2020
Hemodynamic events during carotid stenting are associated with significant periprocedural stroke and adverse events
Arhuidese I, Ottinger M, Shukla A, Moudgil N, Armstrong P, Illig K, Johnson B, Shames M. Hemodynamic events during carotid stenting are associated with significant periprocedural stroke and adverse events. Journal Of Vascular Surgery 2020, 71: 1941-1953.e1. PMID: 32085961, DOI: 10.1016/j.jvs.2019.05.056.Peer-Reviewed Original ResearchConceptsPeriprocedural strokePeriprocedural hypertensionHemodynamic eventsLength of stayCarotid symptomsPreprocedure medicationsMyocardial infarctionAngiotensin-converting enzyme inhibitorsCox regression analysisSymptomatic carotid diseaseVascular Quality InitiativePopulation-based cohortAssociated with significant increasesSusceptible patientsPeriprocedural outcomesBeta-blockersAdverse eventsKaplan-MeierComparing patientsCAS proceduresPeriprocedural hypotensionCardiac diseaseCarotid angioplastyCarotid stentingCarotid disease
2018
Risks Associated With Primary and Redo Carotid Endarterectomy in the Endovascular Era
Arhuidese I, Faateh M, Nejim B, Locham S, Abularrage C, Malas M. Risks Associated With Primary and Redo Carotid Endarterectomy in the Endovascular Era. JAMA Surgery 2018, 153: 252-259. PMID: 29117272, PMCID: PMC5885921, DOI: 10.1001/jamasurg.2017.4477.Peer-Reviewed Original ResearchConceptsPrimary carotid endarterectomyRedo carotid endarterectomyAsymptomatic patientsSymptomatic patientsCarotid endarterectomyMyocardial infarctionProspective cohort of patientsPoint of careCohort of patientsPerioperative myocardial infarctionRisk of deathAsymptomatic carotid stenosisVascular Quality InitiativeRisk of strokeExcess riskMain OutcomesSociety for Vascular SurgeryClinicians' expectationsCommunity hospitalProfessional guidelinesConsecutive patientsProspective cohortNo significant differenceEndovascular therapyQuality Initiative
2017
Carotid artery revascularization in patients with contralateral carotid artery occlusion: Stent or endarterectomy?
Nejim B, Aridi H, Locham S, Arhuidese I, Hicks C, Malas M. Carotid artery revascularization in patients with contralateral carotid artery occlusion: Stent or endarterectomy? Journal Of Vascular Surgery 2017, 66: 1735-1748.e1. PMID: 28666824, DOI: 10.1016/j.jvs.2017.04.055.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarotid StenosisChi-Square DistributionEndarterectomy, CarotidEndovascular ProceduresFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioProportional Hazards ModelsRegistriesRetrospective StudiesRisk FactorsSeverity of Illness IndexStentsTime FactorsTreatment OutcomeUnited StatesConceptsContralateral carotid artery occlusionCarotid artery occlusionCarotid artery stenting patientsCarotid artery stentingArtery occlusionCarotid endarterectomyRisk of strokeAsymptomatic patientsSymptomatic patientsHazard ratioOdds ratioHigh riskMultivariate logistic regression analysisContralateral carotid occlusionLog-rank testVascular Quality Initiative (VQI) registryCohort of patientsRisk of ipsilateral strokeCenters for MedicareShort-term outcomesCarotid artery revascularizationCarotid endarterectomy patientsHistory of strokeLogistic regression analysisCox proportional hazardsFixed and variable cost of carotid endarterectomy and stenting in the United States: A comparative study
Obeid T, Alshaikh H, Nejim B, Arhuidese I, Locham S, Malas M. Fixed and variable cost of carotid endarterectomy and stenting in the United States: A comparative study. Journal Of Vascular Surgery 2017, 65: 1398-1406.e1. PMID: 28216356, DOI: 10.1016/j.jvs.2016.11.062.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngioplastyAsymptomatic DiseasesCarotid StenosisChi-Square DistributionDatabases, FactualDecision Support TechniquesEndarterectomy, CarotidFemaleHospital CostsHumansMaleMiddle AgedModels, EconomicPatient SelectionProcess Assessment, Health CarePropensity ScoreRetrospective StudiesStentsTime FactorsTreatment OutcomeUnited StatesConceptsCost of carotid artery stentingSymptomatic patientsHospital costsPropensity score matchingSymptomatic statusScore matchingPremier Perspective databaseCarotid artery stentingComorbidities of patientsStudent's t-testIn-hospital costsActual hospital costsAsymptomatic patientsSurgeon specialtyHospital characteristicsMale patientsCosts of carotid endarterectomyAsymptomatic cohortPerspective databaseArtery stentingPrimary outcomeCarotid endarterectomyPatientsClinical comorbiditiesHospital dischargeEndarterectomy versus stenting in patients with prior ipsilateral carotid artery stenting
