Carotid Arteries Stenting Complications: Transradial Approach Versus Transfemoral
Carotid AtherosclerosisCarotid Stenosis3 moreThe aim is to compare the safety of using transfemoral and transradial approach in patient undergoing carotid arteries stenting.
Smart Nitinol Stent System for the Treatment of Severe Atherosclerotic Carotid Stenosis
Carotid Artery StenosisTo validate the long-term effects of implantation of the self-expanding Smart nitinol stent system for the treatment of severe atherosclerotic carotid stenosis in a 2-year follow-up study of a large patient cohort
SONOlysis in Prevention of Brain InfaRctions During Internal Carotid Endarterectomy
Internal Carotid Artery StenosisSONOBIRDIE Trial is a randomized, single-blind, sham-controlled study designed for a demonstration of the safety and effectiveness of sonolysis (continual transcranial Doppler (TCD) monitoring) in reduction of risk of stroke or transient ischemic attack (TIA), brain infarctions and cognitive decline using a 2-MHz diagnostic probe with a maximal diagnostic energy on the reduction of risk of brain infarctions by the activation of endogenous fibrinolytic system during carotid endarterectomy (CEA) in patients with ≥ 70% symptomatic or asymptomatic internal carotid artery stenosis. The sample size is based on an expected 2.5% reduction of ischemic stroke, TIA, and death during the 30-day postoperative period in the sonolysis group (estimated prevalence, 1.5 %) compared to the control group (estimated prevalence, 4 %). Pre-study calculations showed that a minimum of 746 patients in each group is needed to reach a significant difference with an alpha value of 0.05 (two-tailed) and a beta value of 0.8 assuming that 10 % would be lost to follow-up or refuse to participate in the study. Consecutive patients will be assigned to the sonolysis or control group by a computer-generated 1:1 randomization. In patients randomized into sonolysis group, middle cerebral artery segment in a depth of 55 mm will be continuously monitored during intervention using a diagnostic 2-MHz TCD probe with a maximal diagnostic energy. In patients randomized into control group, the TCD probe will be fixed in a required position using a special helmet as in sonolysis group patients, but middle cerebral artery segment in a depth of 55 mm will be only localized using a diagnostic 2-MHz TCD probe with a maximal diagnostic energy and the TCD monitoring will be stopped afterwards. Confirmation of the investigators hypothesis that sonothrombolysis is able to activate endogenous fibrinolytic system during CEA with consecutive reduction of ischemic stroke, TIA or death, and the number and volume of brain infarcts, can lead to the increase of the safety of CEA in patients with internal carotid artery stenosis. The investigators can presume that up to 50% of patients indicated for CEA can be treated using these methods in the future.
Effect of Raised CBF During CEA on Cognition in DM Patients
Carotid Artery DiseaseCarotid Artery Stenosis2 moreThe purpose of this study is to determine if we can reduce the incidence of cognitive dysfunction - difficulty in performing certain pencil-paper, memory, finger dexterity and thinking type of tasks called neuropsychometric tests - in patients with adult onset diabetes mellitus (DM) undergoing surgery on the carotid artery (CEA). We hypothesize that cognitive dysfunction can be decreased in patients with type II DM by augmenting cerebral blood flow with a shunt during carotid endarterectomy compared to patients with Type II DM who are treated with "conventional" management in which a shunt is placed only if the electroencephalogram (EEG) indicates cerebral ischemia.
The Effects of Dexmedetomidine and Remifentanil on Carotid Patients
Carotid Artery StenosisWe propose to test whether intraoperative administration of dexmedetomidine will reduce hemodynamic control in the intra- and post-operative periods and reduces PACU analgesic requirements in patients undergoing carotid endarterectomy.
Revacept in Symptomatic Carotid Stenosis
Carotid StenosisAtherosclerosis4 morePatients suffering from symptomatic carotid artery stenosis, transient ischemic attacks (TIAs), amaurosis fugax or stroke receive either Revacept (single dose) plus antiplatelet monotherapy or monotherapy alone. Patients receive a single dose of trial medication by intravenous infusion for 20 minutes. Patients are followed up one and three days after treatment, at 3 months and by a telephone interview at 12 months.
Progression of Carotid Artery Atheroma in Moderately Hypercholesterolemic Subjects
Carotid Artery StenosisHypercholesterolemiaThe purpose of this study is to examine the changes in the carotid artery when subjects receive high or low doses of rosuvastatin.
Comparing Carotid Stenting With Endarterectomy in Severe Asymptomatic Carotid Stenosis
Carotid StenosisPurpose of this study: Primary: • Comparison of cardiovascular mortality and morbidity which includes cardiac and neurological morbidity (TIA and CVA) in the two invasive treatments of asymptomatic carotid artery stenosis Secondary: Comparison of non cardiovascular morbidity caused by the two invasive techniques morbidity at the site of incision (infection or local hematoma) damage to cranial nerves (hypoglossus, vagus) brain hyperperfusion which is defined as severe headache which is not responsive to analgesics with or without nausea and vomiting. events of bradycardia within the first 24 hours, clinically evident and/or silent microembolic brain events immediately after the procedure and their relationship with morbidity and/or mortality due to TIA's or CVA's the change in the stenotic carotid artery at the time of follow up with duplex of neck arteries the comparison of the affect of the two procedures on patient life style
ViVEXX Carotid Revascularization Trial (VIVA)
Carotid Artery StenosisTo evaluate the safety and efficacy of the Bard ViVEXX Carotid Stent and Emboshield BareWire Rapid Exchange Embolic Protection System in the treatment of extracranial carotid artery stenosis in patients at high risk for carotid endarterectomy.
CAPITAL: Carotid Artery Plaque Intravascular Ultrasound Evaluation
Carotid Artery DiseaseTo assess the safety and feasibility of Volcano Corp Eagle Eye Gold Catheter system to correlate the presence and characteristic of carotid artery atherosclerotic disease with anatomic and histologic analysis.