Interventions infobox Name PAGENAME Image Caption ICD10 ICD9 38.1 MeshID D004691 OtherCodes Endarterectomy is a surgical procedure to remove the atheroma atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of soft hardening deposits. It is carried out by separating the plaque from the arterial wall. It was first performed on a superficial femoral artery in 1946 by the Portuguese surgeon Jo o Cid dos Santos. In 1951, E. J. Wylie, an American, performed it on the abdominal aorta . The first successful reconstruction of the carotid artery was performed by Carrea, Molins, and Murphy in Argentina, later in the same year. ref http stroke.ahajournals.org cgi content full 27 8 1427 Thompson, Jesse E., The Evolution of Surgery for the Treatment and Prevention of Stroke retrieved on 2007 04 24 ref The procedure is widely used on the carotid artery of the neck as a way to reduce the risk of cerebrovascular accident stroke , particularly when the carotid artery is narrowed by more than 70 . A carotid endarterectomy may itself cause a stroke at the time of operation. Endarterectomy is also used as a supplement to a vein bypass graft to open up distal segments. Pulmonary hypertension caused by chronic thromboembolic disease CTEPH may be amenable to endarterectomy of the pulmonary artery . This is a highly specialized procedure. The term atherectomy is used to describe reconstruction through a catheter . See also Pulmonary thromboendarterectomy References references External links MeshName Endarterectomy http www.springerlink.com content f0h55146r42q776l Connolly, John E. and Price, Thaine, Aortoiliac Endarterectomy A Lost Art? , 2005 abstract treatment stub Vascular procedures Category Vascular surgery de Endarteriektomie ... more details
. Plaque often builds up at that division, and a carotid endarterectomy cuts open the artery and removes ... in an endarterectomy. Carotid endarterectomy CEA is a surgery surgical procedure used to prevent stroke, by correcting carotid stenosis stenosis narrowing in the common carotid artery . Endarterectomy ... have urgent endarterectomy within 2 weeks. ref Sharon Swain, Claire Turner, Pippa Tyrrell, Anthony ... 2 per year. The surgical mortality of endarterectomy ranges from 1 2 to as much as 10 . Two large ... Study ACAS . Endarterectomy for asymptomatic carotid artery stenosis. Jama. 1995 273 1421 1428. ref ... strokes by successful carotid endarterectomy in patients without recent neurological symptoms ... Journal, MARCH 3, 2009. Layman s summary of surgery vs. medication only debate. ref In endarterectomy ... higher with stenting than with endarterectomy 9.6 vs. 3.9 ref http general medicine.jwatch.org cgi content full 2008 1009 1 Carotid Stenting vs. Endarterectomy Longer Term Outcomes JournalWatch General ... Outcomes of Carotid Stenting and Endarterectomy Results From the SVS Vascular Registry , Sidawy AN, Zwolak ... for Vascular Surgery. J Vasc Surg 2009 49 71 9. ref The Carotid Revascularization Endarterectomy ... Endarterectomy Versus Stenting Trial CREST ClinicalTrials.gov. ref funded by the National Institutes of Health NIH reported that the results of stents and endarterectomy were comparable. However ... article PIIS0140 6736 10 60239 5 fulltext Carotid artery stenting compared with endarterectomy in patients ... that this procedure, known as carotid stenting , was non inferior to carotid endarterectomy in total ... MH, Kuntz RE, et al. title Protected carotid artery stenting versus endarterectomy in high risk ... 2859. ref History The endarterectomy procedure was developed and first done by the Portuguese surgeon ... Symptomatic Carotid Endarterectomy Trial NASCET and the European Carotid Surgery Trial ECST are both large randomized class 1 studies which have helped define current indications for carotid endarterectomy ... more details
Intimal hyperplasia is the thickening of the Tunica intima of a blood vessel as a complication of a reconstruction procedure or endarterectomy . Intimal hyperplasia is the universal response of a vessel to injury and is an important reason of late bypass graft failure, particularly in vein and synthetic vascular grafts. See also Hyperplasia Medical grafting External links http dissertations.ub.rug.nl faculties medicine 2002 g.j.toes Intimal hyperplasia, the obstacle in bypass grafts disease stub Category Diseases of arteries, arterioles and capillaries ... more details
