التفاصيل البيبلوغرافية
| العنوان: |
Effect of Patching on Reducing Restenosis in the Carotid Revascularization Endarterectomy Versus Stenting Trial |
| المؤلفون: |
Malas, Mahmoud, Glebova, Natalia O, Hughes, Susan E, Voeks, Jenifer H, Qazi, Umair, Moore, Wesley S, Lal, Brajesh K, Howard, George, Llinas, Rafael, Brott, Thomas G |
| المصدر: |
Stroke, vol 46, iss 3 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2015 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Biomedical and Clinical Sciences, Clinical Sciences, Brain Disorders, Clinical Research, Cardiovascular, Clinical Trials and Supportive Activities, Stroke, Aged, Carotid Arteries, Carotid Stenosis, Endarterectomy, Carotid, Female, Heart Valve Diseases, Humans, Male, Middle Aged, Myocardial Infarction, Proportional Hazards Models, Prospective Studies, Risk, Stents, Treatment Outcome, carotid artery narrowing, carotid artery stenosis, carotid endarterectomy, vascular closure patches, Cardiorespiratory Medicine and Haematology, Neurosciences, Neurology & Neurosurgery |
| جغرافية الموضوع: |
757 - 761 |
| الوصف: |
Background and purposeThe purpose is to determine whether patching during carotid endarterectomy (CEA) affects the perioperative and long-term risks of restenosis, stroke, death, and myocardial infarction as compared with primary closure.MethodsWe identified all patients who were randomized and underwent CEA in Carotid Revascularization Endarterectomy versus Stenting Trial. CEA patients who received a patch were compared with patients who underwent CEA with primary closure without a patch. We compared periprocedural and 4-year event rates, 2-year restenosis rates, and rates of reoperation between the 2 groups. We further analyzed results by surgeon specialty.ResultsThere were 1151 patients who underwent CEA (753 [65%] with patch and 329 [29%] with primary closure). We excluded 44 patients who underwent eversion CEA and 25 patients missing CEA data (5%). Patch use differed by surgeon specialty: 89% of vascular surgeons, 6% of neurosurgeons, and 76% of thoracic surgeons patched. Comparing patients who received a patch versus those who did not, there was a significant reduction in the 2-year risk of restenosis, and this persisted after adjustment by surgeon specialty (hazard ratio, 0.35; 95% confidence interval, 0.16-0.74; P=0.006). There were no significant differences in the rates of periprocedural stroke and death (hazard ratio, 1.58; 95% confidence interval, 0.33-7.58; P=0.57), in immediate reoperation (hazard ratio, 0.6; 95% confidence interval, 0.16-2.27; P=0.45), or in the 4-year risk of ipsilateral stroke (hazard ratio, 1.23; 95% confidence interval, 0.42-3.63; P=0.71).ConclusionsPatch closure in CEA is associated with reduction in restenosis although it is not associated with improved clinical outcomes. Thus, more widespread use of patching should be considered to improve long-term durability.Clinical trial registration urlhttp://www.clinicaltrials.gov. Unique identifier: NCT00004732. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt7567h46h; https://escholarship.org/uc/item/7567h46hTest |
| الإتاحة: |
https://escholarship.org/uc/item/7567h46hTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.8102DCEB |
| قاعدة البيانات: |
BASE |
