2020
Safety of carotid artery revascularization procedures in patients with atrial fibrillation
Nejim B, Mathlouthi A, Weaver L, Faateh M, Arhuidese I, Malas M. Safety of carotid artery revascularization procedures in patients with atrial fibrillation. Journal Of Vascular Surgery 2020, 72: 2069-2078.e4. PMID: 32471737, DOI: 10.1016/j.jvs.2020.01.074.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAtrial FibrillationCarotid Artery DiseasesCerebral HemorrhageCross-Sectional StudiesDatabases, FactualEndarterectomy, CarotidEndovascular ProceduresFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsCarotid artery stentingInternational Classification of DiseasesClinical Modification codesClassification of DiseasesOdds of intracerebral hemorrhagePredictors of ischemic strokeIntracerebral hemorrhageMultivariate logistic modelIn-hospital strokeCarotid artery diseaseCarotid endarterectomyHospital sizeAFib patientsInternational ClassificationModification codesHealthcare databasesMedication useStatistically significant predictorsAdjusted analysesAtrial fibrillationRandomized clinical trialsArtery diseasePremier Healthcare DatabaseAssociated with worse postoperative outcomesCarotid artery revascularization procedures
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
Outcomes of Primary and Secondary Carotid Artery Stenting
Arhuidese I, Rizwan M, Nejim B, Malas M. Outcomes of Primary and Secondary Carotid Artery Stenting. Stroke 2017, 48: 3086-3092. PMID: 28974632, DOI: 10.1161/strokeaha.117.016963.Peer-Reviewed Original ResearchConceptsAssociated with significantly lower oddsSymptomatic patientsSignificantly lower oddsLower oddsIpsilateral carotid endarterectomyCox regression analysisOdds of hypotensionCarotid artery stentingVascular Quality InitiativeAsymptomatic patientsOdds of hypertensionKaplan-MeierPeriprocedural stroke/deathCAS proceduresPeriprocedural hypotensionArtery stentingCarotid angioplastyCarotid endarterectomyPatientsStroke/deathEvaluate outcomesOddsHypotensionBradycardiaStentCarotid 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
Perioperative and Long-term Outcomes After Carotid Endarterectomy in Hemodialysis Patients
Cooper M, Arhuidese I, Obeid T, Hicks C, Canner J, Malas M. Perioperative and Long-term Outcomes After Carotid Endarterectomy in Hemodialysis Patients. JAMA Surgery 2016, 151: 947-952. PMID: 27366897, DOI: 10.1001/jamasurg.2016.1504.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAsymptomatic DiseasesDatabases, FactualEndarterectomy, CarotidFemaleHeart FailureHispanic or LatinoHumansKidney Failure, ChronicMaleMiddle AgedMobility LimitationMyocardial InfarctionPostoperative PeriodPulmonary Disease, Chronic ObstructiveRenal DialysisRetrospective StudiesRisk FactorsSex FactorsSmokingStrokeSurvival RateTime FactorsUnited StatesConceptsLong-term outcomesRisk of carotid endarterectomyAsymptomatic patientsLong-term strokeSymptomatic patientsCarotid endarterectomyDialysis patientsPerioperative strokeCohort of symptomatic patientsHistory of congestive heart failureMedian follow-up timePredictor of long-term mortalityMyocardial infarctionAssociated with poor outcomesDialysis-dependent patientsFollow-up timeOutcomes of carotid endarterectomyCox regression analysisCongestive heart failurePredictors of perioperative strokeLong-term mortalityChronic obstructive pulmonary diseaseDecrease stroke riskObstructive pulmonary diseasePatient-importantStenting 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 patientsCarotid Revascularization in Asymptomatic Patients after Renal Transplantation
Arhuidese I, Craig-Schapiro R, Obeid T, Nejim B, Hicks C, Malas M. Carotid Revascularization in Asymptomatic Patients after Renal Transplantation. Annals Of Vascular Surgery 2016, 38: 130-135. PMID: 27522968, DOI: 10.1016/j.avsg.2016.06.008.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplastyCarotid Artery DiseasesChi-Square DistributionEndarterectomy, CarotidFemaleHumansIncidenceKaplan-Meier EstimateKidney TransplantationLogistic ModelsMaleMiddle AgedMyocardial InfarctionOdds RatioPropensity ScoreProportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsStentsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsRenal transplant patientsCarotid artery stentingCox regression analysisTransplant patientsLong-term strokeCarotid endarterectomyCarotid revascularizationPerioperative strokeMyocardial infarctionRenal transplantationCarotid artery stenting cohortIncidence of perioperative complicationsCohort of renal transplant patientsChronic renal insufficiencyAssociated with increased riskAsymptomatic carotid artery stenosisRisk of periprocedural strokeRisk of perioperative strokeStroke-free survivalPropensity scoreSociety of Vascular SurgeryBaseline medical characteristicsUnited States Renal Data SystemBenefit of revascularizationCarotid artery stenosisPredictors of perioperative outcomes after carotid revascularization
