Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2012
Meta AnalysisCarotid endarterectomy plus medical therapy or medical therapy alone for carotid artery stenosis in symptomatic or asymptomatic patients: a meta-analysis.
The purpose of this study was to compare carotid endarterectomy (CEA) plus medical therapy (MT) with MT alone for symptomatic and asymptomatic patients suffering from carotid artery stenosis in terms of long-term stroke/death rate. ⋯ CEA is helpful for recently symptomatic patients with carotid artery stenosis ≥50% (NASCET technique) but adds no benefit in terms of stroke/death for asymptomatic patients.
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J. Cardiothorac. Vasc. Anesth. · Oct 2012
ReviewInnovations in treating aortic diseases: the abdominal aorta.
Patients with an abdominal aortic aneurysm (AAA) could benefit from earlier diagnosis to improve long-term outcomes. Candidate serum biomarkers for earlier AAA diagnosis include D-dimer, fibrinogen, low-density lipoprotein, high-density lipoprotein, lipoprotein(a), and the proteolytic enzymes known as matrix metalloproteinases. Furthermore, biomarkers such as brain natriuretic peptide significantly stratify perioperative risk in AAA repair. ⋯ This technology continues to advance with the development of branched and fenestrated grafts as well as total percutaneous endovascular AAA repair. Regardless of these advances, the clinical management of endoleaks will remain a major clinical focus. Taken together, these advances in the management of AAAs likely will significantly influence future clinical approaches to this challenging patient cohort.