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1. Editor's Choice – Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Naylor, A.R., Ricco, J.-B., de Borst, G.J., Debus, S., de Haro, J., Halliday, A., Hamilton, G., Kakisis, J., Kakkos, S., Lepidi, S., Markus, H.S., McCabe, D.J., Roy, J., Sillesen, H., van den Berg, J.C., Vermassen, F., ESVS Guidelines Committee, Kolh, P., Chakfe, N., Hinchliffe, R.J., Koncar, I., Lindholt, J.S., Vega de Ceniga, M., Verzini, F., ESVS Guideline Reviewers, Archie, J., Bellmunt, S., Chaudhuri, A., Koelemay, M., Lindahl, A.-K., Padberg, F., and Venermo, M.

Published
2018
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2. Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS)

Author

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, 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, Geelkerken, B., Gloviczki, P., Huber, T., and Naylor, R.

Published
2017
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3. Editor's Choice – Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M.J., Lachat, M.L., Moll, F.L., Setacci, C., Taylor, P.R., Thompson, M., Trimarchi, S., Verhagen, H.J., Verhoeven, E.L., ESVS Guidelines Committee, Kolh, P., de Borst, G.J., Chakfé, N., Debus, E.S., Hinchliffe, R.J., Kakkos, S., Koncar, I., Lindholt, J.S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Black, J.H., III, Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A.R., Ricco, J.-B., Rousseau, H., and Schmidli, J.

Published
2017
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5. Editor's Choice – Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Wittens, C., Davies, A.H., Bækgaard, N., Broholm, R., Cavezzi, A., Chastanet, S., de Wolf, M., Eggen, C., Giannoukas, A., Gohel, M., Kakkos, S., Lawson, J., Noppeney, T., Onida, S., Pittaluga, P., Thomis, S., Toonder, I., Vuylsteke, M., ESVS Guidelines Committee, Kolh, P., de Borst, G.J., Chakfé, N., Debus, S., Hinchliffe, R., Koncar, I., Lindholt, J., de Ceniga, M.V., Vermassen, F., Verzini, F., Document Reviewers, De Maeseneer, M.G., Blomgren, L., Hartung, O., Kalodiki, E., Korten, E., Lugli, M., Naylor, R., Nicolini, P., and Rosales, A.

Published
2015
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12. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, M. A., Chan, S., Coughlin, P., Awopetu, A., Stather, P., Lane, T., Theodosiou, D., Ahmed, M. A., Vasudevan, T., Ibrahim, M., Al Maadany, F., Eljareh, M., Alkhafeefi, F. S., Coscas, R., Unal, E. U., Pulli, R., Zaca, S., Angiletta, D., Kotsis, T., Moawad, M., Tozzi, M., Patelis, N., Lazaris, A. M., Chuen, J., Croo, A., Tsolaki, E., Zenunaj, G., Kamal, D., Tolba, M. M., Maresch, M., Khetarpaul, V., Mills, J., Gangwani, G., Elahwal, M., Khalil, R., Azab, M. A., Mahomed, A., Whiston, R., Contractor, U., Esposito, D., Pratesi, C., Giacomelli, E., Troncoso, M. V., Elkouri, S., Johansson, F. G., Dodos, I., Benezit, M., Vidoedo, J., Rocha-Neves, J., Pereira-Neves, A. H., Dias-Neto, M. F., Campos Jacome, A. F., Loureiro, L., Silva, I., Garza-Herrera, R., Canata, V., Bezard, C., Bowser, K., Tobar, J. F., Vera, C. G., Parra, C. S., Lopez, E., Serra, Y. G., Varela, J., Rubio, V., Victoria, G., Johnson, A., O'Banion, L. A., Makar, R., Tantawy, T. G., Storck, M., Jongkind, V., Falah, O., Mcbride, O., Isik, A., Papaioannou, A., Ocke Reis, P. E., Bracale, U. M., Atkins, E., Tinelli, Giovanni, Scott, E., Wales, L., Sivaharan, A., Priona, G., Nesbitt, C., Grainger, T., Shelmerdine, L., Chong, P., Bajwa, A., Arwynck, L., Hadjievangelou, N., Elbasty, A., Rubio, O., Ricardo, M., Ulloa, J. H., Tarazona, M., Pabon, M., Pitoulias, G., Corless, K., Ioannidis, O., Friedrich, O., Van Herzeele, I., Vijaynagar, B., Cohnert, T., Bell, R., Moore, H., Saha, P., Gifford, E., Laine, M., Barkat, A., Karkos, C., Binti Safri, L. S., Buitron, G., Del Castillo, J., Carrera, P., Salinas, N., Biagioni, R. B., Benites, S., Mafla, C. A., Pian, P. M., Albino, P., Serrano, E., Marin, A., Gonzalez, M., Foreroga, M., Russo, A., Reyes, A., Guglielmone, D., Grillo, L., Flumignan, R., Palones, F. G., Silveira, P. G., Ramely, R. B., Edeiken, S., Chetter, I., Green, L., Sudarsanam, A., Lyons, O., Lemmon, G., Neville, R., Castelli, M., Hinojosa, C. A., Carvajal, R. R., Rivera, A., Wong, P., Drudi, L., Perkins, J., Sieunarine, K., Attia, D., Atef, M., Eftychios, L., Weaver, F., Ren, L. C., Alomari, M., Jamjoom, R., Aljarrah, Q., Abbas, A., Alomran, F., Kumar, A., Altoijri, A., Elsanhoury, K. T., Alhumaid, A., Fekry, T., Sekhar, R., Theodoridis, P., Panagiotis, T., Roditis, K., Tsiantoula, P., Antoniou, A., Soler, R., Hasemaki, N., Baili, E., Mpaili, E., Huasen, B., Wallace, T., Duncan, A., Metcalfe, M., Mannoia, K., Bechara, C. F., Tsilimparis, N., Aranson, N., Riding, D., Palena, M., Mcdonnell, C., Mouawad, N. J., Banegas, S., Rossi, P., Oshodi, T., Diaz, R., Afifi, R., Dindyal, S., Thapar, A., Kordzadeh, A., Pullas, G., Lin, S., Davies, C., Darvall, K., Kodama, A., Gooneratne, T., Gunawansa, N., Munoz, A., Jie, N. J., Bradley, N., Al-Jundi, W., Meyer, F., Lee, C., Malina, M., Renton, S., Lui, D., Batchelder, A., Oszkinis, G., Freyrie, A., Giordano, J., Saratzis, N., Tigkiropoulos, K., Kyriakos, S., Popov, G., Cheema, M. U., Lapolla, P., Ling Patricia, Y. C., Ennab, R., Ullery, B. W., Pasenidou, K., Tam, J., Sidel, G., Jayaprakash, V. V., Bennett, L., Hardy, S., Davies, E., Baker, S., Wijesinghe, L., Tam, A., Mccune, K., Chana, M., Lowe, C., Goh, A., Powezka, K., Kyrou, I., Altaf, N., Harkin, D., Travers, H., Cragg, J., Sharif, A., Akhtar, T., Chavez, J. A., Ordonez, C., Mazzurco, M., Choke, E., Asghar, I., Summerour, V., Dunlop, P., Morley, R., Hardy, T., Bevis, P., Cuff, R., Stavroulakis, K., Beropoulis, E., Argyriou, A., Loftus, I., Azhar, B., Sheth, S., Usai, M. V., Choudhry, A., Nicole, K., Boyle, E., Joyce, D., Abdelaty Hassan, M. H., Saltiel, A., Frahm-Jensen, G., Antoniou, G., Elhadi, M., Kimyaghalam, A., Malgor, R., Telve, D., Isaak, A., Schmidli, J., Mckevitt, K., Siddiqui, T., Asciutto, G., Floros, N., Papadopoulos, G., Kafetzakis, A., Koutsias, S. G., Nana, P., Giannoukas, A., Kakkos, S., Moulakakis, K. G., Shafique, N., Jawien, A., Popplewell, M., Imray, C., Abayasekara, K., Rowlands, T., Kuhan, G., Rajagopalan, S., Jaipersad, A., Sadia, U., Kobe, I., Mittapalli, D., Enemosah, I., Behrendt, C. -A., Beck, A., Almudhafer, M., Ancetti, S., Jacobs, D., Jayakumar, P., Malekpour, F., Shalhub, S., Keldiyorov, B., Simon, M., Khashram, M., Rich, N., Shepherd, A., Meecham, L., Doherty, D., Benson, R. A., Tinelli G. (ORCID:0000-0002-2212-3226), Ruffino, M. A., Chan, S., Coughlin, P., Awopetu, A., Stather, P., Lane, T., Theodosiou, D., Ahmed, M. A., Vasudevan, T., Ibrahim, M., Al Maadany, F., Eljareh, M., Alkhafeefi, F. S., Coscas, R., Unal, E. U., Pulli, R., Zaca, S., Angiletta, D., Kotsis, T., Moawad, M., Tozzi, M., Patelis, N., Lazaris, A. M., Chuen, J., Croo, A., Tsolaki, E., Zenunaj, G., Kamal, D., Tolba, M. M., Maresch, M., Khetarpaul, V., Mills, J., Gangwani, G., Elahwal, M., Khalil, R., Azab, M. A., Mahomed, A., Whiston, R., Contractor, U., Esposito, D., Pratesi, C., Giacomelli, E., Troncoso, M. V., Elkouri, S., Johansson, F. G., Dodos, I., Benezit, M., Vidoedo, J., Rocha-Neves, J., Pereira-Neves, A. H., Dias-Neto, M. F., Campos Jacome, A. F., Loureiro, L., Silva, I., Garza-Herrera, R., Canata, V., Bezard, C., Bowser, K., Tobar, J. F., Vera, C. G., Parra, C. S., Lopez, E., Serra, Y. G., Varela, J., Rubio, V., Victoria, G., Johnson, A., O'Banion, L. A., Makar, R., Tantawy, T. G., Storck, M., Jongkind, V., Falah, O., Mcbride, O., Isik, A., Papaioannou, A., Ocke Reis, P. E., Bracale, U. M., Atkins, E., Tinelli, Giovanni, Scott, E., Wales, L., Sivaharan, A., Priona, G., Nesbitt, C., Grainger, T., Shelmerdine, L., Chong, P., Bajwa, A., Arwynck, L., Hadjievangelou, N., Elbasty, A., Rubio, O., Ricardo, M., Ulloa, J. H., Tarazona, M., Pabon, M., Pitoulias, G., Corless, K., Ioannidis, O., Friedrich, O., Van Herzeele, I., Vijaynagar, B., Cohnert, T., Bell, R., Moore, H., Saha, P., Gifford, E., Laine, M., Barkat, A., Karkos, C., Binti Safri, L. S., Buitron, G., Del Castillo, J., Carrera, P., Salinas, N., Biagioni, R. B., Benites, S., Mafla, C. A., Pian, P. M., Albino, P., Serrano, E., Marin, A., Gonzalez, M., Foreroga, M., Russo, A., Reyes, A., Guglielmone, D., Grillo, L., Flumignan, R., Palones, F. G., Silveira, P. G., Ramely, R. B., Edeiken, S., Chetter, I., Green, L., Sudarsanam, A., Lyons, O., Lemmon, G., Neville, R., Castelli, M., Hinojosa, C. A., Carvajal, R. R., Rivera, A., Wong, P., Drudi, L., Perkins, J., Sieunarine, K., Attia, D., Atef, M., Eftychios, L., Weaver, F., Ren, L. C., Alomari, M., Jamjoom, R., Aljarrah, Q., Abbas, A., Alomran, F., Kumar, A., Altoijri, A., Elsanhoury, K. T., Alhumaid, A., Fekry, T., Sekhar, R., Theodoridis, P., Panagiotis, T., Roditis, K., Tsiantoula, P., Antoniou, A., Soler, R., Hasemaki, N., Baili, E., Mpaili, E., Huasen, B., Wallace, T., Duncan, A., Metcalfe, M., Mannoia, K., Bechara, C. F., Tsilimparis, N., Aranson, N., Riding, D., Palena, M., Mcdonnell, C., Mouawad, N. J., Banegas, S., Rossi, P., Oshodi, T., Diaz, R., Afifi, R., Dindyal, S., Thapar, A., Kordzadeh, A., Pullas, G., Lin, S., Davies, C., Darvall, K., Kodama, A., Gooneratne, T., Gunawansa, N., Munoz, A., Jie, N. J., Bradley, N., Al-Jundi, W., Meyer, F., Lee, C., Malina, M., Renton, S., Lui, D., Batchelder, A., Oszkinis, G., Freyrie, A., Giordano, J., Saratzis, N., Tigkiropoulos, K., Kyriakos, S., Popov, G., Cheema, M. U., Lapolla, P., Ling Patricia, Y. C., Ennab, R., Ullery, B. W., Pasenidou, K., Tam, J., Sidel, G., Jayaprakash, V. V., Bennett, L., Hardy, S., Davies, E., Baker, S., Wijesinghe, L., Tam, A., Mccune, K., Chana, M., Lowe, C., Goh, A., Powezka, K., Kyrou, I., Altaf, N., Harkin, D., Travers, H., Cragg, J., Sharif, A., Akhtar, T., Chavez, J. A., Ordonez, C., Mazzurco, M., Choke, E., Asghar, I., Summerour, V., Dunlop, P., Morley, R., Hardy, T., Bevis, P., Cuff, R., Stavroulakis, K., Beropoulis, E., Argyriou, A., Loftus, I., Azhar, B., Sheth, S., Usai, M. V., Choudhry, A., Nicole, K., Boyle, E., Joyce, D., Abdelaty Hassan, M. H., Saltiel, A., Frahm-Jensen, G., Antoniou, G., Elhadi, M., Kimyaghalam, A., Malgor, R., Telve, D., Isaak, A., Schmidli, J., Mckevitt, K., Siddiqui, T., Asciutto, G., Floros, N., Papadopoulos, G., Kafetzakis, A., Koutsias, S. G., Nana, P., Giannoukas, A., Kakkos, S., Moulakakis, K. G., Shafique, N., Jawien, A., Popplewell, M., Imray, C., Abayasekara, K., Rowlands, T., Kuhan, G., Rajagopalan, S., Jaipersad, A., Sadia, U., Kobe, I., Mittapalli, D., Enemosah, I., Behrendt, C. -A., Beck, A., Almudhafer, M., Ancetti, S., Jacobs, D., Jayakumar, P., Malekpour, F., Shalhub, S., Keldiyorov, B., Simon, M., Khashram, M., Rich, N., Shepherd, A., Meecham, L., Doherty, D., Benson, R. A., and Tinelli G. (ORCID:0000-0002-2212-3226)

