{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:51:48Z","timestamp":1761058308454},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            During carotid endarterectomy (CEA), microemboli may occur, resulting in perioperative adverse cerebral events. The objective of the present study was to investigate the relation between atherosclerotic plaque characteristics and the occurrence of microemboli or adverse events during CEA.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            Patients (n=200, 205 procedures) eligible for CEA were monitored by perioperative transcranial Doppler. The following phases were discriminated during CEA: dissection, shunting, release of the clamp, and wound closure. Each carotid plaque was stained for collagen, macrophages, smooth muscle cells, hematoxylin, and elastin. Semiquantitative analyses were performed on all stainings. Plaques were categorized into 3 groups based on overall appearance (fibrous, fibroatheromatous, or atheromatous).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Fibrous plaques were associated with the occurrence of more microemboli during clamp release and wound closure compared with atheromatous plaques (\n            <jats:italic>P<\/jats:italic>\n            =0.04 and\n            <jats:italic>P<\/jats:italic>\n            =0.02, respectively). Transient ischemic attacks and minor stroke occurred in 5 of 205 (2.4%) and 6 of 205 (2.9%) patients, respectively. Adverse cerebral outcome was significantly related to the number of microembolic events during dissection (\n            <jats:italic>P<\/jats:italic>\n            =0.003) but not during shunting, clamp release, or wound closure. More cerebrovascular adverse events occurred in patients with atheromatous plaques (7\/69) compared with patients with fibrous or fibroatheromatous plaques (4\/138) (\n            <jats:italic>P<\/jats:italic>\n            =0.04).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Intraoperatively, a higher number of microemboli were associated with the presence of a fibrous but not an atheromatous plaque. However, atheromatous plaques were more prevalent in patients with subsequent immediate adverse events. In addition, specifically the number of microemboli detected during the dissection phase were related to immediate adverse events.\n          <\/jats:p>","DOI":"10.1161\/01.str.0000173153.51295.ee","type":"journal-article","created":{"date-parts":[[2005,7,8]],"date-time":"2005-07-08T00:39:54Z","timestamp":1120783194000},"page":"1735-1740","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Carotid Atherosclerotic Plaque Characteristics Are Associated With Microembolization During Carotid Endarterectomy and Procedural Outcome"],"prefix":"10.1161","volume":"36","author":[{"given":"B.A.N.","family":"Verhoeven","sequence":"first","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.P.P.M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Pasterkamp","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.G.A.","family":"Ackerstaff","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.H.","family":"Schoneveld","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Velema","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.P.V.","family":"de Kleijn","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.L.","family":"Moll","sequence":"additional","affiliation":[{"name":"From the Department of Vascular Surgery (B.A.N.V., F.L.M.) and the Experimental Cardiology Laboratory (B.A.N.V., G.P., A.H.S., E.V., D.P.V.d.K.), University Medical Centre, Utrecht; the Departments of Vascular Surgery (J.P.P.M.d.V.) and Clinical Neurophysiology (R.G.A.A.) of St. Antonius Hospital, Nieuwegein; and the Interuniversity Cardiology Institute of the Netherlands (A.H.S., D.P.V.d.K.), Utrecht, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92916-P"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.9.1751"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16146-1"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.7.1345"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.1999.1009"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.4.685"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(97)70055-7"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.124376"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-821X(89)80050-7"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(88)90274-1"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.125796"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.31.8.1817"},{"key":"e_1_3_1_13_2","doi-asserted-by":"crossref","unstructured":"van Zuilen Moll FL Vermeulen FEE Mauser HW van Gijn J Ackerstaff RGA. Detection of cerebral microemboli by means of transcranial Doppler monitoring before and after carotid endarterectomy. Stroke. 1995;26:210\u2013213.","DOI":"10.1161\/01.STR.26.2.210"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.7.1440"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9150(95)90081-0"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01344-X"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00304-0"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035655"},{"key":"e_1_3_1_19_2","unstructured":"Verhoeven BAN Velema E Schoneveld AH de Vries JPPM de Bruin P Seldenrijk CA de Kleijn DPV Busser E van der Graaf Y Moll F Pasterkamp G. Athero-express: differential atherosclerotic plaque expression of mRNA and protein in relation to cardiovascular events and patient characteristics. Rationale and design. Eur J Epidemiol. In press."},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.69.5.377"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.5.8304996"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02042666"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.19.5.3363593"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(02)75140-9"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2004.00665.x"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.04.025"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.0000173153.51295.ee","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T21:48:33Z","timestamp":1715550513000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.0000173153.51295.ee"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,8]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2005,8]]}},"alternative-id":["10.1161\/01.STR.0000173153.51295.ee"],"URL":"https:\/\/doi.org\/10.1161\/01.str.0000173153.51295.ee","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,8]]},"assertion":[{"value":"2005-01-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-05-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-07-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}