Article
Clinical Neurology
Bin Yang, Yan Ma, Tao Wang, Yanfei Chen, Yinzhou Wang, Zhenwei Zhao, Dong Chen, Jiyue Wang, Xiaolin Xu, Tao Luo, Yang Hua, Feng Ling, Adnan I. Qureshi, Bo Hong, Liqun Jiao
Summary: In Chinese patients with carotid artery stenosis, both carotid endarterectomy (CEA) and carotid artery stenting (CAS) have low rates of recurrent risk, and the occurrence rate of postoperative complications is relatively low.
TRANSLATIONAL STROKE RESEARCH
(2021)
Article
Clinical Neurology
Virginia J. Howard, Ale Algra, George Howard, Leo H. Bonati, Gert J. de Borst, Richard Bulbulia, David Calvet, Hans-Henning Eckstein, Gustav Fraedrich, Jacoba P. Greving, Alison Halliday, Jeroen Hendrikse, Olav Jansen, Martin M. Brown, Jean-Louis Mas, Peter A. Ringleb, Thomas G. Brott
Summary: A pooled analysis of large randomized trials among symptomatic patients revealed differences in the risk of any stroke or death during the 120-day periprocedural period between CAS and CEA treatment based on sex. Despite heterogeneity among trials, there were no significant sex differences in risk during any follow-up period.
Review
Health Care Sciences & Services
Michael T. Bounajem, Ramesh Grandhi, Craig J. Kilburg, Philipp Taussky
Summary: Carotid artery stenosis is a leading cause of acute ischemic strokes in adults. Detecting and treating the condition before symptoms occur is crucial for stroke prevention. Carotid endarterectomy and carotid stenting have similar outcomes for asymptomatic carotid stenosis, but certain factors can help guide treatment decisions.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Medicine, General & Internal
Alison Halliday, Richard Bulbulia, Leo H. Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan
Summary: The international multicentre randomised trial ACST-2 compared the effects of CAS and CEA for asymptomatic patients with severe stenosis, showing that the long-term effects of these two procedures on fatal or disabling stroke are comparable.
Article
Endocrinology & Metabolism
Alexandru Achim, David Lacko, Artur Huettl, Csaba Csobay-Novak, Adam Csavajda, Peter Sotonyi, Bela Merkely, Balazs Nemes, Zoltan Ruzsa
Summary: There was no significant difference between patients with and without diabetes in terms of cerebrovascular events after carotid artery stenting. However, diabetes may lead to a higher rate of in-stent restenosis.
JOURNAL OF DIABETES RESEARCH
(2022)
Article
Surgery
Kimberley Hammar, Ann Charlotte Laska, Per Wester, Kevin Mani, Annika Lundstrom, Magnus Jonsson
Summary: This Swedish study investigated the occurrence of ipsilateral ischemic stroke in patients with symptomatic carotid stenosis after surgical treatment, and found that age above 80 years and carotid artery stenting were associated with an increased risk of ipsilateral ischemic stroke.
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
(2022)
Article
Multidisciplinary Sciences
Wen-Xin Wang, Ting Wang, Lin Ma, Zheng-Hui Sun, Ge-Sheng Wang, Xin Lou
Summary: This study found a relationship between new-onset DWI lesions and changes in CBF before and after CAS in patients with symptomatic unilateral carotid stenosis. Patients in the micro-embolism group may experience a loss of CBF regulation due to long-term hypoperfusion prior to stenting, rather than direct changes in cerebral hemodynamics.
SCIENTIFIC REPORTS
(2021)
Review
Cardiac & Cardiovascular Systems
Christopher J. White, Thomas G. Brott, William A. Gray, Donald Heck, Tudor Jovin, Sean P. Lyden, David Christopher Metzger, Kenneth Rosenfield, Gary Roubin, Ravish Sachar, Adnan Siddiqui
Summary: Significant advances have been made in carotid artery stenting (CAS), including new trial data, professional societal statements, techniques, and devices. The improved selection of CAS candidates and assessment of procedure risk have led to better outcomes.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Review
Clinical Neurology
Jie Wang, Xuesong Bai, Tao Wang, Adam A. Dmytriw, Aman B. Patel, Liqun Jiao
Summary: The study found that carotid artery stenting (CAS) and carotid endarterectomy (CEA) have comparable perioperative and long-term composite outcomes in treating asymptomatic carotid artery stenosis, but CAS may have a higher risk of any stroke and nondisabling stroke during the perioperative period.
Article
Multidisciplinary Sciences
Cheng-Hsuan Tsai, Ying-Hsien Chen, Mao-Shin Lin, Ching-Chang Huang, Chi-Sheng Hung, Chih-Fan Yeh, Sheng-Fu Liu, Sung-Chun Tang, Chi-Chao Chao, Hsien-Li Kao
Summary: This study aimed to evaluate the peri-procedural risk in CANO patients receiving CAS and found that CAS is safe for patients with CANO, with a similar low 30-day peri-procedural event rate comparable to those of non-CANO patients.
