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bilateral carotide artery stenosis

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https://www.readbyqxmd.com/read/28057413/upper-extremity-blood-pressure-difference-in-patients-undergoing-carotid-revascularisation
#1
A Huibers, J Hendrikse, M M Brown, S A Pegge, M Arnold, F L Moll, L J Kapelle, G J de Borst
INTRODUCTION: Blood pressure (BP) regulation is important in patients with carotid artery atherosclerotic disease. Concomitant subclavian artery stenosis (SAS) might lead to an underestimation of the true systemic BP in the monitoring of these patients. This study aimed to assess the prevalence of the inter-arm BP difference in patients undergoing carotid intervention and its association with ipsilateral significant subclavian stenosis and clinical outcome. METHODS: Bilateral BP measurements and vascular imaging (CTA and MRA) of both subclavian arteries and the innominate artery were assessed in 182 symptomatic patients with carotid artery stenosis undergoing revascularisation in the International Carotid Stenting Study (ICSS)...
January 2, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#2
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28018499/advantages-of-selective-use-of-intraluminal-shunt-in-carotid-endarterectomy-a-study-of-122-cases
#3
Muhammad Jamil, Rashid Usman, Salma Ghaffar
Objectives: To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local anesthesia. Materials and Methods: A total of 122 consecutive patients fulfilling international guidelines were included. Shunt was used selectively only in cases of bilateral severe carotid artery occlusive disease or in those patients who developed neurological symptoms on clamping of carotid artery. Follow up was done weekly for one month; then every month for 3 months; and then every 3 months for a year...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/27994990/refractory-case-of-takayasu-arteritis-in-a-young-woman-a-clinical-challenge
#4
Mudassar Ahmed, Salman Mansoor, Salman Assad, Shahar Y Khan, Rizwanullah Khan, Usman Ghani, Taimur Mansoor, Aasim Rehman
Takayasu arteritis (TA) is an idiopathic chronic inflammatory vasculitis of the aorta and its main branches, which if not treated can lead to severe vascular damage and fatal vascular events. Glucocorticoids (GCs) are the mainstay of the therapy of TA but a significant proportion of patients tend to experience flare-ups when their GCs are tapered. We report a case of a 42-year-old female with TA, diagnosed according to the 1990 American College of Rheumatology Criteria for TA. Cardiovascular assessment showed normal carotid upstrokes with bilateral carotid bruits and soft right and left subclavian bruits with weak peripheral pulses...
November 9, 2016: Curēus
https://www.readbyqxmd.com/read/27916638/therapeutical-options-in-the-management-of-carotid-dissection
#5
Ombretta Martinelli, Salvatore Venosi, Jamila BenHamida, Alban Malaj, Cristina Belli, Francesco Giosue' Irace, Roberto Gattuso, Giacomo Frati, Bruno Gossetti, Luigi Irace
BACKGROUND: The best management of carotid artery dissection (CAD) is still controversial ranging from antiplatelet medication to open surgery or endovascular treatment. In this retrospective study, we assessed the safety and efficacy of endovascular stent angioplasty for the treatment of CAD. METHODS: From February 2006 to February 2016, 44 patients (28 women and 16 men, age range 25-65 years, mean 42) with CAD were included in this study. The internal carotid artery dissection was spontaneous in 32 patients and posttraumatic in the remaining 12 (in 1 case, it was bilateral)...