Abstract

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022

14. In-situ bypass is associated with superior infection-free survival compared with extra-anatomic bypass for the management of secondary aortic graft infections without enteric involvement

Author

Janko, M.R. Hubbard, G. Back, M. Shah, S.K. Pomozi, E. Szeberin, Z. DeMartino, R. Wang, L.J. Crofts, S. Belkin, M. Davila, V.J. Lemmon, G.W. Wang, S.K. Czerny, M. Kreibich, M. Humphries, M.D. Shutze, W. Joh, J.H. Cho, S. Behrendt, C.-A. Setacci, C. Hacker, R.I. Sobreira, M.L. Yoshida, W.B. D'Oria, M. Lepidi, S. Chiesa, R. Kahlberg, A. Go, M.R. Rizzo, A.N. Black, J.H. Magee, G.A. Elsayed, R. Baril, D.T. Beck, A.W. McFarland, G.E. Gavali, H. Wanhainen, A. Kashyap, V.S. Stoecker, J.B. Wang, G.J. Zhou, W. Fujimura, N. Obara, H. Wishy, A.M. Bose, S. Smeds, M. Liang, P. Schermerhorn, M. Conrad, M.F. Hsu, J.H. Patel, R. Lee, J.T. Liapis, C.D. Moulakakis, K.G. Farber, M.A. Motta, F. Ricco, J.-B. Bath, J. Coselli, J.S. Aziz, F. Coleman, D.M. Davis, F.M. Fatima, J. Irshad, A. Shalhub, S. Kakkos, S. Zhang, Q. Lawrence, P.F. Woo, K. Chung, J.

Abstract

Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excision of AGI. Methods: A retrospective, multi-institutional study of AGI from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and perioperative variables were recorded. The primary outcome was infection-free survival. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariable analyses were performed. Results: A total of 241 patients at 34 institutions from seven countries presented with AGI during the study period (median age, 68 years; 75% male). The initial aortic procedures that resulted in AGI were 172 surgical grafts (71%), 66 endografts (27%), and three unknown (2%). Of the patients, 172 (71%) underwent complete excision of infected aortic graft material followed by in situ (in-line) bypass (ISB), including antibiotic-treated prosthetic graft (35%), autogenous femoral vein (neo-aortoiliac surgery) (24%), and cryopreserved allograft (41%). Sixty-nine patients (29%) underwent extra-anatomic bypass (EAB). Overall median Kaplan-Meier estimated survival was 5.8 years. Perioperative mortality was 16%. When stratified by ISB vs EAB, there was a significant difference in Kaplan-Meier estimated infection-free survival (2910 days; interquartile range, 391-3771 days vs 180 days; interquartile range, 27-3750 days; P < .001). There were otherwise no significant differences in presentation, comorbidities, or perioperative variables. Multivariable Cox regression showed lower infection-free survival among patients with EAB (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.6-3.6; P < .001), polymicrobial infection (HR, 2.2; 95% CI, 1.4-3.5; P = .001), methicillin-resistant Staphylococcus aureus infection (HR, 1.7; 95% CI, 1.1-2.7; P = .02), as well as the protective effect of omental/muscle flap coverage (HR, 0.59; 95% CI, 0.37-0.92; P = .02). Conclusions: After complete resection of AGI, perioperative mortality is 16% and median overall survival is 5.8 years. EAB is associated with nearly a two and one-half-fold higher reinfection/mortality compared with ISB. Omental and/or muscle flap coverage of the repair appear protective. © 2022 Society for Vascular Surgery

Published
2022

15. Corrigendum to ‘Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections’ [European Journal of Vascular & Endovascular Surgery 59/3 (2020) 339–384] (European Journal of Vascular & Endovascular Surgery (2020) 59(3) (339–384), (S1078588419325328), (10.1016/j.ejvs.2019.10.016))

Author

Chakfe N., Diener H., Lejay A., Assadian O., Berard X., Caillon J., Fourneau I., Glaudemans A. W. J. M., Koncar I., Lindholt J., Melissano G., Saleem B. R., Senneville E., Slart R. H. J. A., Szeberin Z., Venermo M., Vermassen F., Wyss T. R., ESVS Guidelines Committee, de Borst G. J., Goncalves F. B., Kakkos S. K., Kolh P., Tulamo R., de Ceniga M. V., Document Reviewers, von Allmen R. S., van den Berg J. C., Debus E. S., Koelemay M. J. W., Linares-Palomino J. P., Moneta G. L., Ricco J. -B., Wanhainen A., Chakfe, N., Diener, H., Lejay, A., Assadian, O., Berard, X., Caillon, J., Fourneau, I., Glaudemans, A. W. J. M., Koncar, I., Lindholt, J., Melissano, G., Saleem, B. R., Senneville, E., Slart, R. H. J. A., Szeberin, Z., Venermo, M., Vermassen, F., Wyss, T. R., ESVS Guidelines, Committee, de Borst, G. J., Goncalves, F. B., Kakkos, S. K., Kolh, P., Tulamo, R., de Ceniga, M. V., Document, Reviewer, von Allmen, R. S., van den Berg, J. C., Debus, E. S., Koelemay, M. J. W., Linares-Palomino, J. P., Moneta, G. L., Ricco, J. -B., and Wanhainen, A.

Published
2020

16. Clinical Response to Procedural Stroke Following Carotid Endarterectomy

Author

Meershoek, Armelle J.A., de Waard, Djurre D., Trappenburg, Jaap, Zeebregts, Clark J., Bulbulia, Richard, Kappelle, Jaap L.J., de Borst, Gert J., Bonati, L. H., Brott, T. G., McCabe, D., Calvet, D., Engelter, S. T., Leira, E. C., Leys, D., Nederkoorn, P. J., Paciaroni, M., Petersson, J., Ringleb, P., Uyttenbogaart, M., Weimar, C., Antti Lindgren, J. M., Bastos Goncalves, F., Bjorck, M., Bismuth, J., Debus, S., Eckstein, H., Glovizcki, P., Halliday, A., Kakkos, S. K., Koncar, I., Naylor, A. R., Radak, D., Schermerhorn, M. L., Sillesen, H., Tolva, V., Vega de Ceniga, M., Vermassen, F., Zeebregts, C. J., and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
Stroke, Carotid endarterectomy, Treatment algorithm, Surgery, cardiovascular diseases, Cardiology and Cardiovascular Medicine, Delphi consensus study
Abstract

Funding Information: We sincerely thank all the experts who participated in this Delphi study for their time and for sharing their expertise. All Delphi experts qualify for authorship based on the fact that they were involved in data collection and all critically appraised the final manuscript for important intellectual content. See Appendix B for the names of the Delphi experts. Publisher Copyright: © 2021 The Authors Objective: No dedicated studies have been performed on the optimal management of patients with an acute stroke related to carotid intervention nor is there a solid recommendation given in the European Society for Vascular Surgery guideline. By implementation of an international expert Delphi panel, this study aimed to obtain expert consensus on the optimal management of in hospital stroke occurring during or following CEA and to provide a practical treatment decision tree. Methods: A four round Delphi consensus study was performed including 31 experts. The aim of the first round was to investigate whether the conceptual model indicating the traditional division between intra- and post-procedural stroke in six phases was appropriate, and to identify relevant clinical responses during these six phases. In rounds 2, 3, and 4, the aim was to obtain consensus on the optimal response to stroke in each predefined setting. Consensus was reached in rounds 1, 3, and 4 when ≥ 70% of experts agreed on the preferred clinical response and in round 2 based on a Likert scale when a median of 7 – 9 (most adequate response) was given, IQR ≤ 2. Results: The experts agreed (> 80%) on the use of the conceptual model. Stroke laterality and type of anaesthesia were included in the treatment algorithm. Consensus was reached in 17 of 21 scenarios (> 80%). Perform diagnostics first for a contralateral stroke in any phase, and for an ipsilateral stroke during cross clamping, or apparent stroke after leaving the operation room. For an ipsilateral stroke during the wake up phase, no formal consensus was achieved, but 65% of the experts would perform diagnostics first. A CT brain combined with a CTA or duplex ultrasound of the carotid arteries should be performed. For an ipsilateral intra-operative stroke after flow restoration, the carotid artery should be re-explored immediately (75%). Conclusion: In patients having a stroke following carotid endarterectomy, expedited diagnostics should be performed initially in most phases. In patients who experience an ipsilateral intra-operative stroke following carotid clamp release, immediate re-exploration of the index carotid artery is recommended. publishersversion published

Published
2021

18. Management of patients with asymptomatic carotid stenosis may need to be individualized: A multidisciplinary call for action. Republication of J Stroke 2021;23:202-12

Author

Paraskevas K. I., Mikhailidis D. P., Baradaran H., Davies A. H., Eckstein H. -H., Faggioli G., Fernandes E Fernandes J., Gupta A., Jezovnik M. K., Kakkos S. K., Katsiki N., Kooi M. E., Lanza G., Liapis C. D., Loftus I. M., Millon A., Nicolaides A. N., Poredos P., Pini R., Ricco J. -B., Rundek T., Saba L., Spinelli F., Stilo F., Sultan S., Zeebregts C. J., Chaturvedi S., Paraskevas K.I., Mikhailidis D.P., Baradaran H., Davies A.H., Eckstein H.-H., Faggioli G., Fernandes E Fernandes J., Gupta A., Jezovnik M.K., Kakkos S.K., Katsiki N., Kooi M.E., Lanza G., Liapis C.D., Loftus I.M., Millon A., Nicolaides A.N., Poredos P., Pini R., Ricco J.-B., Rundek T., Saba L., Spinelli F., Stilo F., Sultan S., Zeebregts C.J., and Chaturvedi S.

