AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/JHV-2021/012
*Corresponding Author: Mohammad Alsalaldeh, Assistant Professor Doctor, Pamukkale University, Faculty of Medicine Hospital, Cardiovascular Surgery Department. Denizli / TURKEY
Citation: Alsalaldeh M. A. D. Kaya (2021) Our Center Experience with Modified Eversion and Conventional Carotid Endarterectomy J, Heart and Vasculature 1(3); DOI: 10.31579/JHV-2021/012
Copyright: © 2021, Mohammad Alsalaldeh, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 05 April 2021 | Accepted: 15 April 2021 | Published: 11 May 2021
Keywords: modified version carotid endarterectomy, conventional carotid endarterectomy, carotid artery stenosis, revision, postop stroke
Objective: Carotid artery stenosis is considered to be the cause of 10-20% of all strokes and ischemic attacks. Conventional carotid endarterectomy (CCEA) and modified eversion carotid endarterectomy (MECEA) are the most performed surgical procedures nowadays. We compared the results of both surgical techniques to shed light on the advantages and disadvantages of each one.
Materials and Methods: From January 2018 to October 2019 all carotid endarterectomy surgeries were collected and analyzed. 61 patients had been included in this study. 46 patients were operated on with MECEA and 15 patients with CCEA. Age, sex, the side of the operated carotid artery, revision, restenosis, mortality, and comorbidity were checked up.
Results: MECEA had shown superiority to CCEA in post-op stroke possibility while CCEA was superior in postop revisions due to hematoma and bleeding. Operated isolated left carotid arteries were not found in any revision procedure while right and bilateral arteries were equal in revision need. hospitalization stayment time MECEA was found shorter than in CCEA. During analyzing the data we noticed that there are significant relations between age, Diabetes mellitus (DM), hypertension, and smoking when correlated with postop revision. We found, also a significant relationship between smoking, DM, and hypertension with renal disease.
Conclusions: MECEA can be considered the first surgical choice of carotid artery stenosis management. Attention should be taken in some cases where there are long, tough, and strongly adherent plaques that CCEA is still the first choice. We still need more studies with bigger populations to ensure our results.
Carotid artery stenosis is a vascular pathology, usually resulted from atherosclerosis [1] and considered as a major risk factor for ischemic stroke or transient ischemic attacks in about 10-20% of all cases [2]. The management of the stenotic carotid artery depends on the stenosis degree, stenotic lesion location and length, the nature of the plaque, and whether the patient is symptomatic or asymptomatic. Medical treatment, open surgery, and stenting are the possible treatment methods according to the patient's situation and guidelines.
Carotid endarterectomy is a surgical treatment method which should take place in symptomatic patients with stenotic lesions or asymptomatic patients with severe stenotic lesions and high risk of stroke if kept on medical treatment only. According to the CREST study, the restenosis and occlusion were infrequent and there was no significant difference between endarterectomy and stenting up to 2 years [3].
Endarterectomy surgery can be done with the conventional procedure or with classic eversion or modified eversion procedures [4]. Eversion endarterectomy was first described by De Bakey et al in 1959 [5]. This technique has the advantage of complete autogenous repair [6]. Modified endarterectomy had been described lately as an alternative surgical technique to classic eversion with the advantages of less clamping time, fewer neurological problems, and primary closure [7].
In this study, we have reported our experience in treating carotid artery stenosis by modified eversion and conventional endarterectomy.
This is a retrospective study, done in our center over about two years (from January 2018 till October 2019) and by one surgeon. Ethics Committee Approval had been taken on 07/08/2020 under the approval number (60116787-020/41155). 62 patients had been operated on for carotid artery stenosis. 46 (74%) patients were operated on by modified eversion endarterectomy (MECEA) technique while 15 (24.6%) patients were operated on by conventional endarterectomy (CCEA). 80.3 % (n=46) of all patients were male and 19.7% (n=12) were female. According to the side of the operated carotid artery, the left carotid artery number was 29 (47.5%), right was 21 (34.4%) while bilateral operated carotid artery cases were 11 (18.0%). The bilateral stenotic carotid arteries were operated on in different sessions.
