, Christos Karathanos, Stylianos Koutsias, Georgios Kouvelos, Miltiadis Matsagkas, Styliani Ralli, Christos Rountas, Nikolaos Rousas, Konstantinos Spanos, Elias Brountzos, John D Kakisis, Andreas Lazaris, Konstantinos G Moulakakis, Leonidas Stefanis, Georgios Tsivgoulis, Spyros Vasdekis, Constantine N Antonopoulos, Ion Bellenis, Dimitrios Maras, Antonios Polydorou, Victoria Polydorou, Antonios Tavernarakis, Nikolaos Ioannou, Maria Terzoudi, Miltos Lazarides, Michalis Mantatzis, Kostas Vadikolias, Lukasz Dzieciuchowicz, Marcin Gabriel, Zbigniew Krasinski, Grzegorz Oszkinis, Fryderyk Pukacki, Maciej Slowinski, Michal-Goran Stanišic, Ryszard Staniszewski, Jolanta Tomczak, Maciej Zielinski, Piotr Myrcha, Dorota Rózanski, Stanislaw Drelichowski, Wojciech Iwanowski, Katarzyna Koncewicz, Pawel Bialek, Zbigniew Biejat, Wojciech Czepel, Anna Czlonkowska, Anatol Dowzenko, Julia Jedrzejewska, Adam Kobayashi, Jerzy Leszczynski, Andrzej Malek, Jerzy Polanski, Robert Proczka, Maciej Skorski, Mieczyslaw Szostek, Piotr Andziak, Maciej Dratwicki, Robert Gil, Miroslaw Nowicki, Jaroslaw Pniewski, Jaroslaw Rzezak, Piotr Seweryniak, Pawel Dabek, Michal Juszynski, Grzegorz Madycki, Bartosz Pacewski, Witold Raciborski, Piotr Slowinski, Walerian Staszkiewicz, Martin Bombic, Vladimír Chlouba, Jirí Fiedler, Karel Hes, Petr Koštál, Jindrich Sova, Zdenek Kríž, Mojmír Prívara, Michal Reif, Robert Staffa, Robert Vlachovský, Bohuslav Vojtíšek, Tomáš Hrbác, Martin Kuliha, Václav Procházka, Martin Roubec, David Školoudík, David Netuka, Anna Šteklácová, Vladimír Beneš III, Pavel Buchvald, Ladislav Endrych, Miroslav Šercl, Walter Campos Jr, Ivan B Casella, Nelson de Luccia, André E V Estenssoro, Calógero Presti, Pedro Puech-Leão, Celso R B Neves, Erasmo S da Silva, Cid J Sitrângulo Jr, José A T Monteiro, Gisela Tinone, Marcelo Bellini Dalio, Edwaldo E Joviliano, Octávio M Pontes Neto, Mauricio Serra Ribeiro, Patrick Cras, Jeroen M H Hendriks, Mieke Hoppenbrouwers, Patrick Lauwers, Caroline Loos, Laetitia Yperzeele, Mia Geenens, Dimitri Hemelsoet, Isabelle van Herzeele, Frank Vermassen, Parla Astarci, Frank Hammer, Valérie Lacroix, André Peeters, Robert Verhelst, Silvana Cirelli, Pol Dormal, Annelies Grimonprez, Bart Lambrecht, Philipe Lerut, Eddy Thues, Guy De Koster, Quentin Desiron, Alain Maertens de Noordhout, Danielle Malmendier, Mireille Massoz, Georges Saad, Marc Bosiers, Joren Callaert, Koen Deloose, Estrella Blanco Cañibano, Beatriz García Fresnillo, Mercedes Guerra Requena, Pilar C Morata Barrado, Miguel Muela Méndez, Antonio Yusta Izquierdo, Fernando Aparici Robles, Paula Blanes Orti, Luis García Dominguez, Rafael Martínez López, Manuel Miralles Hernández, José I Tembl Ferrairo, Ángel Chamorro, Juan Macho, Víctor Obach, Vincent Riambau, Luis San Román, Frank J Ahlhelm, Kristine Blackham, Stefan Engelter, Thomas Eugster, Henrik Gensicke, Lorenz Gürke, Philippe Lyrer, Luigi Mariani, Marina Maurer, Edin Mujagic, Mandy Müller, Marios Psychogios, Peter Stierli, Christoph Stippich, Christopher Traenka, Thomas Wolff, Benjamin Wagner, Martina M Wiegert, Sandra Clarke, Michael Diepers, Ernst Gröchenig, Philipp Gruber, Andrej Isaak, Timo Kahles, Regula Marti, Krassen Nedeltchev, Luca Remonda, Nadir Tissira, Martina Valença Falcão, Gert J de Borst, Rob H Lo, Frans L Moll, Raechel Toorop, Bart H van der Worp, Evert J Vonken, Jaap L Kappelle, Ommid Jahrome, Floris Vos, Wouter Schuiling, Hendrik van Overhagen, Rudolf W M Keunen, Bob Knippenberg, Jan J Wever, Jan W Lardenoije, Michel Reijnen, Luuk Smeets, Steven van Sterkenburg, Gustav Fraedrich, Elke Gizewski, Ingrid Gruber, Michael Knoflach, Stefan Kiechl, Barbara Rantner, Timur Abdulamit, Patrice Bergeron, Raymond Padovani, Jean-Christophe Trastour, Jean-Marie Cardon, Anne Le Gallou-Wittenberg, Eric Allaire, Jean-Pierre Becquemin, Frédéric Cochennec-Paliwoda, Pascal Desgranges, Hassan Hosseini, Hicham Kobeiter, Jean Marzelle, Mohammed A Almekhlafi, Simerpreet Bal, Phillip A Barber, Shelagh B Coutts, Andrew M Demchuk, Muneer Eesa, Michelle Gillies, Mayank Goyal, Michael D Hill, Mark E Hudon, Anitha Jambula, Carol Kenney, Gary Klein, Marie