<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000400306</article-id>
<article-id pub-id-type="doi">10.48750/acv.414</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Evidência atual da protamina em cirurgia carotídea]]></article-title>
<article-title xml:lang="en"><![CDATA[Current evidence of protamine in carotid surgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[Mafalda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nunes]]></surname>
<given-names><![CDATA[Celso]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Constâncio]]></surname>
<given-names><![CDATA[Vânia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lima]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra Serviço de Angiologia e Cirurgia Vascular ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>4</numero>
<fpage>306</fpage>
<lpage>312</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000400306&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000400306&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000400306&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução e Objetivos:  A administração de heparina constitui um passo standardizado na cirurgia carotídea dada a redução de complicações tromboembólicas no período perioperatório. Esta prática não está livre de riscos visto que as complicações hemorrágicas estão associadas a um aumento de reintervenções. Historicamente, a protamina, enquanto agente capaz de reverter os efeitos anticoagulantes da heparina, tem gerado controvérsia pela alegada associação a trombose carotídea e AVC. Este artigo tem como objetivo rever a literatura publicada sobre a reversão com protamina na cirurgia carotídea.  Métodos: Com recurso à plataforma Pubmed foram selecionados todos os artigos publicados desde janeiro de 2010 até à presente data tendo sido selecionados 10 artigos, onde se incluem duas meta-análises, uma revisão sistemática e seis estudos observacionais multicêntricos de larga escala, num total de 96.708 doentes. Procurou-se avaliar o risco de enfarte, AVC ou morte, bem como as complicações hemorrágicas com a administração de protamina.  Resultados: De entre os artigos selecionados, seis avaliaram o efeito da protamina durante endarterectomia carotídea, três no stenting carotídeo transfemoral e um no stenting transcarotídeo (TCAR). Nos doentes submetidos a endarterectomia, todos os estudos demonstraram uma diminuição estatisticamente significativa na redução de complicações hemorrágicas nos doentes em que se administrou protamina, nomeadamente com redução nas reintervenções e na necessidade de transfusões, não tendo sido relatado em nenhum destes estudos uma diferença estatisticamente significativa na mortalidade, ocorrência de AVC ou enfarte. O único estudo que analisou a utilização da protamina no TCAR obteve resultados semelhantes aos da endarterectomia. O uso de protamina no stenting carotídeo transfemoral, não demonstrou diferenças na incidência de AVC, enfarte, morte ou redução de complicações hemorrágicas em estudos observacionais, no entanto, relacionou-se a um aumento de AVC aos 30 dias numa revisão sistemática. Analisando os doentes submetidos a reintervenção cirúrgica concluiu-se que independentemente do uso de protamina, houve um aumento estatisticamente significativo no enfarte, AVC e morte.  Conclusão:  A reversão com protamina na cirurgia carotídea mostrou-se eficaz e segura, à luz da evidência científica publicada na última década. Não se observou um aumento de eventos trombóticos e a diminuição das complicações hemorrágicas, devem contrariar a controvérsia relacionada com o uso de protamina resultante de estudos históricos com base em análises de amostras de pequenas dimensões ou na experiência da própria instituição. Os estudos reforçam a importância da administração rotineira de protamina na abordagem carotídea.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction and Objectives:  Heparin administration is a standardized step in carotid surgery due to the reduced thromboembolic complication rate during perioperative period. This practice is not free of risks since hemorrhagic complications are associated with a need of reinterventions. Historically, protamine, as an agent capable of reverting the anticoagulant effects of heparin has raised controversy due to its association with carotid thrombosis and stroke. This article aims to review the published literature about the role of protamine reversal in carotid surgery.  Methods:  Using Pubmed, 10 articles published from January 2010 until the present date were selected, including two meta-analysis, one systematic review and six large-scale multicentric observational studies, in a total of 96.708 patients. The aim of this study was to identify the risk of myocardial infarction, stroke and death, as well as hemorrhagic complications after the administration of protamine.  Results:  Six of the selected articles focused on the effects of protamine during carotid endarterectomy, three on transfemoral carotid stenting and one on transcarotid stenting (TCAR). All the studies related to patients undergoing carotid endarterectomy where protamine had been administered, showed a statistically significant reduction in bleeding rate with a reduction in the number of patients undergoing surgical reintervention and the number of blood transfusions required. There was no statistical difference in the rate of myocardial infarction, stroke and death. The only study that analyzed the use of protamine on TCAR showed similar results to endarterectomy. Observational studies showed no differences in the incidence of stroke, myocardial infarction, death and bleeding complications with the use of protamine on transfemoral carotid stenting, yet a systematic review identified protamine as a risk factor for higher 30-day stroke rate. Patients submitted to surgical reinterventions showed higher rates of stroke, myocardial infarction and death, independently of the administration of protamine.  