plus carotid endarterectomy or carotid stenting The goal of treatment is to reduce the risk of stroke cerebrovascular accident . Intervention carotid endarterectomy or carotid stenting can cause ..., carotid endarterectomy by selected surgeons reduces the 5 year absolute incidence of all strokes or perioperative death by approximately 5 . In excellent centers, carotid endarterectomy is associated ... with symptomatic carotid stenosis be given carotid endarterectomy urgently, since the greatest risk of stroke is within days. Carotid endarterectomy reduces the risk of stroke or death from carotid ... endarterectomy has a surgical risk of stroke or death of about 2 4 in the best institutions. Carotid endarterectomy reduced major stroke and death by about half, even after surgical death and stroke ... benefit of surgery is small. Citation needed date December 2008 Surgery Benefits of endarterectomy ... title NEJM Stenting versus Endarterectomy for Treatment of Carotid Artery Stenosis format work accessdate ref A 2010 study found benefits reduced strokes from carotid endarterectomy in those without ... 10 year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis ACST ... more details
Refimprove date February 2009 Endovascular surgery is a form of minimally invasive procedure minimally invasive surgery that was designed to access many regions of the body via major blood vessels . Endovascular techniques were originally designed for diagnostic purposes. Basic techniques involve the introduction of a catheter percutaneously or through the skin, into a large blood vessel. Typically the blood vessel chosen is the femoral artery or vein found near the groin. Access to the femoral artery for example, is required for coronary , carotid , and Cerebrum cerebral Angiography angiographic procedures. The catheter is injected with a radio opaque dye that can be seen on live X ray or fluoroscopy . As the dye courses through the blood vessels, characteristic images are seen by experienced viewers and can assist in the diagnosis of diseases such as atherosclerosis , vascular trauma, or aneurysms . In recent years, however, the development of intravascular balloons, stents and coils have allowed for new therapies as alternatives to traditional surgeries such as Coronary artery bypass surgery CABG , carotid endarterectomy and aneurysm clipping. Stents and coils are composed of fine wire materials such as platinum , that can be inserted through a thin catheter and expanded into a predetermined shape once they are guided into place. Endovascular surgery is performed by radiologist s, neurologist s, neurosurgeon s, cardiologist s, and vascular surgeon s. The field is rapidly growing as its minimally invasive techniques offer an immediate advantage over more traditional, yet highly invasive surgeries. However, the science of endovascular surgery and its developing techniques are so new that it is currently difficult to compare the long term outcomes and complications of these patients. Several trials are underway, including Carotid Revascularization Endarterectomy versus Stent Trial CREST , and International Subarachnoid Aneurysm Trial ISAT , among others. The most co ... more details
, symptomatic patients and very tortuous and twisting vessels. None of these affect open, surgical endarterectomy ... JL, Silver FL, Mohr JP, Lal BK, Meschia JF CREST Investigators. Stenting versus endarterectomy .... Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis EVA 3S trial ... of carotid stenting versus endarterectomy in high risk patients. N Engl J Med. 2008 Apr 10 358 ... author Biller J, Feinberg WM, Castaldo JE, et al. title Guidelines for carotid endarterectomy a statement ... RM, Davies AH title Systematic comparison of the early outcome of angioplasty and endarterectomy ... more details
Atherectomy is a minimally invasive surgical method of removing, mainly, atherosclerosis from a large blood vessel within the body. Today, it is generally used to effectively treat ref http www.jvascsurg.org article S0741 5214 2806 2901618 1 abstract ref ref http www.jvir.org article S1051 0443 2807 2960391 1 abstract ref peripheral arterial disease of the lower extremities. It has also been used to treat coronary artery disease , albeit ineffectively ref http www2.cochrane.org reviews en ab003334.html ref . Procedure Unlike angioplasty and stents , which push plaque into the vessel wall, atherectomy involves removing the plaque burden within the vessel. Increasing the blood vessel vessel lumen anatomy lumen by removing the plaque burden improves downstream wound healing, reduces claudication and pushes amputation levels more distal. While atherectomy is usually employed to treat artery arteries it can be used in vein s and vein graft s as well. Atherectomy falls under the general category of percutaneous revascularization , which implies re canalizing blocked vasculature via a needle puncture in the skin. The most common access point is near the groin through the femoral artery common femoral artery CFA . However, wire and catheter access can occur from wherever a doctor is willing to stick. Other common places are the brachial artery , radial artery , popliteal artery , dorsalis pedis , and others. Advantages The procedure is considered less invasive than endarterectomy , which involves the surgical cut down and removal of plaque from the inner wall of a diseased vessel. The advantages of atherectomy when compared to endarterectomy include less procedure time, ease of use, faster patient recovery, decreased systemic complications, repeatability in light of new occlusions. It also serves as a chance for non surgical candidates. The advantages of atherectomy when compared to balloons angioplasty and stenting are less vessel barotrauma , no foreign object stent metal ... more details