Subjects
Stroke, Endarterectomy, Carotid, Ischemic Attack, Transient, Risk Factor, Carotid Stenosi, Human
Abstract

The optimal management of patients with asymptomatic carotid stenosis (ACS) is the subject of extensive debate. According to the 2017 European Society for Vascular Surgery Guidelines, carotid endarterectomy should (Class IIa; Level of Evidence: B) or carotid artery stenting may be considered (Class IIb; Level of Evidence: B) in the presence of one or more clinical/imaging characteristics that may be associated with an increased risk of late ipsilateral stroke (e.g. silent embolic infarcts on brain computed tomography/magnetic resonance imaging, progression in the severity of ACS, a history of contralateral transient ischemic attack/stroke, microemboli detection on transcranial Doppler, etc.), provided documented perioperative stroke/death rates are 5 years. Besides these clinical/imaging characteristics, there are additional individual, ethnic/racial or social factors that should probably be evaluated in the decision process regarding the optimal management of these patients, such as individual patient needs/patient choice, patient compliance with best medical treatment, patient sex, culture, race/ethnicity, age and comorbidities, as well as improvements in imaging/operative techniques/outcomes. The present multispecialty position paper will present the rationale why the management of patients with ACS may need to be individualized.

Published
2021

20. Global impact of the first coronavirus disease 2019 (COVID-19) pandemic wave on vascular services

Author

Benson, R. A., Sudarsanam, A., Tam, A., Beck, A. W., Barkat, A., Bajwa, A., Elbasty, A., Awopetu, A. I., Kodama, A., Rivera, A. G., Munoz, A., Saltiel, A., Russo, A., Rolls, A., Kafetzakis, A., Kimyaghalam, A., Kordzadeh, A., Shepherd, A., Singh, A., Mingoli, A., Lazaris, A. M., Isaak, A., Marin, A., Valdivia, A. R., Batchelder, A., Duncan, A., Argyriou, A., Jaipersad, A. S., Freyrie, A., Pereira-Neves, A., Mahomed, A., Isik, A., Jawien, A., Choudhry, A. J., Sivaharan, A., Giannoukas, A., Papaioannou, A., Saratzis, A., Abbas, A., Christos, B., Akkaya, B. B., Huasen, B., Patrice, B., Mwipatayi, Azhar, B., Keldiyorov, B., Ullery, B. W., Pratesi, C., Hinojosa, C. A., Bechara, C. F., Parra, C. S., Alexandros, C., Bezard, C., Lee, C. J., Davies, C., Behrendt, C. -A., Lowe, C., Karkos, C. D., Yih, C. L. P., Mcdonnell, C., Ordonez, C., Nesbitt, C., Alexander, C., Guglielmone, D., Doherty, D. T., Riding, D. M., Esposito, D., Harkin, D., Lui, D. H., Kamal, D. M., Telve, D., Theodosiou, D., Angiletta, D., Jacobs, D., Choke, E., Gifford, E. D., Beropoulis, E., Lostoridis, E., Atkins, E., Giacomelli, E., Tsolaki, E., Davies, E., Scott, E., Katsogridakis, E., Serrano, E., Unal, E. U., Lopez, E., Mpaili, E., Minelli, Fabrizio, Malekpour, F., Mousa, F., Meyer, F., Tobar, F., Filipa, J., Johansson, F. G., Weaver, F., Proano, G. A. B., Sidel, G., Kuhan, G., Lemmon, G., Antoniou, G. A., Papadopoulos, G., Pitoulias, G., Sotirios, G., Victoria, G., Frahm-Jensen, G., Tinelli, Giovanni, Asciutto, G., Zenunaj, G., Eduardo, G. V. C., Pullas, G., Oszkinis, G., Popov, G., Iscan, H. Z., Travers, H. C., Barakat, H., Mavioglu, H. L., Chetter, I., Loftus, I., Dodos, I., Asghar, I., Van Herzeele, I., Giordano, J., Cragg, J., Chuen, J., Orrego, J. D. C., Perkins, J., Rocha-Neves, J., Ulloa, J. H., Chavez, J. A., Vidoedo, J., Faraj, J., Mills, J., Varela, J., Ng, J. J., Schmidli, J., Kiriaki, K., Powezka, K., Bowser, K., Darvall, K., Mccune, K., Pasenidou, K., Corless, K., Mckevitt, K., Long, K. N., Moulakakis, K. G., Roditis, K., Stavroulakis, K., Tigkiropoulos, K., Mannoia, K., Abayasekara, K., Jayakumar, L., Wijesinghe, L., Drudi, L., Shelmerdine, L., O'Banion, L. A., Meecham, L., Bennett, L. F., Grillo, L., Green, L., Wales, L., Loureiro, L., Palena, L. M., Tolba, M. M. H., Khashram, M., Chana, M., Pabon, M., Gonzalez, M., Usai, M. V., Tarazona, M., Ruffino, M. A., Castelli, M., Benezit, M., Dias-Neto, M., Malina, M., Maresch, M., Mazzurco, M., Storck, M., Troncoso, M. V., Popplewell, M., Tozzi, M., Metcalfe, M., Laine, M., Rawhi, M., Ricardo, M., Goh, M. A., Ahmed, M. A., Ibrahim, M., Alomari, M., Almudhafer, M., Elhadi, M., Gunawansa, N., Hadjievangelou, N., Hasemaki, N., Shafique, N., Aranson, N., Bradley, N., Mouawad, N. J., Rich, N. C., Floros, N., Patelis, N., Saratzis, N., Tsilimparis, N., Salinas, N., Altaf, N., Friedrich, O., Lyons, O., Mcbride, O. M. B., Ioannidis, O., Falah, O., Theodoridis, P., Sapienza, P., Tsiantoula, P., Chong, P., Coughlin, P., Bevis, P., Carrera, P., Dunlop, P., Wong, P. F., Albino, P., Rossi, P., Nana, P., Stather, P. W., Lapolla, P., Silveira, P. G., Saha, P., Somaiya, P., Pian, P. M., Morley, R. L., Bell, R., Ennab, R. M., Malgor, R., Pulli, R., Makar, R., Sekhar, R., Afifi, R., Coscas, R., Soler, R., Cuff, R. F., Diaz, R., Biagioni, R., Ramely, R. B., Carvajal, R. R., Jhajj, S., Edeiken, S., Benites, S., Zaca, S., Paravastu, S., Chan, S., Sheth, S., Shalhub, S., Dindyal, S., Banegas, S., Hardy, S., Sica, Simona, Tam, S. C., Premnath, S., Renton, S., Rajagopalan, S., Kyriakos, S., Kakkos, S., Ancetti, S., Elkouri, S., Lin, S., Cheng, S. W. K., Koutsias, S. G., Grainger, T., Fekry, T., Tantawy, T. G., Siddiqui, T., Oshodi, T., Akhtar, T., Hardy, T. J., Kotsis, T., Gooneratne, T., Rowlands, T., Cohnert, T. U., Wallace, T., Lane, T. R. A., Bracale, U. M., Cheema, U., Sadia, U., Rubio, V., Canata, V., Jongkind, V., Khetarpaul, V., Summerour, V., Dorigo, W., Al-Jundi, W., Luo, X., Tshomba, Yamume, Serra, Y. G., Minelli F., Tinelli G. (ORCID:0000-0002-2212-3226), Sica S., Tshomba Y. (ORCID:0000-0001-7304-7553), Benson, R. A., Sudarsanam, A., Tam, A., Beck, A. W., Barkat, A., Bajwa, A., Elbasty, A., Awopetu, A. I., Kodama, A., Rivera, A. G., Munoz, A., Saltiel, A., Russo, A., Rolls, A., Kafetzakis, A., Kimyaghalam, A., Kordzadeh, A., Shepherd, A., Singh, A., Mingoli, A., Lazaris, A. M., Isaak, A., Marin, A., Valdivia, A. R., Batchelder, A., Duncan, A., Argyriou, A., Jaipersad, A. S., Freyrie, A., Pereira-Neves, A., Mahomed, A., Isik, A., Jawien, A., Choudhry, A. J., Sivaharan, A., Giannoukas, A., Papaioannou, A., Saratzis, A., Abbas, A., Christos, B., Akkaya, B. B., Huasen, B., Patrice, B., Mwipatayi, Azhar, B., Keldiyorov, B., Ullery, B. W., Pratesi, C., Hinojosa, C. A., Bechara, C. F., Parra, C. S., Alexandros, C., Bezard, C., Lee, C. J., Davies, C., Behrendt, C. -A., Lowe, C., Karkos, C. D., Yih, C. L. P., Mcdonnell, C., Ordonez, C., Nesbitt, C., Alexander, C., Guglielmone, D., Doherty, D. T., Riding, D. M., Esposito, D., Harkin, D., Lui, D. H., Kamal, D. M., Telve, D., Theodosiou, D., Angiletta, D., Jacobs, D., Choke, E., Gifford, E. D., Beropoulis, E., Lostoridis, E., Atkins, E., Giacomelli, E., Tsolaki, E., Davies, E., Scott, E., Katsogridakis, E., Serrano, E., Unal, E. U., Lopez, E., Mpaili, E., Minelli, Fabrizio, Malekpour, F., Mousa, F., Meyer, F., Tobar, F., Filipa, J., Johansson, F. G., Weaver, F., Proano, G. A. B., Sidel, G., Kuhan, G., Lemmon, G., Antoniou, G. A., Papadopoulos, G., Pitoulias, G., Sotirios, G., Victoria, G., Frahm-Jensen, G., Tinelli, Giovanni, Asciutto, G., Zenunaj, G., Eduardo, G. V. C., Pullas, G., Oszkinis, G., Popov, G., Iscan, H. Z., Travers, H. C., Barakat, H., Mavioglu, H. L., Chetter, I., Loftus, I., Dodos, I., Asghar, I., Van Herzeele, I., Giordano, J., Cragg, J., Chuen, J., Orrego, J. D. C., Perkins, J., Rocha-Neves, J., Ulloa, J. H., Chavez, J. A., Vidoedo, J., Faraj, J., Mills, J., Varela, J., Ng, J. J., Schmidli, J., Kiriaki, K., Powezka, K., Bowser, K., Darvall, K., Mccune, K., Pasenidou, K., Corless, K., Mckevitt, K., Long, K. N., Moulakakis, K. G., Roditis, K., Stavroulakis, K., Tigkiropoulos, K., Mannoia, K., Abayasekara, K., Jayakumar, L., Wijesinghe, L., Drudi, L., Shelmerdine, L., O'Banion, L. A., Meecham, L., Bennett, L. F., Grillo, L., Green, L., Wales, L., Loureiro, L., Palena, L. M., Tolba, M. M. H., Khashram, M., Chana, M., Pabon, M., Gonzalez, M., Usai, M. V., Tarazona, M., Ruffino, M. A., Castelli, M., Benezit, M., Dias-Neto, M., Malina, M., Maresch, M., Mazzurco, M., Storck, M., Troncoso, M. V., Popplewell, M., Tozzi, M., Metcalfe, M., Laine, M., Rawhi, M., Ricardo, M., Goh, M. A., Ahmed, M. A., Ibrahim, M., Alomari, M., Almudhafer, M., Elhadi, M., Gunawansa, N., Hadjievangelou, N., Hasemaki, N., Shafique, N., Aranson, N., Bradley, N., Mouawad, N. J., Rich, N. C., Floros, N., Patelis, N., Saratzis, N., Tsilimparis, N., Salinas, N., Altaf, N., Friedrich, O., Lyons, O., Mcbride, O. M. B., Ioannidis, O., Falah, O., Theodoridis, P., Sapienza, P., Tsiantoula, P., Chong, P., Coughlin, P., Bevis, P., Carrera, P., Dunlop, P., Wong, P. F., Albino, P., Rossi, P., Nana, P., Stather, P. W., Lapolla, P., Silveira, P. G., Saha, P., Somaiya, P., Pian, P. M., Morley, R. L., Bell, R., Ennab, R. M., Malgor, R., Pulli, R., Makar, R., Sekhar, R., Afifi, R., Coscas, R., Soler, R., Cuff, R. F., Diaz, R., Biagioni, R., Ramely, R. B., Carvajal, R. R., Jhajj, S., Edeiken, S., Benites, S., Zaca, S., Paravastu, S., Chan, S., Sheth, S., Shalhub, S., Dindyal, S., Banegas, S., Hardy, S., Sica, Simona, Tam, S. C., Premnath, S., Renton, S., Rajagopalan, S., Kyriakos, S., Kakkos, S., Ancetti, S., Elkouri, S., Lin, S., Cheng, S. W. K., Koutsias, S. G., Grainger, T., Fekry, T., Tantawy, T. G., Siddiqui, T., Oshodi, T., Akhtar, T., Hardy, T. J., Kotsis, T., Gooneratne, T., Rowlands, T., Cohnert, T. U., Wallace, T., Lane, T. R. A., Bracale, U. M., Cheema, U., Sadia, U., Rubio, V., Canata, V., Jongkind, V., Khetarpaul, V., Summerour, V., Dorigo, W., Al-Jundi, W., Luo, X., Tshomba, Yamume, Serra, Y. G., Minelli F., Tinelli G. (ORCID:0000-0002-2212-3226), Sica S., and Tshomba Y. (ORCID:0000-0001-7304-7553)