Arhuidese I, Nejim B, Chavali S, Locham S, Obeid T, Hicks C, Malas M. Endarterectomy versus stenting in patients with prior ipsilateral carotid artery stenting. Journal Of Vascular Surgery 2017, 65: 1418-1428. PMID: 28190720, DOI: 10.1016/j.jvs.2016.11.041.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid StenosisChi-Square DistributionDatabases, FactualDisease-Free SurvivalEndarterectomy, CarotidFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient SelectionProportional Hazards ModelsRecurrenceRetreatmentRetrospective StudiesRisk AssessmentRisk FactorsStentsTime FactorsTreatment OutcomeConceptsCohort of patientsCarotid endarterectomyIpsilateral CAIn-stent restenosisPerioperative stroke/deathAsymptomatic patientsMyocardial infarctionNo significant differenceVascular Quality Initiative (VQI) databaseTreatment of in-stent restenosisSignificant differenceComplication of carotid angioplastyCox regression analysisCompare carotid endarterectomyAdverse event ratesIncreased risk of strokeCarotid artery stentingOverall stroke rateRisk of strokeSymptomatic patientsIV statusPostoperative strokeCase seriesKaplan-MeierPatient characteristics
2016
Stenting versus endarterectomy after prior ipsilateral carotid endarterectomy
Arhuidese I, Obeid T, Nejim B, Locham S, Hicks C, Malas M. Stenting versus endarterectomy after prior ipsilateral carotid endarterectomy. Journal Of Vascular Surgery 2016, 65: 1-11. PMID: 27707617, DOI: 10.1016/j.jvs.2016.07.115.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid StenosisChi-Square DistributionCranial Nerve InjuriesDatabases, FactualEndarterectomy, CarotidFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionPatient SelectionPropensity ScoreProportional Hazards ModelsRecurrenceReoperationRetrospective StudiesRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsIpsilateral CEACohort of patientsCarotid endarterectomyMyocardial infarctionPatient characteristicsOutcomes of carotid revascularizationVascular Quality Initiative (VQI) databaseSuperiority of carotid endarterectomyAssociated with high mortalityCranial nerve injuryIpsilateral carotid endarterectomyCompare patient characteristicsCox regression analysisRedo carotid endarterectomyIncreased risk of strokeAccess site complicationsPopulation-based studyPopulation-based evaluationRisk of strokeIpsilateral eventsAsymptomatic patientsSymptomatic patientsPeriprocedural periodPostoperative strokeCAS patients
2015
Poststent ballooning is associated with increased periprocedural stroke and death rate in carotid artery stenting
Obeid T, Arnaoutakis D, Arhuidese I, Qazi U, Abularrage C, Black J, Perler B, Malas M. Poststent ballooning is associated with increased periprocedural stroke and death rate in carotid artery stenting. Journal Of Vascular Surgery 2015, 62: 616-623.e1. PMID: 26033011, DOI: 10.1016/j.jvs.2015.03.069.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAngioplasty, BalloonCarotid StenosisChi-Square DistributionDatabases, FactualFemaleHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient SelectionRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexStentsStrokeTime FactorsTreatment OutcomeYoung AdultConceptsCarotid artery stentingCarotid endarterectomyHemodynamic depressionPerioperative strokeArtery stentingVascular Quality Initiative databaseApplication of carotid artery stentingAge of patientsIncreased perioperative riskIpsilateral CEASevere residual stenosisDeath rateCarotid artery lesionsLogistic regression analysisDegree of stenosisComplication rateSurgical riskPatient agePreoperative medicationsPerioperative riskRetrospective analysisSymptomatic statusIntraoperative techniquesResidual stenosisComparison to carotid endarterectomy
2014
Surgeon’s 30-Day Outcomes Supporting the Carotid Revascularization Endarterectomy versus Stenting Trial