McClelland, Alim Mitha, Bijoy K Menon, William F Morrish, Steven Peters, Karla J Ryckborst, Greg Samis, Supriya Save, Eric E Smith, Peter Stys, Suresh Subramaniam, Garnette R Sutherland, Tim Watson, John H Wong, L Zimmel, Vojko Flis, Jože Matela, Kazimir Miksic, Franko Milotic, Božidar Mrdja, Barbara Stirn, Erih Tetickovic, Mladen Gasparini, Anton Grad, Ingrid Kompara, Zoren Miloševic, Veronika Palmiste, Toomas Toomsoo, Balzhan Aidashova, Nursultan Kospanov, Roman Lyssenko, Daulet Mussagaliev, Rafi Beyar, Aaron Hoffman, Tony Karram, Arthur Kerner, Eugenia Nikolsky, Samy Nitecki, Silva Andonova, Chavdar Bachvarov, Vesko Petrov, Ivan Cvjetko, Vinko Vidjak, Damir Halužan, Mladen Petrunic, Bao Liu, Chang-Wei Liu, Daniel Bartko, Peter Beno, František Rusnák, Kamil Zelenák, Masayuki Ezura, Takashi Inoue, Naoto Kimura, Ryushi Kondo, Yasushi Matsumoto, Hiroaki Shimizu, Hidenori Endo, Eisuke Furui, Søren Bakke, Kristen Krohg-Sørensen, Terje Nome, Mona Skjelland, Bjørn Tennøe, João Albuquerque e Castro, Gonçalo Alves, Frederico Bastos Gonçalves, José de Aragão Morais, Ana C Garcia, Hugo Valentim, Leonor Vasconcelos, Fernando Belcastro, Fernando Cura, Patricio Zaefferer, Foad Abd-Allah, Mohamed H Eldessoki, Hussein Heshmat Kassem, Haytham Soliman Gharieb, Mary P Colgan, Syed N Haider, Joe Harbison, Prakash Madhavan, Dermot Moore, Gregor Shanik, Viviane Kazan, Munier Nazzal, Vicki Ramsey-Williams, ACST-2 Collaborative Group, Group, ACST-2 Collaborative, Halliday A., Bulbulia R., Bonati L.H., Chester J., Cradduck-Bamford A., Peto R., Pan H., Potter J., Henning Eckstein H., Farrell B., Flather M., Mansfield A., Mihaylova B., Rahimi K., Simpson D., Thomas D., Sandercock P., Gray R., Molyneux A., Shearman C.P., Rothwell P., Belli A., Herrington W., Judge P., Leopold P., Mafham M., Gough M., Cao P., MacDonald S., Bari V., Berry C., Bradshaw S., Brudlo W., Clarke A., Cox R., Fathers S., Gaba K., Gray M., Hayter E., Holliday C., Kurien R., Lay M., le Conte S., McManus J., Madgwick Z., Morris D., Munday A., Pickworth S., Ostasz W., Poorthuis M., Richards S., Teixeira L., Tochlin S., Tully L., Wallis C., Willet M., Young A., Casana R., Malloggi C., Odero A., Silani V., Parati G., Malchiodi G., Malferrari G., Strozzi F., Tusini N., Vecchiati E., Coppi G., Lauricella A., Moratto R., Silingardi R., Veronesi J., Zini A., Ferrero E., Ferri M., Gaggiano A., Labate C., Nessi F., Psacharopulo D., Viazzo A., Malacrida G., Mazzaccaro D., Meola G., Modafferi A., Nano G., Occhiuto M.T., Righini P., Stegher S., Chiarandini S., Griselli F., Lepidi S., Pozzi Mucelli F., Naccarato M., D'Oria M., Ziani B., Stella A., Dieng M., Faggioli G., Gargiulo M., Palermo S., Pini R., Puddu G.M., Vacirca A., Angiletta D., Desantis C., Marinazzo D., Mastrangelo G., Regina G., Pulli R., Bianchi P., Cireni L., Coppi E., Pizzirusso R., Scalise F., Sorropago G., Tolva V., Caso V., Cieri E., DeRango P., Farchioni L., Isernia G., Lenti M., Parlani G.B., Pupo G., Pula G., Simonte G., Verzini F., Carimati F., Delodovici M.L., Fontana F., Piffaretti G., Tozzi M., Civilini E., Poletto G., Reimers B., Praquin B., Ronchey S., Capoccia L., Mansour W., Sbarigia E., Speziale F., Sirignano P., Toni D., Galeotti R., Gasbarro V., Mascoli F., Rocca T., Tsolaki 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Subjects
Male, medicine.medical_specialty, Time Factors, Time Factor, medicine.medical_treatment, Carotid Stenosi, MEDLINE, Carotid endarterectomy, Rate ratio, Risk Assessment, Asymptomatic, law.invention, Randomized controlled trial, law, Risk Factors, carotid artery stenting (CAS), carotid endarterectomy (CEA), Stent, medicine, Humans, Carotid Stenosis, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, business.industry, carotid artery, Risk Factor, Articles, General Medicine, trial, medicine.disease, Settore MED/22 - CHIRURGIA VASCOLARE, Surgery, Stenosis, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Stents, Human medicine, medicine.symptom, business, Human
Abstract

Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.

Published
2021

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