Conclusion:  The scientific data published on the last decade supports the safety of protamine reversal during carotid surgery, lowering hemorrhagic complications without showing an increase in thrombotic events. This is supported by meta-analysis and large-scale observational studies, going against the historical controversy surrounding protamine usage based on small sample analysis and local experience.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Protamina]]></kwd>
<kwd lng="pt"><![CDATA[Cirurgia Carotídea]]></kwd>
<kwd lng="pt"><![CDATA[Endarterectomia carotídea]]></kwd>
<kwd lng="pt"><![CDATA[Stenting carotídeo]]></kwd>
<kwd lng="en"><![CDATA[Protamine]]></kwd>
<kwd lng="en"><![CDATA[Carotid Surgery]]></kwd>
<kwd lng="en"><![CDATA[Carotid endarterectomy]]></kwd>
<kwd lng="en"><![CDATA[Carotid stenting]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Newhall]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Saunders]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
<name>
<surname><![CDATA[Larson]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Stone]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Goodney]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of Protamine for Anticoagulation During Carotid Endarterectomy A Meta-analysis]]></article-title>
<source><![CDATA[JAMA Surg]]></source>
<year>2016</year>
<volume>151</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>247-55</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liang]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protamine use in transfemoral carotid artery stenting is not associated with an increased risk of thromboembolic events]]></article-title>
<source><![CDATA[J Vasc Surg.]]></source>
<year>2021</year>
<volume>73</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McDonald]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kallmes]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
<name>
<surname><![CDATA[Lanzino]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Cloft]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protamine does not increase risk of stroke in patients with elective carotid stenting]]></article-title>
<source><![CDATA[Stroke]]></source>
<year>2013</year>
<volume>44</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>2028-30</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Applefield]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Krishnan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protamine. [Updated 2020 May 24]]]></article-title>
<source><![CDATA[StatPearls]]></source>
<year>2021</year>
<publisher-loc><![CDATA[Treasure Island(FL) ]]></publisher-loc>
<publisher-name><![CDATA[StatPearls Publishing]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baracchini]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ballotta]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Benefit of Heparin Reversal With Protamine During Carotid Endarterectomy]]></article-title>
<source><![CDATA[JAMA Surg]]></source>
<year>2016</year>
<volume>151</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>255-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boer]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Meesters]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Veerhoek]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Vonk]]></surname>
<given-names><![CDATA[ABA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anticoagulant and side-effects of protamine in cardiac surgery a narrative review]]></article-title>
<source><![CDATA[Br J Anaesth]]></source>
<year>2018</year>
<volume>120</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>914-27</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stone]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Giles]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Kubilis]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Suckow]]></surname>
<given-names><![CDATA[BD]]></given-names>
</name>
<name>
<surname><![CDATA[Goodney]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
<name>
<surname><![CDATA[Huber]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Editor&amp;apos;s Choice - Protamine Reduces Serious Bleeding Complications Associated with Carotid Endarterectomy in Asymptomatic Patients without Increasing the Risk of Stroke, Myocardial Infarction, or Death in a Large National Analysis]]></article-title>
<source><![CDATA[Eur J Vasc Endovasc Surg]]></source>
<year>2020</year>
<volume>60</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>800-7</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stone]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vascular Study Group of Northern New England. Protamine reduces bleeding complications associated with carotid endarterectomy without increasing the risk of stroke]]></article-title>
<source><![CDATA[J Vasc Surg.]]></source>
<year>2010</year>
<volume>51</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>559-64</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vascular Study Group of New England. Shared quality data are associated with increased protamine use and reduced bleeding complications after carotid endarterectomy in the Vascular Study Group of New England]]></article-title>