Grimm J, Arhuidese I, Beaulieu R, Qazi U, Perler B, Freischlag J, Malas M. Surgeon’s 30-Day Outcomes Supporting the Carotid Revascularization Endarterectomy versus Stenting Trial. JAMA Surgery 2014, 149: 1314-1318. PMID: 25391047, DOI: 10.1001/jamasurg.2014.1762.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid StenosisEndarterectomy, CarotidFemaleFollow-Up StudiesHumansMaleRetrospective StudiesStentsTreatment OutcomeConceptsComposite major adverse eventsCarotid Revascularization Endarterectomy Versus Stenting TrialCarotid artery stentingMajor adverse eventsAdverse eventsRisk of strokeCarotid endarterectomyMyocardial infarctionVascular surgeonsTreatment modalitiesHigh-risk patient characteristicsRisk of myocardial infarctionRetrospective analysis of patientsPeriprocedural risk of strokeComposite adverse eventsImprove patient selectionAnalysis of patientsRates of myocardial infarctionIncidence of perioperative strokeFisher's exact testPeriprocedural stroke rateCarotid Revascularization EndarterectomyNo significant differencePeriprocedural riskPatient selectionDevelopment of a duplex-derived velocity risk prediction model of disease progression in patients with moderate asymptomatic carotid artery stenosis
Hicks CW, Canner JK, Arhuidese I, Glebova NO, Schneider E, Qazi U, Perler B, Malas MB. Development of a duplex-derived velocity risk prediction model of disease progression in patients with moderate asymptomatic carotid artery stenosis. Journal Of Vascular Surgery 2014, 60: 1585-1592. PMID: 25238724, DOI: 10.1016/j.jvs.2014.08.056.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArea Under CurveAsymptomatic DiseasesBlood Flow VelocityCarotid Artery, CommonCarotid Artery, InternalCarotid StenosisChi-Square DistributionDecision Support TechniquesDisease ProgressionFemaleHumansMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsProportional Hazards ModelsRegional Blood FlowRetrospective StudiesRisk AssessmentRisk FactorsROC CurveTime FactorsUltrasonography, Doppler, DuplexConceptsAsymptomatic carotid artery stenosisICA/CCA ratioCarotid artery stenosisInternal carotid arteryDisease progressionEnd-diastolic velocityPeak systolic velocityRisk prediction modelCCA ratioArtery stenosisSystolic velocityRisk factorsInitial peak systolic velocityProportional hazards regression modelsHigh-risk patientsRisk of progressionRisk-stratify patientsHazards regression modelsSignificant independent predictorsICA/CCACharacteristic curve analysisClinical prediction modelCarotid artery ratioIndependent predictorsDuplex imagingRisk of Disease Progression in Patients with Moderate Asymptomatic Carotid Artery Stenosis: Implications of Tobacco Use and Dual Antiplatelet Therapy
Hicks C, Talbott K, Canner J, Qazi U, Arhuidese I, Glebova N, Freischlag J, Perler B, Malas M. Risk of Disease Progression in Patients with Moderate Asymptomatic Carotid Artery Stenosis: Implications of Tobacco Use and Dual Antiplatelet Therapy. Annals Of Vascular Surgery 2014, 29: 1-8. PMID: 24530720, DOI: 10.1016/j.avsg.2014.02.007.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyAsymptomatic DiseasesBaltimoreCarotid StenosisChi-Square DistributionDisease ProgressionDrug Therapy, CombinationEndarterectomy, CarotidFemaleHumansIncidenceIschemic Attack, TransientLinear ModelsMaleMultivariate AnalysisPlatelet Aggregation InhibitorsPredictive Value of TestsProportional Hazards ModelsRetrospective StudiesRisk FactorsSeverity of Illness IndexSmokingStentsStrokeTertiary Care CentersTime FactorsTreatment OutcomeUltrasonography, Doppler, DuplexConceptsProgression to severe stenosisAsymptomatic carotid artery stenosisDual antiplatelet therapyCarotid artery stenosisDisease progressionRisk factorsSevere stenosisIncidence of symptomsAntiplatelet therapyArtery stenosisPatient populationMean follow-up timeRisk of disease progressionSevere diseaseCox proportional hazards regression modelsRisk of progressionProportional hazards regression modelsFollow-up timeCarotid artery duplexAll-cause mortalityHazards regression modelsImproved medical therapyTransient ischemic attackTobacco useAsymptomatic carotid disease