SCIENTIFIC REPORTS
(2021)
Article
Clinical Neurology
Salomeh Keyhani, Eric M. Cheng, Katherine Hoggatt, Peter C. Austin, Erin Madden, Paul L. Hebert, Ethan A. Halm, Ayman Naseri, Jason Johanning, Ann Abraham, Dawn M. Bravata
Summary: This study compared carotid artery stenting (CAS) to medical therapy (MT) in the treatment of asymptomatic carotid stenosis and found no difference in the risk of fatal and nonfatal stroke between the two treatment methods over a 5-year follow-up period.
Review
Cardiac & Cardiovascular Systems
Christopher J. White, Thomas G. Brott, William A. Gray, Donald Heck, Tudor Jovin, Sean P. Lyden, David Christopher Metzger, Kenneth Rosenfield, Gary Roubin, Ravish Sachar, Adnan Siddiqui
Summary: Significant advances have been made in the field of carotid artery stenting, with new trial data, professional statements, new techniques, and better candidate selection methods. The outdated coverage decision regarding CAS should be updated to approve CAS in selected symptomatic and asymptomatic patients for stroke prevention. Optimized CAS strategies and new technologies are leading to improved outcomes in CAS procedures.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Surgery
Roy W. Jones, Mark Conant, Adam Tanious, Paul Armstrong, Neil Moudgill, Martin Back, Karl Illig, James Brooks
Summary: This study reviewed the long-term outcomes of carotid artery stenting in veteran patients with a history of head and/or neck cancer treatment. The results showed low long-term survival rates in these patients, although low rates of neurologic events and need for reintervention were observed.
ANNALS OF VASCULAR SURGERY
(2021)
Article
Clinical Neurology
Christina L. Cui, Hanaa Dakour-Aridi, Jinny J. Lu, Kevin S. Yei, Marc L. Schermerhorn, Mahmoud B. Malas
Summary: This study compares the in-hospital outcomes of three different carotid artery revascularization procedures performed within different time intervals. The results show that carotid endarterectomy (CEA) remains the safest method during the urgent period. For revascularizations performed outside of 48 hours, transcarotid artery revascularization (TCAR) and CEA have comparable outcomes, while transfemoral carotid stenting (TFCAS) carries a higher risk of stroke or death.
Article
Surgery
Kara A. Rothenberg, Lue-Yen Tucker, Rebecca C. Gologorsky, Andrew L. Avins, Hui C. Kuang, Rishad M. Faruqi, Alexander C. Flint, Mai N. Nguyen-Huynh, Robert W. Chang
Summary: This study reports low rates of adverse events and long-term stroke risk up to 5 years following carotid endarterectomy (CEA) in a large health care system. The outcomes for both asymptomatic and symptomatic indications are within consensus guidelines and published trial outcomes, supporting the optimal use of CEA for severe carotid stenosis.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Peripheral Vascular Disease
Matthew T. Mefford, Parag Goyal, George Howard, Raegan W. Durant, Nancy E. Dunlap, Monika M. Safford, Paul Muntner, Emily B. Levitan
JOURNAL OF CLINICAL HYPERTENSION
(2020)
Review
Clinical Neurology
Fred Stephen Sarfo, Rufus Akinyemi, George Howard, Virginia J. Howard, Kolawole Wahab, Mary Cushman, Deborah A. Levine, Adesola Ogunniyi, Fred Unverzagt, Mayowa Owolabi, Bruce Ovbiagele
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2020)
Letter
Clinical Neurology
George Howard, Virginia J. Howard
Article
Cardiac & Cardiovascular Systems
Daniel T. Lackland, Virginia J. Howard, Mary Cushman, Suzanne Oparil, Brett Kissela, Monika M. Safford, Dawn O. Kleindorfer, Leslie A. McClure, George Howard
Article
Pharmacology & Pharmacy
Md Motiur Rahman, George Howard, Jingjing Qian, Kimberly Garza, Ash Abebe, Richard Hansen
Summary: This study analyzed data from U.S. adults aged 45 and older and found that white individuals had an increased risk of mortality with PIM use, while black individuals had a higher mortality rate without PIM use. Lower income and education levels were independent predictors of higher mortality rates.
JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION
(2021)
Article
Clinical Neurology
Virginia J. Howard, Ale Algra, George Howard, Leo H. Bonati, Gert J. de Borst, Richard Bulbulia, David Calvet, Hans-Henning Eckstein, Gustav Fraedrich, Jacoba P. Greving, Alison Halliday, Jeroen Hendrikse, Olav Jansen, Martin M. Brown, Jean-Louis Mas, Peter A. Ringleb, Thomas G. Brott
Summary: A pooled analysis of large randomized trials among symptomatic patients revealed differences in the risk of any stroke or death during the 120-day periprocedural period between CAS and CEA treatment based on sex. Despite heterogeneity among trials, there were no significant sex differences in risk during any follow-up period.