Abstract

This online structured survey has demonstrated the global impact of the COVID-19 pandemic on vascular services. The majority of centres have documented marked reductions in operating and services provided to vascular patients. In the months during recovery from the resource restrictions imposed during the pandemic peaks, there will be a significant vascular disease burden awaiting surgeons. One of the most affected specialties

Published
2020

24. Corrigendum to ‘Management of Chronic Venous Disease: Clinical Practice Guidelines’ [European Journal of Vascular & Endovascular Surgery 49/6 (2015) 678/737]

Author

Wittens, C., primary, Davies, A.H., additional, Bækgaard, N., additional, Broholm, R., additional, Cavezzi, A., additional, Chastanet, S., additional, de Wolf, M., additional, Eggen, C., additional, Giannoukas, A., additional, Gohel, M., additional, Kakkos, S., additional, Lawson, J., additional, Noppeney, T., additional, Onida, S., additional, Pittaluga, P., additional, Thomis, S., additional, Toonder, I., additional, Vuylsteke, M., additional, Kolh, P., additional, de Borst, G.J., additional, Chakfé, N., additional, Debus, S., additional, Hinchliffe, R., additional, Koncar, I., additional, Lindholt, J., additional, Vega de Ceniga, M., additional, Vermassen, F., additional, Verzini, F., additional, De Maeseneer, M.G., additional, Blomgren, L., additional, Hartung, O., additional, Kalodiki, E., additional, Korten, E., additional, Lugli, M., additional, Naylor, R., additional, Nicolini, P., additional, and Rosales, A., additional

Published
2020
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28. Management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS)

Author

Naylor, A. R., Ricco, J. -B., de Borst, G. J., Debus, S., de Haro, J., Halliday, A., Hamilton, G., Kakisis, J., Kakkos, S., Lepidi, S., Markus, H. S., Mccabe, D. J., Roy, J., Sillesen, H., van den Berg, J. C., Vermassen, F., Kolh, P., Chakfe, N., Hinchliffe, R. J., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Verzini, F., Archie, J., Bellmunt, S., Chaudhuri, A., Koelemay, M., Lindahl, A. -K., Padberg, F., Venermo, M., ACS - Amsterdam Cardiovascular Sciences, Surgery, ACS - Atherosclerosis & ischemic syndromes, Naylor, A. R., Ricco, J. -B., de Borst, G. J., Debus, S., de Haro, J., Halliday, A., Hamilton, G., Kakisis, J., Kakkos, S., Lepidi, S., Markus, H. S., Mccabe, D. J., Roy, J., Sillesen, H., van den Berg, J. C., Vermassen, F., Kolh, P., Chakfe, N., Hinchliffe, R. J., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Verzini, F., Archie, J., Bellmunt, S., Chaudhuri, A., Koelemay, M., Lindahl, A. -K., Padberg, F., and Venermo, M.

Subjects
Bypa, Complications, Medical therapy, Stenting, Transient ischaemic attack, medicine.medical_treatment, Disease, 030204 cardiovascular system & hematology, Imaging, 0302 clinical medicine, Restenosis, Stroke, Endarterectomy, Thrombolysis, 3. Good health, Asymptomatic, Centre for Surgical Research, Cardiology, Screening, Vertebral, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Vertebral artery, Bypass, Thrombolysi, Restenosi, Symptomatic, 03 medical and health sciences, Carotid, Dementia, Patch infection, Surgical techniques, Internal medicine, medicine.artery, Surgery, medicine, business.industry, Surgical technique, Vascular surgery, medicine.disease, business, Complication, 030217 neurology & neurosurgery
Abstract

The European Society of Vascular Surgery (ESVS) has prepared guidelines for treating patients with atherosclerotic carotid and vertebral artery (VA) disease. This does not include non-atherosclerotic conditions such as fibromuscular dysplasia, dissection, arteritis, or trauma. Potential users include vascular surgeons, neurologists, stroke physicians, angiologists, primary care physicians, cardiologists, and interventional radiologists. Guidelines promote standards of care, based on evidence; however, they should not be viewed as the legal standard of care. This document is a “guiding principle” and care given depends on the individual patient (presentation, comorbidities, age) and treatment setting (techniques available, local expertise).

Published
2017
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29. Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Writing Committee, Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, M J, Lachat, M L, Moll, F L, Setacci, C, Taylor, P R, Thompson, M, Trimarchi, S, Verhagen, H J, Verhoeven, E L, Esvs Guidelines Committee, Kolh, P, de Borst, G J, Chakfé, N, Debus, E S, Hinchliffe, R J, Kakkos, S, Koncar, I, Lindholt, J S, Vega de Ceniga, M, Vermassen, F, Verzini, F, Document Reviewers, Black, J H, Busund, R, Björck, M, Dake, M, Dick, F, Eggebrecht, H, Evangelista, A, Grabenwöger, M, Milner, R, Naylor, A R, Ricco, J-B, Rousseau, H, Schmidli, J, Writing Committee, Null, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Null, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Null, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. -B., Rousseau, H., and Schmidli, J.

Subjects
Descending thoracic aorta, Endovascular Procedure, Descending thoracic aortic management, Aorta, Thoracic, Thoracic aorta disease, Thoraco-abdominal aorta, Recommendations, Clinical practice, Guideline, Recommendation, Thoracic aorta abnormalitie, Aortic Disease, Thoracic aorta abnormalities, Surgery, Thoracic aorta disorder, Postoperative Complication, Cardiology and Cardiovascular Medicine, Thoracic aorta disorders, Thoracic aorta diseases, Human
Published
2017
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30. European Society for Vascular Surgery Guidelines on the management of Aort0-iliac Abdominal Aortic Aneurysms

Author

Wanhainen, A, Verzini, F, Van Herzeele, I, Allaire, E, Bown, M, Cohnert, T, Dick, F, Van Herwaarden, J, Karkos, C, Koelemay, M, Kölbel, T, Loftus, I, Mani, K, Melissano, G, Powell, J, Szeberin, Z, Esvs Guidelines Committee, De Borst, GJ, Chakfe, N, Debus, S, Hinchliffe, R, Kakkos, S, Koncar, I, Kolh, P, Lindholdt, J, De Vega, M, Vermassen, F, Document Reviewers, Björck, M, Cheng, S, Dalman, R, Davidovic, L, Donas, K, Earnshaw, J, Eckstein, H-H, Golledge, J, Haulon, S, Mastracci, T, Naylor, R, Ricco, J-B, and Verhagen, H

Subjects
Male, ACUTE KIDNEY INJURY, Iliac Artery, POSITRON-EMISSION-TOMOGRAPHY, Postoperative Complications, QUALITY-OF-LIFE, IN-HOSPITAL MORTALITY, Humans, 1102 Cardiorespiratory Medicine and Haematology, Aged, Aged, 80 and over, Science & Technology, PERIOPERATIVE BETA-BLOCKADE, ENDOVASCULAR AAA REPAIR, LONG-TERM SURVIVAL, Disease Management, 1103 Clinical Sciences, SINGLE-CENTER EXPERIENCE, Peripheral Vascular Disease, Cardiovascular System & Hematology, Research Design, Cardiovascular System & Cardiology, INFRARENAL AORTIC-ANEURYSM, Surgery, Female, IDIOPATHIC RETROPERITONEAL FIBROSIS, Life Sciences & Biomedicine, Vascular Surgical Procedures, Aortic Aneurysm, Abdominal
Published
2018

31. Editor's Choice – Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Naylor, A.R. Ricco, J.-B. de Borst, G.J. Debus, S. de Haro, J. Halliday, A. Hamilton, G. Kakisis, J. Kakkos, S. Lepidi, S. Markus, H.S. McCabe, D.J. Roy, J. Sillesen, H. van den Berg, J.C. Vermassen, F. Kolh, P. Chakfe, N. Hinchliffe, R.J. Koncar, I. Lindholt, J.S. Vega de Ceniga, M. Verzini, F. Archie, J. Bellmunt, S. Chaudhuri, A. Koelemay, M. Lindahl, A.-K. Padberg, F. Venermo, M. ESVS Guidelines Committee

Published
2018

34. Severity of Asymptomatic Carotid Stenosis and Risk of Ipsilateral Hemispheric Ischaemic Events: Results from the ACSRS Study

Author

Nicolaides, A, Kakkos, S, Griffin, M, Sabetai, M, Dhanjil, S, Tegos, T, Thomas, D, Giannoukas, A, Geroulakos, G, Georgiou, N, Francis, S, Ioannidou, E, Doré, C, Adovasio, R, Ziani, B, Aló, E, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkauskas, E, Barros D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, DeRango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopolous, E, Andreadis, E, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Norgren, L, Ribbie, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, P, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Schroeder, T, Gronholdt, M, Finocchi, C, Rodriguez, G, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardilleas, n, Aloi, T, Salerno, M, Fernandes, J., BIASI, GIORGIO MARIA, MINGAZZINI, PAOLO, Nicolaides, A, Kakkos, S, Griffin, M, Sabetai, M, Dhanjil, S, Tegos, T, Thomas, D, Giannoukas, A, Geroulakos, G, Georgiou, N, Francis, S, Ioannidou, E, Doré, C, Adovasio, R, Ziani, B, Aló, E, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkauskas, E, Barros D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, Biasi, G, Mingazzini, P, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, Derango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopolous, E, Andreadis, E, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Norgren, L, Ribbie, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, P, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Schroeder, T, Gronholdt, M, Finocchi, C, Rodriguez, G, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardilleas, N, Aloi, T, Salerno, M, Fernandes, J, NICOLAIDES A N, KAKKOS S K, GRIFFIN M, SABETAI M, DHANJIL S, TEGOS T, THOMAS D J, GIANNOUKAS A, GEROULAKOS G, GEORGIOU N, FRANCIS S, IOANNIDOU E, and NOVO S