All our patients were checked up for diabetes mellitus (DM), hypertension, cerebrovascular accident (CVA), coronary artery bypass grafting (CABG), chronic renal disease, chronic obstructive pulmonary disease (COPD), peripheral artery disease (PAD), smoking, mortality, hospitalization time, revision, and re-occlusion. The mean age of the patients was around 67 years. The youngest patient was 46 and the eldest one was 86 years old. The hospitalization period was calculated too and found to be between 2 and 16 days with a mean of 5.8 days. 13 (21.3%) patients stayed 3 days while 12 (19.9%) patients stayed 4 days, one (1.6%) patient stayed 2 days and one patient who had CABG in the same admission stayed 16 days at the hospital postoperatively. According to the data of comorbidities, we found that 37 (60.7%) of the patients were hypertensive, 27 (44.3%) were diabetic, 14 (23%) had coronary artery bypass grafting (CABG) operations and four of them had CABG at the same admission, 15 (24.6%) patients had a history of CVA, 8 of them had CVA within one month prior carotid endarterectomy, 2 patients had CVA postoperatively and the remain 5 patients had CVA long time ago. Patients with renal diseases were 13 (21.3%), COPD and asthmatic patients were 9 (14.8%) and those who had peripheral artery disease were 4 (6.6%) while 20 (23.8%) patients were found, smokers. There were 6 patients needed revision operations for bleeding and hematoma. All of them had been operated on with MECEA surgical technique. Three of the revision cases were operated for the right carotid and the remaining three for the bilateral carotid artery stenosis.
Surgical Procedure: All patients were operated on under general anesthesia. The head is tilted to the contralateral side, and a folded dressing roll or an intravenous fluid bag is put under their shoulders to elevate the side of the neck which will be operated on. After painting and toweling of the operation are completed incision is done in oblique shape along with the medial border of the sternocleidomastoid muscle of about 8-10 cm in length. Gentle dissection of the underlying tissues is done after opening the platysma muscle downward to the carotid artery. Attention is taken to avoid vagal nerve injury. Common carotid artery (CCA) and its both main branches; internal carotid artery (ICA) and external carotid artery (ECA) are mobilized from the surrounding tissues and hanged by Dacron tapes (figure 1). Superior thyroid artery is hanged up too by silk suture. Systemic heparinization is given with the dosage of (70 IU/kg) and an average of 5000 IU bolus I.V to maintain ACT around 200-250.
MECEA Surgical Procedure: After heparin has been administrated and vascular clamps applied over CCA, ECA, and ICA with tightening a silk suture over superior thyroid artery, longitudinal arteriotomy is done in the CCA priorly to the bifurcation and extended to the ECA. ICA endarterectomy was done with a modified eversion technique without division the artery from CCA (figure 2a). Primary closure is done side by
side with the de-airing of the three arteries from the air.
CCEA Surgical Procedure:
the first steps are done typically as in MECEA while the arteriotomy is done here starting from CCA priorly to the bifurcation and extended to ICA and the endarterectomy is done as usual. (figure 2b).
Statistical analysis: Statistically we analyzed all our data using IBM SPSS statistics version 21, independent variables were compared by independent samples the Levene's Test for Equality of Variances and t-test for Equality of Means. p<0>
Over about two years we reported the results of our surgical procedures in managing carotid artery stenosis disease. We found significant differences when MECEA was compared to CCEA in hospitalization stayment time (p=0.03) and revision need (p=0.001) in favor of MECEA (Table 1)
Patients who developed post-op CVA (n=2) were both operated on for right carotid artery stenosis and with CCEA surgical procedure. When we compared the two surgical procedures for those two cases there was a significant difference in favor of the MECEA procedure (p=0.000).
We noticed that there was no significant relationship between age and hospitalization stayment time while age has a significant correlation with the need for revision (p=0.021). Revision operations were found to have a significant difference when correlated with left carotid (p=0.017) and bilateral carotid artery stenosis (p=0.032) as well as it was significant in MECEA when the two surgical procedures were compared (p=0.001) (Table 2).
