Koinonia

A Preliminary Manifesto for Christian Student Affairs Practitioners President\u27s Corner Editor\u27s Disk Christian vs. Secular Universities: Where Should You Work? CoCCA: Involvement through Campus Activities & Hot Ideas ACSD Placement Update & ACSD Electronic Discussion Group Book Review: The Fabric of Faithfulness by Steven Garberhttps://pillars.taylor.edu/acsd_koinonia/1029/thumbnail.jp

Koinonia

ACSD Celebrates 20 Year AnniversaryACSD: Past, Present, Future, Barry Loy and Skip Trudeau ACSD Memories, Tim Nichols Our Scrapbook: The People, The Places, The Lives We\u27ve Touched In This IssueWhy Do We Do the Things We Do?: Questions to be asked by the follower of Jesus, David Johnstone Be Prepared to Prepare: Our students search for a simple faith and a simple truth, Brad Bowser and Damon Seacott In The FieldPreparing for a Professional Transition, Steve Beers Regular FeaturesPresident\u27s Corner Editor\u27s Disk Coalition of Christian College Activities (CoCCA) News from the Regions: Spotlight on the North Central Region ACSD Business: Executive Committee Ballot Proposed ACSD Constitution Changes Perspective: A University of Characterhttps://pillars.taylor.edu/acsd_koinonia/1018/thumbnail.jp

Outcome of carotid stent-assisted angioplasty versus open surgical repair of recurrent carotid stenosis

AbstractPurposeWe compared outcome and durability of carotid stent-assisted angioplasty (CAS) with open surgical repair (ie, repeat carotid endarterectomy [CEA]) to treat recurrent carotid stenosis (RCS).MethodsA retrospective review of anatomic and neurologic outcomes was carried out after 27 repeat CEA procedures (1993-2002) and 52 CAS procedures (1997-2002) performed to treat high-grade internal carotid artery (ICA) RCS after CEA. The incidence of intervention because of symptomatic RCS was similar (repeat CEA, 63%; CAS, 60%), but the interval from primary CEA to repeat intervention was greater (P < .05) in the repeat CEA group (83 ± 15 months) compared with the CAS group (50 ± 8 months). In the CAS group, 17 of 52 arteries (33%) were judged not to be surgical candidates because of surgically inaccessible high lesions (n = 8), medical comorbid conditions (n = 4), neck irradiation (n = 3), or previous surgery with cranial nerve deficit or stroke (n = 2). Three patients who underwent repeat CEA had lesions not appropriate for treatment with CAS.ResultsOverall 30-day morbidity was similar after CAS (12%; death due to ipsilateral intracranial hemorrhage, 1; nondisabling stroke, 1; reversible neurologic deficits or transient ischemic attack, 2; access site complication, 2) and repeat CEA (11%; no death; nondisabling stroke, 1; reversible cranial nerve injury, 1; cervical hematoma, 1). Combined stroke and death rate was 3.7% for repeat CEA and 5.7% for CAS (P > .1). All duplex ultrasound scans obtained within 3 months after CEA and CAS demonstrated patent ICA and velocity spectra of less than 50% stenosis. During follow-up, no repeat CEA (mean, 39 months) or CAS (mean, 26 months) repair demonstrated ICA occlusion, but two patients (8%) who underwent repeat CEA and 4 patients (8%) who underwent CAS required balloon or stent angioplasty because of 80% RCS. At last follow-up, no patient had ipsilateral stroke and all ICA remain patent. At duplex scanning, stenosis-free (<50% diameter reduction) ICA patency at 36 months was 75% after repeat CEA and 57% after CAS (P = .26, log-rank test).ConclusionsCarotid angioplasty for treatment of high-grade stenotic ICA after CEA resulted in similar anatomic and neurologic outcomes compared with open surgical repair. Most lesions are amenable to endovascular therapy, and CAS enabled treatment in patients judged not to be suitable surgical candidates. Duplex scanning surveillance after repeat CEA or CAS is recommended, because stenosis can recur after either secondary procedure

Orientation-- making a difference in the lives of new students

There is no abstract available for this creative project.Thesis (M.A.)Department of Educational Leadershi