Subjects
Risk, medicine.medical_specialty, medicine.medical_treatment, Carotid Stenosi, Predictive Value of Test, Carotid endarterectomy, Severity of Illness Index, Asymptomatic, Brain Ischemia, chemistry.chemical_compound, Cerebrovascular Accident, medicine.artery, Internal medicine, Severity of illness, NASCET, MED/22 - CHIRURGIA VASCOLARE, medicine, Carotid, Stenosis, Medicine(all), Ultrasonography, Doppler, Duplex, Creatinine, business.industry, Risk Factor, Incidence (epidemiology), medicine.disease, major clinical study, Ultrasonography, Duplex, Doppler, chemistry, Predictive value of tests, Cardiology, Surgery, ECST, Radiology, Internal carotid artery, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Objectives. This study determines the risk of ipsilateral ischaemic neurological events in relation to the degree of asymptomatic carotid stenosis and other risk factors. Methods. Patients (n = 1115) with asymptomatic internal carotid artery (ICA) stenosis greater than 50% in relation to the bulb diameter were followed up for a period of 6-84 (mean 37.1) months. Stenosis was graded using duplex, and clinical and biochemical risk factors were recorded. Results. The relationship between ICA stenosis and event rate is linear when stenosis is expressed by the ECST method, but S-shaped if expressed by the NASCET method. In addition to the ECST grade of stenosis (RR 1.6; 95% CI 1.21-2.15), history of contralateral TIAs (RR 3.0; 95% CI 1.90-4.73) and creatinine in excess of 85 μmol/L (RR 2.1; 95% CI 1.23-3.65) were independent risk predictors. The combination of these three risk factors can identify a high-risk group (7.3% annual event rate and 4.3% annual stroke rate) and a low risk group (2.3% annual event rate and 0.7% annual stroke rate). Conclusions. Linearity between ECST percent stenosis and risk makes this method for grading stenosis more amenable to risk prediction without any transformation not only in clinical practice but also when multivariable analysis is to be used. Identification of additional risk factors provides a new approach to risk stratification and should help refine the indications for carotid endarterectomy. © 2005 Elsevier Ltd. All rights reserved.

Published
2005
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35. Editor's Choice – Management of Chronic Venous Disease

Author

Writing Committee, Wittens, C., Davies, A.H., Bækgaard, N., Broholm, R., Cavezzi, A., Chastanet, S., de Wolf, M., Eggen, C., Giannoukas, A., Gohel, M., Kakkos, S., Lawson, J., Noppeney, T., Onida, S., Pittaluga, P., Thomis, S., Toonder, I., Vuylsteke, M., ESVS Guidelines Committee, Kolh, P., de Borst, G.J., Chakfé, N., Debus, S., Hinchliffe, R., Koncar, I., Lindholt, J., de Ceniga, M.V., Vermassen, F., Verzini, F., Document Reviewers, De Maeseneer, M.G., Blomgren, L., Hartung, O., Kalodiki, E., Korten, E., Lugli, M., Naylor, R., Nicolini, P., and Rosales, A.

Subjects
Medicine(all), medicine.medical_specialty, Klippel-Trenaunay syndrome, business.industry, medicine.medical_treatment, Vascular surgery, medicine.disease, Inferior vena cava, law.invention, Randomized controlled trial, medicine.vein, law, Severity of illness, medicine, Sclerotherapy, Surgery, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, Venous malformation, Venous disease
Abstract

Editor's Choice - Management of Chronic Venous Disease : Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Published
2015
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36. 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

37. Editor's Choice – Management of Descending Thoracic Aorta Diseases : Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., and Schmidli, J.

Subjects
Descending thoracic aorta, Descending thoracic aortic management, Thoraco-abdominal aorta, Clinical practice, Guideline, Recommendations, Thoracic aorta abnormalities, Centre for Surgical Research, Journal Article, Surgery, Cardiology and Cardiovascular Medicine, Thoracic aorta disorders, Thoracic aorta diseases
Published
2017
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38. Editor's choice - management of descending thoracic aorta diseases clinical practice guidelines of the European Society for Vascular Surgery (ESVS)

Author

Writing Committee, Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, M J, Lachat, M L, Moll, F L, Setacci, C, Taylor, P R, Thompson, M, Trimarchi, S, Verhagen, H J, Verhoeven, E L, Esvs Guidelines Committee, Kolh, P, de Borst, G J, Chakfé, N, Debus, E S, Hinchliffe, R J, Kakkos, S, Koncar, I, Lindholt, J S, Vega de Ceniga, M, Vermassen, F, et al, and University of Zurich

Subjects
610 Medicine & health, abdominal aorta, Thoraco, Clinical practice, Guideline, Recommendations, 2705 Cardiology and Cardiovascular Medicine, 10020 Clinic for Cardiac Surgery, 2746 Surgery, Thoracic aorta abnormalities, Descending thoracic aortic Management, Descending thoracic Aorta, Thoracic aorta disorders, Thoracic aorta diseases
Published
2017
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39. Editor's Choice - Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Ricco, J-B, Hinchliffe, R J, Brunkwall, J, Rousseau, H, Kakkos, S, Lachat, M L, Kolh, P, Chiesa, R, Setacci, C, Verzini, F, Coppi, G, Debus, E S, Fraedrich, G, Verhagen, H J, Lindholt, J S, Schmidli, Jürg, Vega De Ceniga, M, Milner, R, Naylor, A R, Haulon, S, Vermassen, F, Koncar, I, Moll, F L, Czerny, Martin, Busund, R, Eggebrecht, H, Trimarchi, S, Jacobs, M J, Cao, P, Taylor, P R, Dick, Florian, Evangelista, A, Thompson, M, De Borst, G J, Böckler, D, Björck, M, Riambau, V, Chakfé, N, Dake, M, Black, J H, Verhoeven, E L, and Grabenwöger, M

Subjects
610 Medicine & health
Published
2017
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40. Editor’s Choice e Management of Descending Thoracic Aorta Diseases Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, Mj, Lachat, Ml, Moll, Fl, Setacci, C, Taylor, Pr, Thompson, M, Trimarchi, S, Verhagen, Hj, Verhoeven, El, Kolh, P, de Borst Gj, Chakfé, N, Debus, Es, Hinchliffe, Rj, Kakkos, S, Koncar, I, Lindholt, Js, Vega de Ceniga, M, Vermassen, F, Verzini, F, Black III Jh, Busund, R, Björck, M, Dake, M, Dick, F, Eggebrecht, H, Evangelista, A, Grabenwöger, M, Milner, R, Naylor, Ar, Ricco, Jb, Rousseau, H, and Stimuli, J

Subjects
Descending thoracic aorta, Descending thoracic aortic management, Clinical practice, Guideline, Recommendations, Thoracic aorta abnormalities, Thoracic aorta diseases, Thoracic aorta disorders, Thoraco-abdominal aorta
Published
2017

41. 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, Björck, Martin, Koelemay, M, Acosta, S, Bastos Goncalves, F, Kölbel, T, Kolkman, J J, Lees, T, Lefevre, J H, Menyhei, G, Oderich, G, Esvs Guidelines Committee, 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, Geelkerken, B, Gloviczki, P, Huber, T, Naylor, R, Writing Committee, Björck, Martin, Koelemay, M, Acosta, S, Bastos Goncalves, F, Kölbel, T, Kolkman, J J, Lees, T, Lefevre, J H, Menyhei, G, Oderich, G, Esvs Guidelines Committee, 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, Geelkerken, B, Gloviczki, P, Huber, T, and Naylor, R

Published
2017
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42. Editor's Choice – Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author

Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., Schmidli, J., Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., and Schmidli, J.