<source><![CDATA[J Vasc Surg.]]></source>
<year>2013</year>
<volume>58</volume>
<numero>6</numero>
<issue>6</issue>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mazzalai]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Piatto]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Toniato]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lorenzetti]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Baracchini]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ballotta]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Using protamine can significantly reduce the incidence of bleeding complications after carotid endarterectomy without increasing the risk of ischemic cerebral events]]></article-title>
<source><![CDATA[World J Surg]]></source>
<year>2014</year>
<volume>38</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1227-32</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kakisis]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Antonopoulos]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Moulakakis]]></surname>
<given-names><![CDATA[KG]]></given-names>
</name>
<name>
<surname><![CDATA[Schneider]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Geroulakos]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Ricco]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protamine Reduces Bleeding Complications without Increasing the Risk of Stroke after Carotid Endarterectomy A Meta-analysis]]></article-title>
<source><![CDATA[Eur J Vasc Endovasc Surg]]></source>
<year>2016</year>
<volume>52</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>296-307</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Naylor]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Ricco]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[de Borst]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
<name>
<surname><![CDATA[Debus]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[de Haro]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Halliday]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Editor&amp;apos;s Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)]]></article-title>
<source><![CDATA[Eur J Vasc Endovasc Surg]]></source>
<year>2018</year>
<volume>55</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3-81</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McDonald]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kallmes]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
<name>
<surname><![CDATA[Lanzino]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Cloft]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protamine does not increase risk of stroke in patients with elective carotid stenting]]></article-title>
<source><![CDATA[Stroke]]></source>
<year>2013</year>
<volume>44</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>2028-30</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Qureshi]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors Associated with Increased Rates of Post-procedural Stroke or Death following Carotid Artery Stent Placement A Systematic Review]]></article-title>
<source><![CDATA[J Vasc Interv Neurol]]></source>
<year>2014</year>
<volume>7</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11-20</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aronow]]></surname>
<given-names><![CDATA[HD]]></given-names>
</name>
<name>
<surname><![CDATA[Gray]]></surname>
<given-names><![CDATA[WA]]></given-names>
</name>
<name>
<surname><![CDATA[Ramee]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Mishkel]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
<name>
<surname><![CDATA[Schreiber]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors of neurological events associated with carotid artery stenting in high-surgical-risk patients insights from the Cordis Carotid Stent Collaborative]]></article-title>
<source><![CDATA[Circ Cardiovasc Interv]]></source>
<year>2010</year>
<volume>3</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>577-84</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liang]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Motaganahalli]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Malas]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
<name>
<surname><![CDATA[Eldrup-Jorgensen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cronenwett]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Nolan]]></surname>
<given-names><![CDATA[BW]]></given-names>
</name>
<name>
<surname><![CDATA[Kashyap]]></surname>
<given-names><![CDATA[VS]]></given-names>
</name>
<name>
<surname><![CDATA[Schermerhorn]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protamine use in transcarotid artery revascularization is associated with lower risk of bleeding complications without higher risk of thromboembolic events]]></article-title>
<source><![CDATA[J Vasc Surg]]></source>
<year>2020</year>
<volume>72</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>2079-87</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schermerhorn]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Liang]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Eldrup-Jorgensen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association of Transcarotid Artery Revascularization vs Transfemoral Carotid Artery Stenting With Stroke or Death Among Patients With Carotid Artery Stenosis]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2019</year>
<volume>322</volume>
<numero>23</numero>
<issue>23</issue>
<page-range>2313-22</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