December 1, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27789153/de-novo-development-of-moyamoya-disease-in-an-adult-female-with-a-genetic-variant-of-the-rnf-213-gene-case-report
#6
Ryosuke Tashiro, Miki Fujimura, Kuniyasu Niizuma, Hidenori Endo, Hiroyuki Sakata, Mika Sato-Maeda, Teiji Tominaga
BACKGROUND: The de novo development of moyamoya disease (MMD) in adults is extremely rare, with only 2 cases being previously reported. Furthermore, the mechanisms underlying the progression of adult MMD have not been elucidated yet. CASE REPORT: A transient ischemic attack occurred in a 46-year-old woman, owing to progressive MMD. Magnetic resonance (MR) angiography performed 7 years before the diagnosis of MMD did not detect any steno-occlusive changes in the major intracranial vessels, including the internal carotid artery (ICA) and the middle cerebral artery (MCA)...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27754130/os-25-05-mas1-receptor-deficiency-does-not-deteriorate-cognitive-function-in-vascular-dementia-model-of-mice
#7
Akinori Higaki, Masaki Mogi, Jun Iwanami, Li-Juan Min, Hirotomo Nakaoka, Bao-Shuai Shan, Masayoshi Kukida, Toshihiro Yamauchi, Takafumi Okura, Jitsuo Higaki, Masatsugu Horiuchi
OBJECTIVE: Classical renin-angiotensin system (RAS) is mainly known as angiotensin (Ang) converting enzyme (ACE)/Ang II/Ang type 1 (AT1) receptor axis which induces various organ damages including cognitive decline. On the other hand, ACE2/Ang-(1-7)/Mas axis has been known to exert antagonistic actions against the classical RAS axis in cardiovascular system. However, the roles of ACE2/Ang-(1-7)/Mas axis in cognitive function remain to be elucidated. Here, we examined possible roles of ACE2/Ang-(1-7)/Mas axis in cognitive function in vascular dementia model...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754070/os-18-02-antihypertensive-treatment-and-risk-of-brain-ischemia-due-to-carotid-stenosis-in-a-survey-of-hospitalised-patients-aged-90-years-and-older
#8
Jürgen Bohlender, Jürg Nussberger, Beate Bohlender
OBJECTIVE: In elderly hypertensive patients, systolic blood pressure (sBP) goals recommended by US and European guidelines (ESH) for the initiation of treatment are more liberal than in younger patients because of an increased risk of treatment-associated side-effects and hypotension. Carotid stenosis increases with age and poses a risk of brain ischemia if hypotension occurs. Its relevance for the routine care of elderly hypertensives, however, remains unclear. We analyzed data on precerebral artery morphology and BP evolution from a survey of aged hospitalized patients...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753982/sy-08-2-hypertension-management-for-secondary-prevention-of-stroke
#9
Kazuyuki Shimada
Stroke is known to frequently recur in patients with a history of cerebrovascular disease, and the control of hypertension is extremely important for the treatment of those patients. The robust relationship between the recurrent cerebrovascular disease and blood pressure control has been demonstrated in large-scale clinical studies. The antihypertensive drug therapy significantly reduces the recurrence rate of all types of cerebrovascular disease, incidences of myocardial infarction and all vascular events...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751333/bilateral-spontaneous-internal-carotid-artery-dissection-managed-with-endovascular-stenting-a-case-report
#10
Manoj Kumar Agarwala, Azeez Asad, Naveen Gummadi, Sundar Chidambaram, J Venkateswaralu
Carotid artery dissection (CAD) is a frequent cause of stroke, accounting for up to 25% of all ischemic strokes in young and middle-aged patients.(1,2) It may be traumatic or spontaneous, with multi-factorial etiology. A tear in the arterial wall causes intrusion of blood within its layers, producing intra-luminal stenosis, or aneurysmal dilatation.(3) Thrombo-embolism arising from this anatomic disruption has been postulated as the essential stroke mechanism in CAD.(4) Bilateral internal carotid artery dissection (ICAD) has been rarely reported...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27729604/-emergency-bypass-surgery-for-progressive-cerebral-infarction-following-hemorrhagic-onset-of-moyamoya-disease-a-case-report
#11
Junya Hatakeyama, Toshiharu Yanagisawa, Erina Kudo, Shuntaro Togashi, Hiroaki Shimizu
Progressive cerebral infarction in patients with hemorrhagic onset of moyamoya disease is rare, and a treatment strategy is not well established. Here, we report a case that was successfully treated with emergency bypass surgery. A 58-year-old woman presented with a sudden disturbance of consciousness and right-sided hemiparesis. Computed tomography(CT)showed intraventricular hemorrhage involving the head of the left caudate nucleus. Ventricular drainage was immediately performed, and the patient was treated conservatively...
October 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27699162/bovine-aortic-arch-and-bilateral-retroesophageal-course-of-common-carotid-arteries-in-a-symptomatic-patient
#12
Daniele Bissacco, Maurizio Domanin, Giuseppina Schinco, Livio Gabrielli
Anatomical variations of carotid arteries may be related to their development (agenesis, aplasia, hypoplasia) or course (coiling, kinking, tortuosity). Partial or total aberrancies in carotid vessel anatomy rarely occur. We describe the case of a 95-year-old woman presented with sudden onset of confusion and disorientation together with upper limb clonus. Computed tomography (CT)-scan revealed a left frontal brain injury with a not conclusive carotid doppler ultrasound. CT angiography reported a bovine aortic arch with bilateral retroesophageal course of both common carotid arteries and left severe (>70%) internal carotid artery stenosis...
September 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27649086/the-number-of-stenotic-intracranial-arteries-is-independently-associated-with-ischemic-stroke-severity
#13
Xiaodan Wei, Zhuang Liu, Min Li, Chunhua Yang, Wenming Wang, Xianglin Li, Shuping Zhang, Xuri Li, Geng Tian, Jonas Bergquist, Bin Wang, Jia Mi
BACKGROUND: The severity of ischemic stroke symptoms varies among patients and is a critical determinant of patient outcome. To date, the association between the number of stenotic intracranial arteries and stroke severity remains unclear. AIMS: We aimed to investigate the association between the number of stenotic major intracranial arteries (NSMIA) and ischemic stroke severity, as well as the degree of stenosis and common stroke risk factors. METHODS: We performed a retrospective analysis of patients with digital subtraction angiography (DSA)-confirmed ischemic stroke...