Published
2017

43. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

Author

Nicolaides, Andrew N, Kakkos, Stavros K., Kyriacou, Efthyvoulos, Griffin, Maura, Sabetai, Michael, Thomas, Dafydd J., Tegos, Thomas, Geroulakos, George, Labropoulos, Nicos, Dor, Caroline J., Morris, Tim P., Naylor, Ross, Abbott, Anne L., Adovasio, Roberto, Ziani, B., Alò, F. P., Cicilioni, C. G., Ambrosio, G., Andreev, A., Andreozzi, G. M., Verlato, F., Camporese, G., Arosio, E., Barkauskas, E., Barros D'Sa, A. A. B., Brannigan, P., Batchvarova, V., Dramov, A., Belardi, P., Novelli, Gp, Simoni, G., Bell, P., Biasi, G. M., Mingazzini, P., Bornstein, N. M., Bouchier Hayes, D., Fitzgerald, P., Cairols, M. A., Cao, P. G., Derango, P., Carboni, G. P., Geoffredo, C., Catalano, M., Chambers, B., Goetzmann, M., Dickinson, A., Clement, D., Bobelyn, M., Coccheri, S., Conti, E., Diamantopoulos, E., Andreadis, E. A., Dimakakos, P. B., Kotsis, T., Eikelboom, B., Entz, L., Ferrari Bardile, Null, Aloi, T., Salerno, M., Fernandes e. Fernandes, J., Pedro, L., Fitzgerald, D. E., O'Shaunnersy, Anne, Fletcher, J., Forconi, S., Cappeli, R., Bicchi, M., Arrigucci, S., Gallai, V., Cardaiolli, G., Geroulakos, G., Kakkos, S., Gomez Isaza, L. F., Gorgoyannis, G., Liasis, N., Graf, M., Guarini, P., Hardy, S., Harris, P., Aston, S., Iosa, G., Katsamouris, A., Giannoukas, A., Krzanowski, M., Ladurner, G., Leal Monedero, J., Lee, B. B., Liapis, C., Galanis, P., Liboni, W., Pavanelli, E., Mannarino, E., Vaudo, G., Mccollum, P., Levison, R., Micieli, G., Bosone, D., Middleton, L., Pantziaris, M., Tyllis, T., Minar, E., Willfort, A., Moggi, L., Nenci, G., Radicchia, S., Nicolaides, A., Thomas, D, Norgren, L., Ribbe, E., Novo, S., Tantillo, R., Olinic, D., Paaske, W., Pagnan, A., Pauletto, P., Pagliara, V., Pettina, G., Pratesi, C., Matticari, S., Polivka, J., Sevcik, P., Poredos, P., Blinc, A., Videcnik, V., Pujia, A., Raso, A., Rispoli, P., Conforti, M., Robinson, T., Dennis, M. S. J., Rosfors, S., Rudofsky, G., Schroeder, T., Gronholdt, M. L., Finocchi, C., Rodriguez, G., Spartera, C., Ventura, M., Scarpelli, P., Sprynger, M., Sadzot, B., Hottermans, C., Moonen, Null, Taylor, P. R., Tovar Pardo, A., Negreira, J., Vayssairat, M., Faintuch, J. M., Valaikiené, J., Walker, M. G., Wilkinson, A. R., Nicolaides, A, Kakkos, S, Kyriacou, E, Griffin, M, Sabetai, M, Thomas, D, Tegos, T, Geroulakos, G, Labropoulos, N, Dor, C, Morris, T, Naylor, R, Abbott, A, Adovasio, R, Ziani, B, Alò, F, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkauskas, E, Barros D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, Biasi, G, Mingazzini, P, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, Derango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopoulos, E, Andreadis, E, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardileah, N, Aloi, T, Salerno, M, Fernandes, J, Pedro, L, Fitzgerald, D, O'Shaunnersy, A, Fletcher, J, Forconi, S, Cappeli, R, Bicchi, M, Arrigucci, S, Gallai, V, Cardaiolli, G, Gomez Isaza, L, Gorgoyannis, G, Liasis, N, Graf, M, Guarini, P, Hardy, S, Harris, P, Aston, S, Iosa, G, Katsamouris, A, Giannoukas, A, Krzanowski, M, Ladurner, G, Leal Monedero, J, Lee, B, Liapis, C, Galanis, P, Liboni, W, Pavanelli, E, Mannarino, E, Vaudo, G, Mccollum, P, Levison, R, Micieli, G, Bosone, D, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Norgren, L, Ribbe, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, P, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Schroeder, T, Gronholdt, M, Finocchi, C, Rodriguez, G, Spartera, C, Ventura, M, Scarpelli, P, Sprynger, M, Sadzot, B, Hottermans, C, Moonenbp, N, Taylor, P, Tovar Pardo, A, Negreira, J, Vayssairat, M, Faintuch, J, Valaikiené, J, Walker, M, Wilkinson, A, Nicolaides, Andrew N, Kakkos, Stavros K., Kyriacou, Efthyvoulo, Griffin, Maura, Sabetai, Michael, Thomas, Dafydd J., Tegos, Thoma, Geroulakos, George, Labropoulos, Nico, Dor, Caroline J., Morris, Tim P., Naylor, Ro, Abbott, Anne L., Adovasio, Roberto, Ziani, B., Alò, F. P., Cicilioni, C. G., Ambrosio, G., Andreev, A., Andreozzi, G. M., Verlato, F., Camporese, G., Arosio, E., Barkauskas, E., Barros D'Sa, A. A. B., Brannigan, P., Batchvarova, V., Dramov, A., Belardi, P., Novelli, Gp, Simoni, G., Bell, P., Biasi, G. M., Mingazzini, P., Bornstein, N. M., Bouchier Hayes, D., Fitzgerald, P., Cairols, M. A., Cao, P. G., Derango, P., Carboni, G. P., Geoffredo, C., Catalano, M., Chambers, B., Goetzmann, M., Dickinson, A., Clement, D., Bobelyn, M., Coccheri, S., Conti, E., Diamantopoulos, E., Andreadis, E. A., Dimakakos, P. B., Kotsis, T., Eikelboom, B., Entz, L., Ferrari Bardile, Null, Aloi, T., Salerno, M., Fernandes e. Fernandes, J., Pedro, L., Fitzgerald, D. E., O'Shaunnersy, Anne, Fletcher, J., Forconi, S., Cappeli, R., Bicchi, M., Arrigucci, S., Gallai, V., Cardaiolli, G., Geroulakos, G., Kakkos, S., Gomez Isaza, L. F., Gorgoyannis, G., Liasis, N., Graf, M., Guarini, P., Hardy, S., Harris, P., Aston, S., Iosa, G., Katsamouris, A., Giannoukas, A., Krzanowski, M., Ladurner, G., Leal Monedero, J., Lee, B. B., Liapis, C., Galanis, P., Liboni, W., Pavanelli, E., Mannarino, E., Vaudo, G., Mccollum, P., Levison, R., Micieli, G., Bosone, D., Middleton, L., Pantziaris, M., Tyllis, T., Minar, E., Willfort, A., Moggi, L., Nenci, G., Radicchia, S., Nicolaides, A., Norgren, L., Ribbe, E., Novo, S., Tantillo, R., Olinic, D., Paaske, W., Pagnan, A., Pauletto, P., Pagliara, V., Pettina, G., Pratesi, C., Matticari, S., Polivka, J., Sevcik, P., Poredos, P., Blinc, A., Videcnik, V., Pujia, A., Raso, A., Rispoli, P., Conforti, M., Robinson, T., Dennis, M. S. J., Rosfors, S., Rudofsky, G., Schroeder, T., Gronholdt, M. L., Finocchi, C., Rodriguez, G., Spartera, C., Ventura, M., Scarpelli, P., Sprynger, M., Sadzot, B., Hottermans, C., Moonen, Null, Taylor, P. R., Tovar Pardo, A., Negreira, J., Vayssairat, M., Faintuch, J. M., Valaikiené, J., Walker, M. G., and Wilkinson, A. R.

Subjects
Male, Carotid Stenosi, carotid artery stenosis, Brain Ischemia, 80 and over, MED/22 - CHIRURGIA VASCOLARE, Carotid Stenosis, Cerebrovascular disease, cerebrovascular risk, Stroke, Ultrasonography, Aged, 80 and over, Middle Aged, cardiovascular system, Female, Radiology, Internal carotid artery, medicine.symptom, Cardiology and Cardiovascular Medicine, Carotid Artery, Internal, Adult, Aged, Amaurosis Fugax, Humans, ROC Curve, Risk Assessment, Surgery, Human, medicine.medical_specialty, Asymptomatic, Central nervous system disease, medicine.artery, medicine, Asymtomatic carotid stenosis, cardiovascular diseases, Risk factor, carotid surgery, Vascular disease, business.industry, Amaurosis fugax, medicine.disease, Internal, Stenosis, atherosclerosis, Carotid Artery, business
Abstract

Background: The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis. Methods: This was a prospective, multicenter, cohort study of patients undergoing medical intervention for vascular disease. Hazard ratios for ICA stenosis, clinical features, and plaque texture features associated with ipsilateral cerebrovascular or retinal ischemic (CORI) events were calculated using proportional hazards models. Results: A total of 1121 patients with 50% to 99% asymptomatic ICA stenosis in relation to the bulb (European Carotid Surgery Trial [ECST] method) were followed-up for 6 to 96 months (mean, 48). A total of 130 ipsilateral CORI events occurred. Severity of stenosis, age, systolic blood pressure, increased serum creatinine, smoking history of more than 10 pack-years, history of contralateral transient ischemic attacks (TIAs) or stroke, low grayscale median (GSM), increased plaque area, plaque types 1, 2, and 3, and the presence of discrete white areas (DWAs) without acoustic shadowing were associated with increased risk. Receiver operating characteristic (ROC) curves were constructed for predicted risk versus observed CORI events as a measure of model validity. The areas under the ROC curves for a model of stenosis alone, a model of stenosis combined with clinical features and a model of stenosis combined with clinical, and plaque features were 0.59 (95% confidence interval [CI] 0.54-0.64), 0.66 (0.62-0.72), and 0.82 (0.78-0.86), respectively. In the last model, stenosis, history of contralateral TIAs or stroke, GSM, plaque area, and DWAs were independent predictors of ipsilateral CORI events. Combinations of these could stratify patients into different levels of risk for ipsilateral CORI and stroke, with predicted risk close to observed risk. Of the 923 patients with

Published
2010
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44. Palpable Mass on the Head after Minor Trauma

Author

Nikolakopoulos, K. M., Papageorgopoulou, C. P., Ntouvas, I. G., Kakkos, S., and Tsolakis, I.

Subjects
Article Subject, cardiovascular diseases
Abstract

Temporal artery is superficially exhibited and easily traumatized. Rarely, a minor and blunt trauma, especially in elderly who are under anticoagulants, can cause a pseudoaneurysm. Diagnosis should be based, primarily, on history and physical examination and secondarily on duplex ultrasound scanning which will lead to confirmation and preoperative planning. The therapeutical plan consists of surgical ligation and excision of the aneurysm. Surgery can be performed under local anesthesia with no postoperative major or minor complications. Endovascular approach consists of catheter embolization and remains a second option due to the risk of complications and the inconclusive results. On this review, authors present a case of an 80-year-old male with a pseudoaneurysm of superficial temporal artery.

Published
2016
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45. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial

Author

Halliday, A, Harrison, M, Hayter, E, Kong, X, Mansfield, A, Marro, J, Pan, H, Peto, R, Potter, J, Rahimi, K, Rau, A, Robertson, S, Streifler, J, Thomas, D, Fraedrich G, Asymptomatic Carotid Surgery Trial Collaborative G. r. o. u. p., Schmidauer, C, Hölzenbein, Th, Huk, I, Haumer, M, Kretschmer, G, Metz, V, Polterauer, P, Teufelsbauer, H, Cras, P, Hendriks, J, Lauwers, P, Van Schil, P, de Souza EB, Dourado, Me, Gurgel, G, Rocha, Gm, Petrov, V, Slabakov, G, Cooper, Me, Gubitz, G, Holness, R, Howes, W, Langille, R, Legg, K, Nearing, S, Mackean, G, Mackay, M, Phillips, Sj, Sullivan, J, Wood, J, Erdelez, L, Sosa, T, Angelides, Ns, Christopoulos, G, Malikidou, A, Pesta, A, Ambler, Z, Mracek, J, Polivka, J, Rohan, V, Sevcik, P, Simaná, J, Benes, V, Kramár, F, Kaste, M, Lepäntalo, M, Soinne, L, Cardon, Jm, Legalou, A, Gengenbach, B, Pfadenhauer, K, Wölfl, Kd, Flessenkämper, I, Klumpp, Bf, Marsch, J, Kolvenbach, R, Pfeiff, T, Sandmann, W, Beyersdorf, F, Hetzel, A, Sarai, K, Schöllhorn, J, Spillner, G, Lutz, Hj, Böckler, D, Maeder, N, Busse, O, Grönniger, J, Haukamp, F, Balzer, K, Knoob, Hg, Roedig, G, Virreira, L, Franke, S, Moll, R, Schneider, J, Dayantas, J, Sechas, Mn, Tsiaza, S, Kiskinis, D, Apor, A, Dzinich, C, Entz, L, Hüttl, K, Jàrànyi, Z, Mogan, I, Nagy, Z, Szabo, A, Varga, D, Juhász, G, Mátyás, L, Hutchinson, M, Mehigan, D, Aladjem, Z, Harah, E, Elmakias, S, Gurvich, D, Yoffe, B, Ben Meir, H, Dagan, L, Karmeli, R, Keren, G, Shimony, A, Weller, B, Avrahami, R, Koren, R, Streifler, Jy, Tabachnik, S, Zelikovski, A, Angiletta, D, Federico, F, Impedovo, G, Marotta, V, Pascazio, L, Regina, G, Andreoli, A, Pozzati, E, Bonardelli, S, Giulini, Sm, Guarneri, B, Caiazzo, P, Mascoli, F, Becchi, G, Masini, R, Santoro, E, Simoni, G, Ventura, M, Scarpelli, P, Spartera, C, Arena, O, Collice, M, Puttini, M, Romani, F, Santilli, I, Segramora, V, Sterzi, R, Deriu, G, Verlato, F, Cao, Pg, Cieri, Enrico, De Rango, P, Moggi, L, Ricci, S, Antico, A, Spigonardo, F, Malferrari, G, Tusini, N, Vecchiati, E, Cavallaro, A, Kasemi, H, Marino, M, Sbarigia, E, Speziale, F, Zinicola, N, Alò, Fp, Bartolini, M, Carbonari, L, Caporelli, S, Grili Cicilioni, C, Lagalla, G, Ioannidis, G, Pagliariccio, G, Silvestrini, M, Palombo, D, Peinetti, F, Adovasio, R, Chiodo Grandi, F, Mase, G, Zamolo, F, Fregonese, V, Gonano, N, Mozzon, L, Blair, R, Chuen, J, Ferrar, D, Garbowski, M, Hamilton, Mj, Holdaway, C, Muthu, S, Shakibaie, F, Vasudevan, Tm, Kroese, A, Slagsvold, Ce, Dahl, T, Johnsen, Hj, Lange, C, Myhre, Ho, Gniadek, J, Andziak, P, Elwertowski, M, Leszczynski, J, Malek, Ak, Mieszkowski, J, Noszczyk, W, Szostek, M, Toutounchi, S, Correia, C, Pereira, Mc, Akchurin, Rs, Flis, V, Miksic, K, Stirn, B, Tetickovic, E, Cairols, M, Capdevila, Jm, Iborra Ortega, E, Obach, V, Riambau, V, Vidal Barraquer, F, Vila Coll, R, Diaz Vidal, E, Iglesias Negreia JI, Tovar Pardo, A, Iglesias, Rj, Alfageme, Af, Barba Velez, A, Estallo Laliena, L, Garcia Monco JC, Gonzalez, Lr, Corominas, C, Julia, J, Lozano, P, Marti Masso JF, Porta, Rm, Carrera, Ar, Gomez, J, Blomstrand, C, Gelin, J, Holm, J, Karlström, L, Mattsson, E, Bornhov, S, Dahlstrom, J, De Pedis, G, Jensen, Sm, Pärsson, H, Plate, G, Qvarfordt, P, Arvidsson, B, Brattström, L, Forssell, C, Potemkowski, A, Skiöldebrand, C, Stoor, P, Blomqvist, M, Calander, M, Lundgren, F, Almqvist, H, Norgren, L, Norrving, B, Ribbe, E, Thörne, J, Gottsäter, A, Mätzsch, T, Nilsson, Me, Lonsson, M, Stahre, B, Stenberg, B, Konrad, P, Jarl, L, Lundqvist, L, Olofsson, P, Rosfors, S, Swedenborg, J, Takolander, R, Bergqvist, D, Ljungman, C, Kniemeyer, Hw, Widmer, Mk, Kuster, R, Kaiser, R, Nagel, W, Sege, D, Weder, B, De Nie, J, Doelman, J, Yilmaz, N, Buth, J, Stultiens, G, Boiten, J, Boon, A, van der Linden, F, Busman, Dc, Sinnige, Ha, Yo, Ti, de Borst GJ, Eikelboom, Bc, Kappelle, Lj, Moll, F, Dortland, Rw, Westra, Te, Jaber, H, Manaa, J, Meftah, Rb, Nabil, Br, Sraieb, T, Bateman, D, Budd, J, Horrocks, M, Kivela, M, Shaw, L, Walker, R, D'Sa, Aa, Fullerton, K, Hannon, R, Hood, Jm, Lee, B, Mcguigan, K, Morrow, J, Reid, J, Soong, Cv, Simms, M, Baird, R, Campbell, M, Cole, S, Ferguson, It, Lamont, P, Mitchell, D, Sassano, A, Smith, Fc, Blake, K, Kirkpatrick, Pj, Martin, P, Turner, C, Clegg, Jf, Crosley, M, Hall, J, De Cossart, L, Edwards, P, Fletcher, D, Rosser, S, Mccollum, Pt, Davidson, D, Levison, R, Bradbury, Aw, Chalmers, Rt, Dennis, M, Murie, J, Ruckley, Cv, Sandercock, P, Campbell, Wb, Frankel, T, Gardner Thorpe, C, Gutowski, N, Hardie, R, Honan, W, Niblett, P, Peters, A, Ridler, B, Thompson, Jf, Bone, I, Welch, G, Grocott, Ec, Overstall, P, Aldoori, Mi, Dafalla, Be, Bryce, J, Clarke, C, Ming, A, Wilkinson, Ar, Bamford, J, Berridge, D, Scott, J, Abbott, Rj, Naylor, R, Harris, P, Humphrey, P, Adiseshiah, M, Aukett, M, Baker, D, Bishop, Cc, Boutin, A, Brown, M, Burke, P, Burnand, Kg, Colchester, A, Coward, L, Davies, Ah, Espasandin, M, Giddings, Ae, Hamilton, G, Judge, C, Kakkos, S, Mcguiness, C, Morris Vincent, P, Nicolaides, A, Padayachee, Ts, Riordan, H, Sullivan, E, Taylor, P, Thompson, M, Wolfe, Jh, Mccollum, Cn, O'Neill, Pa, Welsh, S, Barnes, J, Cleland, P, Davis, M, Gholkar, A, Jones, R, Jaykishnam, V, Mendelow, Ad, O'Connell, Je, Siddique, Ms, Stansby, G, Vivar, R, Ashley, S, Cosgrove, C, Gibson, J, Wilkins, Dc, Chant, Ad, Frankel, J, Shearman, Cp, Williams, J, Hall, G, Holdsworth, R, Davies, Jn, Mclean, B, Woodburn, Kr, Brown, G, Curley, P, Loizou, L, Chaturvedi, S, Diaz, F, Radak, D, Todorovic, Pr, Kamugasha, D, Baxter, A, Berry, C, Burrett, J, Collins, R, Crowther, J, Davies, C, Farrell, B, Godwin, J, Gray, R, Harwood, C, Hirt, L, Hope, C, Knight, S, Lay, M, Munday, A, Murawska, A, Peto, Cg, Radley, A, Richards, S., Cras, Patrick, van Schil, Paul, et al., Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group, Halliday, A, Harrison, M, Hayter, E, Kong, X, Mansfield, A, Marro, J, Pan, H, Peto, R, Potter, J, Rahimi, K, Rau, A, Robertson, S, Streifler, J, Thomas, D, Adovasio, Roberto, and Asymptomatic Carotid Surgery Trial Collaborative, Group

Subjects
Male, Time Factors, medicine.medical_treatment, Kaplan-Meier Estimate, Carotid endarterectomy, Aged, 80 and over, Carotid Stenosis, Endarterectomy, Carotid, Female, Humans, Incidence, Middle Aged, Primary Prevention, Stroke, Treatment Outcome, Stroke/epidemiology, law.invention, Randomized controlled trial, law, Aged, 80 and over, Endarterectomy, Carotid, endarterectomy, Carotid Stenosis/mortality, Incidence (epidemiology), Carotid*/mortality, General Medicine, Carotid Stenosis | Internal Carotid Artery | Endarterectomy, medicine.symptom, medicine.medical_specialty, Asymptomatic, Internal medicine, asymptomatic carotid artery stenosi, medicine, asymptomatic carotid artery stenosis, business.industry, Carotid Stenosis/complications, Stroke/prevention & control, Perioperative, medicine.disease, Surgery, Stenosis, Human medicine, business
Abstract

SummaryBackgroundIf carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA.MethodsBetween 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3–2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6–11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392.Findings1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7% versus 4·8% at 1 year (and 92·1% vs 16·5% at 5 years). Perioperative risk of stroke or death within 30 days was 3·0% (95% CI 2·4–3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1% versus 10·0% at 5 years (gain 5·9%, 95% CI 4·0–7·8) and 10·8% versus 16·9% at 10 years (gain 6·1%, 2·7–9·4); ratio of stroke incidence rates 0·54, 95% CI 0·43–0·68, p

Published
2010
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46. Editor's Choice - Management of Secondary Aorto-enteric and Other Abdominal Arterio-enteric Fistulas : A Review and Pooled Data Analysis

Author

Kakkos, S. K., Bicknell, C. D., Tsolakis, I. A., Bergqvist, David, Kakkos, S. K., Bicknell, C. D., Tsolakis, I. A., and Bergqvist, David

Abstract

Objectives: To compare management strategies for secondary abdominal arterio-enteric fistulas (AEFs). Methods: This study is a review and pooled data analysis. Medline and Scopus databases were searched for studies published between 1999 and 2015. Particular emphasis was given to short- and long-term outcomes in relation to AEF repair type. Results: Two hundred and sixteen publications were retrieved, reporting on 823 patients. In-hospital mortality was 30.7%. Open surgery had higher in-hospital mortality (246/725, 33.9%), than endovascular methods (7/98, 7.1%, p<.001, OR 6.7, 95% CI 3-14.7, including staged endovascular to open surgery, 0/13, 0%). In-hospital mortality after graft removal/extra-anatomical bypass grafting was 31.2% (66/226), graft removal/in situ repair 34% (137/403), primary closure of the arterial defect 62.5% (10/16), and for miscellaneous open procedures 41.3% (33/80), p=.019. Among the subgroups of in situ repair, homografts were associated with a higher mortality than impregnated prosthetic grafts (p=.047). There was no difference in recurrent AEF-free rates between open and endovascular procedures. Extra-anatomical bypass/graft removal and in situ repair had a lower AEF recurrence rate than primary closure and homografts. Late sepsis occurred more often after endovascular surgery (2-year rates 42% vs. 19% for open, p=.001). The early survival benefit of endovascular surgery was blunted during follow-up, although it remained significant (p<.001). Within the in situ repair group, impregnated prosthetic grafts were associated with the worst overall and AEF related mortality free rates and vein grafts with the best. No recurrence, sepsis, or mortality was reported following staged endograft placement to open repair after a mean follow-up of 16.8 months (p=.18, p=.22, and p=.006, respectively, compared with patients in other groups). Conclusions: Endovascular surgery, where appropriate, is associated with better early survival than open surg

Published
2016
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47. Prevention and treatment of venous thromboembolism--International Consensus Statement

Author

Nicolaides, An, Fareed, J, Kakkar, Ak, Comerota, Aj, Goldhaber, Sz, Hull, R, Myers, K, Samama, M, Fletcher, J, Kalodiki, E, Bergqvist, D, Bonnar, J, Caprini, Ja, Carter, C, Prandoni, Paolo, Conard, J, Eklof, B, Elalamy, I, Gerotziafas, G, Geroulakos, G, Giannoukas, A, Greer, I, Griffin, M, Kakkos, S, Lassen, Mr, Lowe, Gd, Markel, A, Raskob, G, Spyropoulos, Ac, Turpie, Ag, Walenga, Jm, and Warwick, D.

Subjects
Evidence-Based Medicine, Postoperative Complications, Cost-Benefit Analysis, Humans, Venous Thromboembolism
Abstract

The aim of this document is to provide a clear and concise account of the evidence regarding efficacy or harm for various methods available to prevent and manage venous thromboembolism (VTE).