The popliteal artery entrapment syndrome is a rather uncommon pathology , which results into claudication and chronic leg ischemia . The popliteal artery may be compressed behind the knee , due to congenital deformity of the muscle s or tendon insertions of the popliteal space . This repetitive trauma may result in Stenosis stenotic artery degeneration, complete artery Vascular occlusion occlusion or even formation of an aneurysm . History The syndrome was first described in 1879 by Anderson Stuart, a medical student , in a 64 year old male. Hamming and Vink in 1959 first described the management of the popliteal artery syndrome in a 12 year old patient. The patient was treated with myotomy of the medial head of the gastrocnemius muscle and http en.wiktionary.org wiki concomitant concomitant endarterectomy of the popliteal artery. They later reported four more cases and claimed that the incidence of this pathology in patients younger than 30 years old with claudication was 40 . Servello was the first to draw attention to diminished distal pulses observed with forced plantar or dorsiflexion in patients suffering from this syndrome. Bouhoutsos and Daskalakis in 1981 reported 45 cases of this syndrome in a population of 20,000 Greek soldiers. During the recent years the increasing frequency with which popliteal artery entrapment is reported, strongly suggests a greater awareness of the syndrome. Classification Love and Whelan proposed a classification of this pathology into four types, ref cite journal author Love J, Whelan T title Popliteal artery entrapment syndrome journal Am J Surg volume 109 issue 5 pages 620 4 year 1965 pmid 14281885 doi 10.1016 S0002 9610 65 80016 2 ref according to the various relationships between the popliteal artery and the muscles of the popliteal space. Rich and Hughes described popliteal vein compression, Fact date February 2007 thus adding a fifth type into the former classification. Vein ... but the article is about popliteal artery The ... more details
Rfam box acc RF00179 description GAIT element abbreviation GAIT avg length 71.30 avg identity 89.00 type Cis reg se See reference 1 ss Published PMID 12588972 release 10.0 The gamma interferon inhibitor of translation element or GAIT element is a cis acting RNA element located in the 3 UTR of the ceruloplasmin Cp mRNA . The GAIT element forms a stem loop secondary structure. The GAIT element is involved in selective translational silencing of the Cp transcript. Cp is a multifunctional, copper containing glycoprotein produced by the liver and secreted into the plasma. As an acute phase protein, its plasma concentration can double during multiple inflammatory conditions. Plasma Cp has been reported to be an independent risk factor for cardiovascular disease , including atherosclerosis, carotid restenosis after endarterectomy, and myocardial infarction. Translational silencing of Cp, and possibly other transcripts, mediated by the GAIT element may contribute to the resolution of the local inflammatory response following cytokine activation of macrophages. ref cite journal last Sampath first P coauthors Mazumder B, Seshadri V, Fox PL year 2003 title Transcript selective translational silencing by gamma interferon is directed by a novel structural element in the ceruloplasmin mRNA 3 untranslated region journal Mol Cell Biol volume 23 issue 5 pages 1509&ndash 1519 pmid 12588972 pmc 151701 doi 10.1128 MCB.23.5.1509 1519.2003 ref The silencing of Cp requires binding of the IFN gamma activated inhibitor of translation GAIT inhibitor complex to the GAIT element. ref name pmid16267389 cite journal author Mazumder B, Sampath P, Fox PL title Regulation of macrophage ceruloplasmin gene expression one paradigm of 3 UTR mediated translational control. journal Mol Cells volume 20 issue 2 pages 167 72 year 2005 pmid 16267389 ref The GAIT complex consists of the proteins RPL13A ribosomal protein L13a , EPRS glutamyl prolyl tRNA synthetase , NSAP1 NS1 associated protein 1 , and glycera ... more details