Nejim B, Obeid T, Arhuidese I, Hicks C, Wang S, Canner J, Malas M. Predictors of perioperative outcomes after carotid revascularization. Journal Of Surgical Research 2016, 204: 267-273. PMID: 27565060, DOI: 10.1016/j.jss.2016.04.074.Peer-Reviewed Original ResearchConceptsCarotid artery stentingPredictor of perioperative outcomesCarotid endarterectomyPerioperative outcomesAmerican College of Surgeons National Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePredictor of postoperative MIAmerican College of Surgeons National Surgical Quality Improvement ProgramSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramMultivariate logistic regression analysisRisk of postoperative strokeOdds of reoperationPredictors of reoperationOutcomes of carotid endarterectomyCongestive heart failurePerioperative outcomes of carotid endarterectomyChronic obstructive pulmonary diseaseAssociated with higher oddsLogistic regression analysisObstructive pulmonary diseasePrevalence of diabetesAbstract TP115: Carotid Endarterectomy in Young and Middle Aged Patients
Arhuidese I, Obeid T, Nejim B, Yin K, Wang S, Hicks C, Malas M. Abstract TP115: Carotid Endarterectomy in Young and Middle Aged Patients. Stroke 2016, 47 DOI: 10.1161/str.47.suppl_1.tp115.Peer-Reviewed Original ResearchMiddle aged patientsNational Surgical Quality Improvement ProgramCarotid endarterectomyAged patientsCardiac interventionsPatient characteristicsAmerican College of Surgeons National Surgical Quality Improvement ProgramSurgeons National Surgical Quality Improvement ProgramDay post-operative periodPopulation of young patientsPredictor of adverse outcomesLength of in-hospital staySurgical Quality Improvement ProgramCompare patient characteristicsDay of surgeryIn-hospital stayPost-operative periodPhysically dependent patientsMyocardial infarction ratePredictors of strokeQuality Improvement ProgramPostoperative outcomesYounger patientsSymptomatic statusAdverse outcomesAbstract 102: Carotid Endarterectomy versus Stenting in Patients on Chronic Hemodialysis
Arhuidese I, Obeid T, Nejim B, Yin K, Wang S, Malas M. Abstract 102: Carotid Endarterectomy versus Stenting in Patients on Chronic Hemodialysis. Stroke 2016, 47 DOI: 10.1161/str.47.suppl_1.102.Peer-Reviewed Original ResearchLong-term outcomesPropensity score matching analysisCohort of HD patientsRisk of perioperative strokeScore matching analysisCarotid endarterectomyPerioperative strokeHD patientsCompare long-term outcomesMean follow-upMultivariate Cox regressionMatching analysisStroke-free survivalPredictors of perioperative strokeCarotid artery stenosisPerioperative stroke rateFree survivalStroke free survivalChronic hemodialysisSymptomatic statusCarotid revascularizationFollow-upCox regressionArtery stenosisMedicare database
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 ResearchConceptsComposite 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 selectionAbstract 309: Vasovasorum Volume Can Be Measured by Contrast-Enhanced 3D Carotid Duplex Ultrasound: Concept and Design of a Novel Method for Predicting Stroke Risk in Patients With Carotid Artery Stenosis
Arhuidese I, Nodel A, Qazi U, Call D, Perler B, Malas M. Abstract 309: Vasovasorum Volume Can Be Measured by Contrast-Enhanced 3D Carotid Duplex Ultrasound: Concept and Design of a Novel Method for Predicting Stroke Risk in Patients With Carotid Artery Stenosis. Arteriosclerosis Thrombosis And Vascular Biology 2014, 34 DOI: 10.1161/atvb.34.suppl_1.309.Peer-Reviewed Original ResearchAsymptomatic patientsStroke riskDuplex ultrasoundMulti-center clinical trialCarotid artery stenosisCarotid duplex ultrasoundPredicting stroke riskPredictor of stroke riskDegree of stenosisExperience strokeOccurrence of symptomsPatient selectionSevere stenosisArtery stenosisClinical trialsCarotid stenosisCarotid endarterectomyCarotid ultrasoundStenosisHigh riskPatientsPrevent strokeAtherosclerotic diseaseClinical practiceCarotid