Article
Clinical Neurology
Brajesh K. Lal, James F. Meschia, Thomas G. Brott, Michael Jones, Herbert D. Aronow, Angelica Lackey, George Howard
Summary: Despite a more adverse cardiovascular risk profile, Black and Hispanic individuals have a lower prevalence of high-grade carotid artery stenosis compared to White individuals. This difference may contribute to the lower usage of carotid revascularization procedures in these minority populations.
Article
Health Care Sciences & Services
Debora Kamin Mukaz, Erica Dawson, Virginia J. Howard, Mary Cushman, John C. Higginbotham, Suzanne E. Judd, Brett M. Kissela, Monika M. Safford, Elsayed Z. Soliman, George Howard
Summary: This study found that hypertension, diabetes, and heart disease were more prevalent in rural areas compared to urban areas, with higher odds in the most rural regions. Adjustment for neighborhood socioeconomic status partially attenuated the odds for hypertension and heart disease in rural areas, completely attenuated the odds for diabetes, and revealed an association with current smoking.
JOURNAL OF RURAL HEALTH
(2022)
Article
Hematology
Jordan A. Munger, Insu Koh, George Howard, Virginia Howard, Timothy B. Plante, Katherine Wilkinson, Mary Cushman, Neil A. Zakai
Summary: In a racially and geographically diverse US cohort, there was no significant association found between television viewing and risk of venous thromboembolism (VTE), even after adjusting for factors like physical activity.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Clinical Neurology
Oluwasegun P. Akinyelure, Byron C. Jaeger, Tony L. Moore, Demetria Hubbard, Suzanne Oparil, Virginia J. Howard, George Howard, Joy N. Buie, Gayenell S. Magwood, Robert J. Adams, Leonardo Bonilha, Daniel T. Lackland, Paul Muntner
Summary: The study revealed that Black individuals, both stroke survivors and non-stroke survivors, had lower rates of blood pressure control compared to White individuals, with no significant differences after multivariable adjustment.
Article
Cardiac & Cardiovascular Systems
Matthew J. Singleton, Ya Yuan, Farah Z. Dawood, George Howard, Suzanne E. Judd, Neil A. Zakai, Virginia J. Howard, David M. Herrington, Elsayed Z. Soliman, Mary Cushman
Summary: This study found that circulating stroke risk biomarkers such as cystatin C, factor VIII antigen, interleukin-6, and NT-proBNP were associated with stroke risk in atrial fibrillation patients. A multimarker risk score incorporating these biomarkers was developed, showing improved predictive accuracy for stroke risk in atrial fibrillation.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Peripheral Vascular Disease
Jordan B. King, Laura C. Pinheiro, Joanna Bryan Ringel, Adam P. Bress, Daichi Shimbo, Paul Muntner, Kristi Reynolds, Mary Cushman, George Howard, Jennifer J. Manly, Monika M. Safford
Summary: The increase in social vulnerabilities is associated with a higher risk of developing hypertension and dying. The association between social vulnerability count and risk varies by race. The more social vulnerabilities an individual has, the higher the risk of developing hypertension and dying.
Article
Clinical Neurology
Thomas G. Brott, James F. Meschia, Brajesh K. Lal, Angel Chamorro, Virginia J. Howard, George Howard
Summary: The SPACE-2 trial compared three treatments for preventing stroke in patients with asymptomatic carotid stenosis. The findings were inconclusive due to low enrollment. The CREST-2 trial is expected to provide much-needed evidence for guiding treatment in asymptomatic patients.
Article
Peripheral Vascular Disease
Oluwasegun P. P. Akinyelure, Byron C. C. Jaeger, Suzanne Oparil, April P. P. Carson, Monika M. M. Safford, George Howard, Paul Muntner, Shakia T. T. Hardy
Summary: This study analyzed data to determine the impact of social determinants of health on the higher proportion of Black adults with uncontrolled blood pressure. Factors such as low education, low income, living in a health professional shortage area, disadvantaged neighborhood, and high-poverty zip code contribute to this disparity.
Article
Cardiac & Cardiovascular Systems
Russell P. Sawyer, Bradford B. Worrall, Virginia J. Howard, Michael G. Crowe, George Howard, Hyacinth I. Hyacinth
Summary: This study aims to examine the racial disparity in the prevalence and trajectory of vascular cognitive impairment and dementia in non-Hispanic White and non-Hispanic Black participants. It will focus on the role of cerebral small vessel disease and genetic risk factors for Alzheimer's disease and related dementias.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)