Paolo Macchiarini , M.D., Ph.D. is head and chairman of the Hospital Cl nic Barcelona Metro de Barcelona, University of Barcelona in Barcelona, Spain, as well as professor of surgery at the University of Barcelona in Spain, and at the Hannover Medical School in Hannover, Germany. Dr. Macchiarini completed his residency in thoracic surgery at the University of Pisa in Pisa, Italy. Dr. Macchiarini completed a fellowship in the department of thoracic surgery at the University of Alabama at Birmingham in Birmingham, Alabama, with an additional fellowship completed in the department of thoracic and vascular surgery and heart lung transplantation, H pital Marie Lannelongue, Paris Sud University, Le Plessis Robinson, France. Dr. Macchiarini s interests include extended surgery for lung, esophageal, and mediastinal tumors adult and pediatric tracheal surgery lung and heart lung transplantation pulmonary endarterectomy bio artificial lung and experimental research, education, training. ref http www.reachmd.com xmradioguest.aspx?pid 44903 ReachMD Paolo Macchiarini, MD ref ref http www.ctsnet.org home pmacchiarini Paolo Macchiarini CTSNET Member Homepage ref Dr. Macchiarini has contributed to the field of Regenerative medicine when in 2008 he performed the first Adult stem cell grown trachea transplant. ref http www.bristol.ac.uk news 2008 6010.html Adult stem cell breakthrough University of Bristol , November 19, 2008 ref ref http www.sciencedaily.com releases 2008 11 081119092939.htm Adult Stem Cell Breakthrough First Tissue Engineered Trachea Successfully Transplanted Science Daily , November 18, 2008 ref ref http www.nydailynews.com lifestyle health 2008 11 19 2008 11 19 doctors give woman a new windpipe using .html Doctors give woman a new windpipe, using her own stem cells New York Daily News AP , November 19, 2008 ref The first successful operation on a child followed in March 2010. ref http news.bbc.co.uk 2 hi health 8576493.stm Windpipe transplant success in UK child ... more details
following carotid endarterectomy , carotid angiography , cardiac catheterization , and cardiac bypass ... Beneficial effect of carotid endarterectomy in symptomatic patients with high grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators journal N. Engl. J. Med ... I, Kerstein MD title Carotid endarterectomy for amaurosis fugax without angiography journal ... lesion, aspirin is indicated, and a carotid endarterectomy if the stenosis is surgically ... the indication for endarterectomy. Amaurosis fugax appears to be a particularly favorable indication for carotid endarterectomy. Left untreated, this event carries a high risk of stroke after carotid endarterectomy, which has a low operative risk, there is a very low postoperative stroke rate. ref name bernstein cite journal author Bernstein EF, Dilley RB title Late results after carotid endarterectomy ... more details
The abbreviation Cea or CEA may refer to People Jos Pedro Cea 1900 1970 , Uruguayan footballer Jos Roberto Cea born 1939 , Salvadoran novelist and poet Eusebio Rodolfo Cord n Cea 1899 1966 , Salvadoran politician Government entities Council of Economic Advisers , a group of three respected economists who advise the President of the United States on economic policy Central Electricity Authority of India , an advisory organization to the Indian Government China Earthquake Administration , or Chinese Seismic Bureau Commissariat l nergie Atomique Commissariat l nergie atomique et aux nergies alternatives , French national establishment for nuclear matters Businesses and organizations California Earthquake Authority , a privately funded, publicly managed organization that sells California earthquake insurance policies Cambridge Environmental Assessments , a company specializing in chemical risk assessment China Eastern Airlines , based in Shanghai, People s Republic of China Canadian Education Association , a non profit organization that fosters dialogue on education policy Centro de Educaci n Art stica , an arts institute in Mexico City, owned by Televisa Cheer Extreme All Stars , a internationally known cheerleading organization based in North Carolina Christian Evangelistic Assemblies , a Christian organization supporting non denominational churches Cinema Exhibitors Association , the national trade association for cinema operators in the United Kingdom College of Engineering Adoor , an engineering college at Adoor, Kerala, affiliated with CUSAT Comit Europ en des Assurances , an organization representing the European insurance and reinsurance industry Consumer Electronics Association , a trade organization for the consumer electronics industry in the United States In medicine Carcinoembryonic antigen , a tumor marker for colorectal cancer Carotid endarterectomy , a surgical procedure involving the carotid artery Amygdala Central nucleus of the amygdala , of ... more details