Published
2014

48. Predictors and clinical significance of progression or regression of asymptomatic carotid stenosis

Author

Kakkos, Sk, Nicolaides, An, Charalambous, I, Thomas, D, Giannopoulos, A, Naylor, Ar, Geroulakos, G, Abbott, Al, Asymptomatic Carotid Stenosis, Risk of Stroke Study Group Adovasio, R, Ziani, B, Alò, F, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkauskas, E, D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, Biasi, G, Mingazzini, P, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, Derango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopoulos, E, Andreadis, E, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardile, A, Aloi, T, Salerno, M, Fernandes J, Fernandes e., Pedro, L, Fitzgerald, D, O'Shaughnessy, A, Fletcher, J, Forconi, S, Cappeli, R, Bicchi, M, Arrigucci, S, Gallai, V, Cardaiolli, G, Kakkos, S, Gomez Isaza, L, Gorgoyannis, G, Liasis, N, Graf, M, Guarini, P, Hardy, S, Harris, P, Aston, S, Iosa, G, Katsamouris, A, Giannoukas, A, Krzanowski, M, Ladurner, G, Leal Monedero, J, Lee, B, Liapis, C, Galanis, P, Liboni, W, Pavanelli, E, Mannarino, E, Vaudo, G, Mccollum, P, Levison, R, Micieli, G, Bosone, D, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Nicolaides, A, Norgren, L, Ribbe, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, Pietro, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Schroeder, T, Gronholdt, M, Finocchi, C, Rodriguez, G, Spartera, C, Ventura, M, Scarpelli, P, Sprynger, M, Sadzot, B, Hottermans, C, Moonen, M, Taylor, P, Tovar Pardo, A, Negreira, J, Vayssairat, M, Faintuch, J, Valaikiené, J, Walker, M, Wilkinson, A. R., Kakkos, Stavros K., Nicolaides, Andrew N., Charalambous, Ioanna, Thomas, Dafydd, Giannopoulos, Argyrio, Naylor, A. Ro, Geroulakos, George, Abbott, Anne L., Adovasio, Roberto, Ziani, B., Alò, F. P., Cicilioni, C. G., Ambrosio, G., Andreev, A., Andreozzi, G. M., Verlato, F., Camporese, G., Arosio, E., Barkauskas, E., Barros D'Sa, A. A. B., Brannigan, P., Batchvarova, V., Dramov, A., Belardi, P., Novelli, G. P., Simoni, G., Bell, P., Biasi, G. M., Mingazzini, P., Bornstein, N. M., Bouchier Hayes, D., Fitzgerald, P., Cairols, M. A., Cao, P. G., Derango, P., Carboni, G. P., Geoffredo, C., Catalano, M., Chambers, B., Goetzmann, M., Dickinson, A., Clement, D., Bobelyn, M., Coccheri, S., Conti, E., Diamantopoulos, E., Andreadis, E. A., Dimakakos, P. B., Kotsis, T., Eikelboom, B., Entz, L., Ferrari Bardile, A., Aloi, T., Salerno, M., Fernandes E. Fernandes, J., Pedro, L., Fitzgerald, D. E., O'Shaughnessy, A. M., Fletcher, J., Forconi, S., Cappeli, R., Bicchi, M., Arrigucci, S., Gallai, V., Cardaiolli, G., Gomez Isaza, L. F., Gorgoyannis, G., Liasis, N., Graf, M., Guarini, P., Hardy, S., Harris, P., Aston, S., Iosa, G., Katsamouris, A., Giannoukas, A., Krzanowski, M., Ladurner, G., Leal Monedero, J., Lee, B. B., Liapis, C., Galanis, P., Liboni, W., Pavanelli, E., Mannarino, E., Vaudo, G., Mccollum, P., Levison, R., Micieli, G., Bosone, D., Middleton, L., Pantziaris, M., Tyllis, T., Minar, E., Willfort, A., Moggi, L., Nenci, G., Radicchia, S., Norgren, L., Ribbe, E., Novo, S., Tantillo, R., Olinic, D., Paaske, W., Pagnan, A., Pauletto, P., Pagliara, V., Pettina, G., Pratesi, C., Matticari, S., Polivka, J., Sevcik, P., Poredos, P., Blinc, A., Videcnik, V., Pujia, A., Raso, A., Rispoli, P., Conforti, M., Robinson, T., Dennis, M. S. J., Rosfors, S., Rudofsky, G., Schroeder, T., Gronholdt, M. L., Finocchi, C., Rodriguez, G., Spartera, C., Ventura, M., Scarpelli, P., Sprynger, M., Sadzot, B., Hottermans, C., Moonen, M., Taylor, P. R., Tovar Pardo, A., Negreira, J., Vayssairat, M., Faintuch, J. M., Valaikiené, J., Walker, M. G., and Wilkinson, A. R.

Subjects
Male, Time Factors, Cost effectiveness, medicine.medical_treatment, Carotid Stenosi, Predictive Value of Test, Kaplan-Meier Estimate, Carotid endarterectomy, Retinal Disease, Risk Factors, 80 and over, Carotid Stenosis, Plaque, Atherosclerotic, Ultrasonography, Aged, 80 and over, Ultrasonography, Doppler, Duplex, Incidence, Remission Induction, Doppler, Middle Aged, Prognosis, Plaque, Atherosclerotic, Duplex, Europe, Stroke, Predictive value of tests, Disease Progression, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Carotid Artery, Internal, Human, Adult, medicine.medical_specialty, Time Factor, Victoria, Prognosi, Asymptomatic, Retinal Diseases, Predictive Value of Tests, Internal medicine, medicine, Humans, Clinical significance, Aged, Asymptomatic Disease, business.industry, Risk Factor, medicine.disease, Internal, Confidence interval, Surgery, Stenosis, Asymptomatic Diseases, Relative risk, asymptomatic carotid artery stenosis, Carotid Artery, business
Abstract

OBJECTIVE: To determine baseline clinical and ultrasonographic plaque factors predictive of progression or regression of asymptomatic carotid stenosis and the predictive value of changes in stenosis severity on risk of first ipsilateral cerebral or retinal ischemic events (including stroke).METHODS: A total of 1121 patients with asymptomatic carotid stenosis of 50% to 99% in relation to the bulb diameter (European Carotid Surgery Trial [ECST] method) underwent six monthly clinical assessments and carotid duplexes for up to 8 years (mean follow-up, 4 years). Progression or regression was considered present if there was a change of at least one grade higher or lower, respectively, persisting for at least two consecutive examinations.RESULTS: Regression occurred in 43 (3.8%), no change in 856 (76.4%), and progression in 222 (19.8%) patients. Younger age, high grades of stenosis, absence of discrete white areas in the plaque, and taking lipid lowering therapy were independent baseline predictors of increased incidence of regression. High serum creatinine, male gender, not taking lipid lowering therapy, low grades of stenosis, and increased plaque area were independent baseline predictors of progression. One hundred and thirty first ipsilateral cerebral or retinal ischemic events, including 59 strokes, occurred. Forty (67.8%) of the strokes occurred in patients whose stenosis was unchanged, 19 (32.2%) in those with progression, and zero in those with regression. For the entire cohort, the 8-year cumulative ipsilateral cerebral ischemic stroke rate was zero in patients with regression, 9% if the stenosis was unchanged, and 16% if there was progression (average annual stroke rates of 0%, 1.1%, and 2.0%, respectively; log-rank, P = .05; relative risk in patients with progression, 1.92; 95% confidence interval, 1.14-3.25). For patients with baseline stenosis 70% to 99% in relation to the distal internal carotid (North American Symptomatic Carotid Endarterectomy Trial [NASCET] method), in the absence of progression (n = 349), the 8-year cumulative ipsilateral cerebral ischemic stroke rate was 12%. In the presence of progression (n = 77), it was 21% (average annual stroke rates of 1.5% and 2.6%, respectively; log-rank, P = .34). Only nine (30%) of the 30 strokes occurred in the progression group.CONCLUSIONS: Progressive asymptomatic carotid stenosis identified a subgroup with about twice the risk of ipsilateral stroke compared with those without progression. However, the clinical value of screening for progression simply for selecting patients for carotid procedures is limited because of the low frequency of progression and its relatively low associated stroke rate. The cost effectiveness of screening for change in stenosis severity to better direct current optimal medical treatment needs testing.

Published
2014
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49. Silent embolic infarcts on computed tomography brain scans and risk of ipsilateral hemispheric events in patients with asymptomatic internal carotid artery stenosis

Author

Kakkos, S, Sabetai, M, Tegos, T, Stevens, J, Thomas, D, Griffin, M, Geroulakos, G, Nicolaides, A, Adovasio, R, Ziani, B, Alò, F, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkaukas, E, Barros D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, BIASI, GIORGIO MARIA, MINGAZZINI, PAOLO, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, DeRango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopoulos, E, Andreadis, A, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardile, T, Salerno, M, Fernandes, J, Pedro, L, Fitzgerald, D, O'Shaunnersy, A, Fletcher, J, Forconi, S, Capelli, R, Bicchi, M, Arrigucci, S, Gallai, V, Cardaiolli, G, Gomez Isaza, L, Gorgoyannis, G, Liasis, N, Graf, M, Guarini, P, Hardy, S, Harris, P, Aston, S, Iosa, G, Katsamouris, A, Giannoukas, A, Krzanowski, M, Ladurner, G, Leal Monedero, J, Lee, B, Liapis, C, Galanis, P, Liboni, W, Pavanelli, E, Mannarino, E, Vaudo, G, McCollum, P, Levison, R, Micieli, G, Bosone, D, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Norgren, L, Ribbe, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, P, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Finocchi, C, Rodriguez, G, Spartera, C, Ventura, M, Scarpelli, P, Sprynger, M, Sadzot, B, Hottermans, C, Moonenbj, n, Taylor, P, Tovar Pardo, A, Negreira, J, Vayssairat, M, Faintuch, J, Valaikiene, J, Walker, M, Wilkinson, A., Kakkos, S, Sabetai, M, Tegos, T, Stevens, J, Thomas, D, Griffin, M, Geroulakos, G, Nicolaides, A, Adovasio, R, Ziani, B, Alò, F, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkaukas, E, Barros D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, Biasi, G, Mingazzini, P, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, Derango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopoulos, E, Andreadis, A, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardile, T, Salerno, M, Fernandes, J, Pedro, L, Fitzgerald, D, O'Shaunnersy, A, Fletcher, J, Forconi, S, Capelli, R, Bicchi, M, Arrigucci, S, Gallai, V, Cardaiolli, G, Gomez Isaza, L, Gorgoyannis, G, Liasis, N, Graf, M, Guarini, P, Hardy, S, Harris, P, Aston, S, Iosa, G, Katsamouris, A, Giannoukas, A, Krzanowski, M, Ladurner, G, Leal Monedero, J, Lee, B, Liapis, C, Galanis, P, Liboni, W, Pavanelli, E, Mannarino, E, Vaudo, G, Mccollum, P, Levison, R, Micieli, G, Bosone, D, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Norgren, L, Ribbe, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, P, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Finocchi, C, Rodriguez, G, Spartera, C, Ventura, M, Scarpelli, P, Sprynger, M, Sadzot, B, Hottermans, C, Moonenbj, N, Taylor, P, Tovar Pardo, A, Negreira, J, Vayssairat, M, Faintuch, J, Valaikiene, J, Walker, M, and Wilkinson, A

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, internal carotid artery, Carotid endarterectomy, Kaplan-Meier Estimate, brain embolism, Asymptomatic, Risk Assessment, Central nervous system disease, Duplex scanning, Predictive Value of Tests, MED/22 - CHIRURGIA VASCOLARE, medicine, Humans, Carotid Stenosis, brain infarction, cardiovascular diseases, Prospective Studies, Stroke, Aged, Proportional Hazards Models, Ultrasonography, Doppler, Duplex, Cerebral infarction, business.industry, Amaurosis fugax, Cerebral Infarction, medicine.disease, major clinical study, neurologic disease, Stenosis, multicenter study, Intracranial Embolism, Ischemic Attack, Transient, transient ischemic attack, Disease Progression, carotid artery obstruction, Surgery, Female, Radiology, medicine.symptom, business, Cardiology and Cardiovascular Medicine, Tomography, X-Ray Computed, Carotid Artery, Internal, prospective study
Abstract

Udgivelsesdato: 2009-Apr OBJECTIVES: This study tested the hypothesis that silent embolic infarcts on computed tomography (CT) brain scans can predict ipsilateral neurologic hemispheric events and stroke in patients with asymptomatic internal carotid artery stenosis. METHODS: In a prospective multicenter natural history study, 821 patients with asymptomatic carotid stenosis graded with duplex scanning who had CT brain scans were monitored every 6 months for a maximum of 8 years. Duplex scans were reported centrally, and stenosis was expressed as a percentage in relation to the normal distal internal carotid criteria used by the North American Symptomatic Carotid Endarterectomy Trialists. CT brain scans were reported centrally by a neuroradiologist. In 146 patients (17.8%), 8 large cortical, 15 small cortical, 72 discrete subcortical, and 51 basal ganglia ipsilateral infarcts were present; these were considered likely to be embolic and were classified as such. Other infarct types, lacunes (n = 15), watershed (n = 9), and the presence of diffuse white matter changes (n = 95) were not considered to be embolic. RESULTS: During a mean follow-up of 44.6 months (range, 6 months-8 years), 102 ipsilateral hemispheric neurologic events (amaurosis fugax in 16, 38 transient ischemic attacks [TIAs], and 47 strokes) occurred, 138 patients died, and 24 were lost to follow-up. In 462 patients with 60% to 99% stenosis, the cumulative event-free rate at 8 years was 0.81 (2.4% annual event rate) when embolic infarcts were absent and 0.63 (4.6% annual event rate) when present (log-rank P = .032). In 359 patients with

Published
2008
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