Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 31,940 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
Monday, September 1, 2025
Analysis of Safety of Carotid Endarterectomy in Nonagenarians and the Implications of Frailty - A National Surgical Quality Improvement Program Analysis
Why would you want to do stenting at all if your doctor won't guarantee no problems?
I still don't understand why you would medically need to
stent a carotid artery or do an endarterectomy at all if the Circle of Willis is complete. (Unless the whole point is revenue and profit generation)
It would seem to make more sense to just close it up and prevent
problems from there. My right carotid artery was closed for 10 years
and I cognitively functioned quite well with no episodes of
fainting.
Didn't your competent? doctor tell you of these possible complications of endarterectomy? NO? So, your doctor isn't competent?
The complication rate of CEA can meet acceptable thresholds in select nonagenarians.
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Functional dependence and self-reported dyspnea correlated with higher odds of MI.
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Elective surgery and aspirin/statin use correlated with fewer complications.
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The 2-factor mFI outperformed the 5-factor mFI in predicting complications.
ABSTRACT
Background
Carotid artery stenosis prevalence increases with age, and carotid endarterectomy (CEA) is a possible treatment option. However, nonagenarians are at high risk of experiencing postoperative complications and are often not considered surgical candidates. We aimed to identify risk factors associated with postoperative myocardial infarction (MI), stroke, and death within 30 days for nonagenarians undergoing CEA and to analyze the predictive ability of modified frailty indices (mFI) in predicting adverse outcomes for this population
Materials and Methods
This was a retrospective cohort study of patients aged 90+ years who underwent CEA from 2015-2019 utilizing the validated multi-institutional National Surgical Quality Improvement Program (NSQIP) vascular targeted registry. Multivariable logistic regression was used to analyze and identify factors associated with incidence of MI, stroke, and death within 30 days of surgery. The utility of 2-factor mFI consisting of functional dependence and dyspnea in predicting these complications was separately tested with univariable logistic regression.
Results
Of 191 patients meeting study criteria, 2.1% had strokes, 3.7% MIs, and 3.7% died. Preoperative aspirin use (OR 0.09, 95% CI:0.01–0.8, p=.02) was associated with lower odds of stroke. Functional status (OR 14.1, 95% CI:1.4–151.0, p=.02) and dyspnea (OR 22.6, 95% CI:2.1–309.3, p<.01) were associated with higher odds of MI, while statin use (OR 0.07, 95% CI:0.007–0.5, p=.01) was associated with lower odds. Death was less frequent in elective cases (OR 0.1, 95% CI:0.005–0.6, p=.04). The 2-factor mFI was not predictive of stroke but did predict MI and death and outperformed an existing 5-factor mFI.
Conclusion
The risk profile of CEA can be acceptable(But will you GUARANTEE NO PROBLEMS?) in highly select nonagenarians. Functionally independent, non-dyspneic nonagenarians with preoperative aspirin and statin use who are scheduled electively have the lowest risk for a 30-day complication following CEA. Functional dependence and dyspnea are reasonable surrogate measures of frailty and may indicate a high complication risk for nonagenarians being considered for CEA.
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