Orphan date February 2009 PBB geneid 64094 SPARC related modular calcium binding protein 2 is a protein that in humans is encoded by the SMOC2 gene . ref name pmid12031507 cite journal author Nishimoto S, Hamajima Y, Toda Y, Toyoda H, Kitamura K, Komurasaki T title Identification of a novel smooth muscle associated protein, smap2, upregulated during neointima formation in a rat carotid endarterectomy model journal Biochim Biophys Acta volume 1576 issue 1 2 pages 225 30 year 2002 month May pmid 12031507 pmc doi ref ref name entrez cite web title Entrez Gene SMOC2 SPARC related modular calcium binding 2 url http www.ncbi.nlm.nih.gov sites entrez?Db gene&Cmd ShowDetailView&TermToSearch 64094 accessdate ref The PBB Summary template is automatically maintained by Protein Box Bot. See Template PBB Controls to Stop updates. PBB Summary section title summary text References reflist Further reading refbegin 2 PBB Further reading citations cite journal author Wilk JB, Herbert A, Shoemaker CM, et al. title Secreted modular calcium binding protein 2 haplotypes are associated with pulmonary function. journal Am. J. Respir. Crit. Care Med. volume 175 issue 6 pages 554 60 year 2007 pmid 17204727 doi 10.1164 rccm.200601 110OC pmc 1899283 cite journal author Rocnik EF, Liu P, Sato K, et al. title The novel SPARC family member SMOC 2 potentiates angiogenic growth factor activity. journal J. Biol. Chem. volume 281 issue 32 pages 22855 64 year 2006 pmid 16774925 doi 10.1074 jbc.M513463200 cite journal author Gerhard DS, Wagner L, Feingold EA, et al. title The status, quality, and expansion of the NIH full length cDNA project the Mammalian Gene Collection MGC . journal Genome Res. volume 14 issue 10B pages 2121 7 year 2004 pmid 15489334 doi 10.1101 gr.2596504 pmc 528928 cite journal author Ota T, Suzuki Y, Nishikawa T, et al. title Complete sequencing and characterization of 21,243 full length human cDNAs. journal Nat. Genet. volume 36 issue 1 pages 40 5 year 2004 pmid 14702039 doi 10.1 ... more details
abstract 339 20 1415 Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1998 ... more details
carotid endarterectomy Showed in 2005 ref Stroke 2005 36 2373 2378 ref that with intensive medical therapy most patients with asymptomatic carotid stenosis cannot benefit from endarterectomy or stenting ... more details
excision and homograft replacement. Postgrad Med 1954 16 334 342 ref First successful carotid endarterectomy in the world. ref name Twenty five years ref Cooley DA. Carotid endarterectomy from first ... 4. ref First laser coronary endarterectomy procedure in the United States. ref name Milestones ref Livesay JJ, Cooley DA Laser coronary endarterectomy proposed treatment for diffuse coronary atherosclerosis ... MS, Frazier OH, Cooley DA. Preliminary report on laser coronary endarterectomy in patients. Circulation ... more details
cellpadding 2 cellspacing 0 border 1 align right style margin left 0.5em width 300px bgcolor 6699FF Reibl v. Hughes align center Image Supreme Court of Canada.jpg 125px br Supreme Court of Canada bgcolor 6699FF Argued June 5, 1980 br Decided October 7, 1980 align center valign top small Full case name valign top small John Reibl v. Robert A. Hughes valign top small Citations valign top small 1980 2 S.C.R. 880 valign top small Prior history valign top small bgcolor 6699FF Holding In order to obtain medical consent, physicians must provide the patient with enough information so that an objective, reasonable person in the patient s position could make an informed decision. bgcolor 6699FF Court membership align center Chief Justice Bora Laskin Puisne Justices Ronald Martland , Julien Chouinard , Jean Beetz , Willard Estey , William McIntyre , and Brian Dickson bgcolor 6699FF Case opinions align top Unanimous decision by By the Court opinions of the Supreme Court of Canada The Court Reibl v. Hughes 1980 2 S.C.R. 880 is a leading decision of the Supreme Court of Canada on negligence, medical malpractice, informed consent , the duty to warn, and causation. The case settled the issue of when a physician may be sued for battery crime battery and when it is more appropriate to sue the doctor in negligence. The Court wrote unanimously that unless there has been misrepresentation or fraud to secure consent to the treatment, a failure to disclose the attendant risks, however serious, should go to negligence rather than to battery. The case also marked the creation of a standard whereby a physician must give the patient sufficient information so that an objective, reasonable person in the patient s position would be able to make an informed choice about a medical procedure. Background Robert A. Hughes, a physician, was in the process of competently performing an endarterectomy on his patient, John Reibl, when Reibl suffered a massive stroke. Paralysis and impotence resulted. Reib ... more details
has residual function in the affected side, carotid endarterectomy surgical removal of the stenosis ... endarterectomy is also indicated to decrease the risk of cerebral infarction for symptomatic carotid ... more details
Extracranial cerebrovascular disease Carotid Endarterectomy and other carotid surgery Surgery of the vertebral ... AAA repair EVAR Carotid stenosis Carotid endarterectomy Carotid stenting Varicose veins Vein stripping ... artery bypass surgery Bypass surgery Endarterectomy Atherectomy Acute limb ischaemia Balloon embolectomy ... more details
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