According to the data that we had obtained from our patients we found interesting correlations among patients comorbidities and habits, for example; there were significant correlations between renal disease with hypertension (p=0.008), DM (p=0.042), and smoking (p=0.000)
Carotid artery stenosis is one of the vascular pathologies which affect directly the central nervous system representing in stroke or transient cerebrovascular attacks. Surgical treatment according to the guidelines played a big role in managing carotid artery stenosis. The surgical procedures have been changed from time to time and nowadays the most acceptable types of such procedures are the eversion endarterectomy and for some surgeons the conventional ones. The stenotic lesion type, length, and localization are the main factors affecting the decision of the surgical procedure type.
In our study, we reported our experience in one center in managing carotid artery stenosis disease over the last two years. Our data of the patients were collected from computerized medical records. We used to perform modified eversion endarterectomy in most of our cases. On the other hand, conventional endarterectomy still has a place in our management. We tried to study those two procedures in the favor of the need for revision, the type of carotid artery, age, sex, and the other comorbidities associated with the carotid artery stenosis.
In 2016 Scott E. Musicant et al had done a similar study to analyze the clinical and financial outcomes of the modified eversion surgical technique in treating carotid artery stenosis. 197 patients were included in that study and (77.7%) of them were operated on with modified eversion endarterectomy while the others were operated on with conventional endarterectomy. The arteriotomy of modified eversions was done longitudinally and limited to the carotid bulb. All the operations were done by three surgeons. They had found that late stroke and death were higher in conventional endarterectomy while they were similar in the perioperative period. Also, the average time and cost of modified eversion operations were less than those in conventional ones [8]. In our study, all the operations were done by one surgeon. Our modified eversion endarterectomy was not limited to the carotid bulb but extended to the external carotid artery while in the conventional endarterectomy the arteriotomy was started from the common carotid artery and extended longitudinally upward the internal carotid artery. We preferred the conventional technique when the stenotic lesion is too long and it was seemed to be difficult to be managed by eversion. We had one case where we had started with the modified technique but because of the tough, long, and very conjoined lesion we had to convert our technique to a conventional one. None of our both techniques had significant restenosis over the short-mid term of the study. We had not included a financial review in our study but we found that the hospitalization stayment time was shorter when MECEA was performed.
In another study done by Khan, K. A et al where the two techniques were performed by four surgeons for forty patients. They had to use patch plasty in (2.5%) of the patients and selective shunt in 10% of the patients. 2 patients had to be reviewed in the operation room for hematoma [7].
We had used nor patch plasty neither selective shunt for any patient in both groups. We had a revision for 6 (9.8%) patients. All the revision cases had been operated with MECEA, 3 of them were done to the right carotid artery and the remaining 3 were done to both arteries (bilateral). Statistically, when we compared the two surgical procedures we found a significant difference in favor of the modified one (p=0.001).
In the 2020 year, another study was done by Davidovic L.B et al. They reviewed multi centers studies in modified Everson and conventional endarterectomy and the authors emphasized the efficacy, safety, and reduction of operative time of the modified eversion carotid endarterectomy, also they considered this procedure as the first choice in carotid surgery [9]. According to our study, we recognized that the modified eversion technique had a disadvantage in revision when compared to conventional surgery. We also noticed that the revision cases were limited in the right and bilateral carotid artery surgeries.
Postop CVA cases were operated by conventional technique. We had two patients developed CVA postoperatively and both of them were operated on for the right carotid artery stenosis. Statistically, there was a significant difference (p=0.000)
In this study, we evaluated the data of all patients not only according to their surgical procedures but also for their comorbidities too. We found that there are strong and significant relations between age, smoking, DM, and hypertension with postop revision due to hematoma and bleeding. Also, we found such a significant relationship between smoking, DM, and hypertension with renal disease.
According to our experience, MECEA can be considered as the first choice of the management of carotid artery stenosis with taking attention to its possibility of postop revision while CCEA has a higher risk for postop CVA. In long, tough, and strongly adherent plaques CCEA is still the first choice. The hospitalization stayment time in MECEA was found shorter than in CCEA. We still need more studies with a bigger population to ensure our results.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