2016: PloS One
https://www.readbyqxmd.com/read/27643057/os-25-05-mas1-receptor-deficiency-does-not-deteriorate-cognitive-function-in-vascular-dementia-model-of-mice
#14
Akinori Higaki, Masaki Mogi, Jun Iwanami, Li-Juan Min, Hirotomo Nakaoka, Bao-Shuai Shan, Masayoshi Kukida, Toshihiro Yamauchi, Takafumi Okura, Jitsuo Higaki, Masatsugu Horiuchi
OBJECTIVE: Classical renin-angiotensin system (RAS) is mainly known as angiotensin (Ang) converting enzyme (ACE)/Ang II/Ang type 1 (AT1) receptor axis which induces various organ damages including cognitive decline. On the other hand, ACE2/Ang-(1-7)/Mas axis has been known to exert antagonistic actions against the classical RAS axis in cardiovascular system. However, the roles of ACE2/Ang-(1-7)/Mas axis in cognitive function remain to be elucidated. Here, we examined possible roles of ACE2/Ang-(1-7)/Mas axis in cognitive function in vascular dementia model...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642991/os-18-02-antihypertensive-treatment-and-risk-of-brain-ischemia-due-to-carotid-stenosis-in-a-survey-of-hospitalised-patients-aged-90-years-and-older
#15
Jürgen Bohlender, Jürg Nussberger, Beate Bohlender
OBJECTIVE: In elderly hypertensive patients, systolic blood pressure (sBP) goals recommended by US and European guidelines (ESH) for the initiation of treatment are more liberal than in younger patients because of an increased risk of treatment-associated side-effects and hypotension. Carotid stenosis increases with age and poses a risk of brain ischemia if hypotension occurs. Its relevance for the routine care of elderly hypertensives, however, remains unclear. We analyzed data on precerebral artery morphology and BP evolution from a survey of aged hospitalized patients...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642893/sy-08-2-hypertension-management-for-secondary-prevention-of-stroke
#16
Kazuyuki Shimada
Stroke is known to frequently recur in patients with a history of cerebrovascular disease, and the control of hypertension is extremely important for the treatment of those patients. The robust relationship between the recurrent cerebrovascular disease and blood pressure control has been demonstrated in large-scale clinical studies. The antihypertensive drug therapy significantly reduces the recurrence rate of all types of cerebrovascular disease, incidences of myocardial infarction and all vascular events...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27547473/refractory-hypotension-as-an-initial-presentation-of-bilateral-subclavian-artery-stenosis
#17
Maxwell Eyram Afari, John V Wylie, Joseph P Carrozza
Bilateral subclavian stenosis is a rare clinical condition. An interbrachial pressure difference of 15 mm Hg can raise suspicion for unilateral subclavian artery stenosis, but the diagnosis of bilateral subclavian artery stenosis can be challenging. We present a case of a 75-year-old woman who presented with refractory hypotension after surgery. Initial vitals revealed blood pressure in the 60s/50s mm Hg in both arms. Cardiopulmonary examination was remarkable for diminished pulses in all 4 extremities and audible carotid bruits...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27535801/substantial-reduction-of-parenchymal-cerebral-blood-flow-in-mice-with-bilateral-common-carotid-artery-stenosis
#18
Yorito Hattori, Jun-Ichiro Enmi, Satoshi Iguchi, Satoshi Saito, Yumi Yamamoto, Kazuyuki Nagatsuka, Hidehiro Iida, Masafumi Ihara
The bilateral common carotid artery stenosis (BCAS) mouse model, which replicates chronic cerebral hypoperfusion and white matter ischemic lesions, is considered to model some aspects of vascular cognitive impairment. Cerebral blood flow (CBF) changes in the brain surface post-BCAS have been demonstrated by laser speckle flowmetry, but CBF levels in the brain parenchyma remain unknown. Adult C57BL/6J male mice were subjected to BCAS using external microcoils. Brain magnetic resonance angiography (MRA) was conducted to visualize the intracranial main arteries while arterial spin labeling (ASL) was used to measure cortical and subcortical parenchymal CBF levels before and after BCAS...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27530284/mcp-1-mediated-activation-of-microglia-promotes-white-matter-lesions-and-cognitive-deficits-by-chronic-cerebral-hypoperfusion-in-mice
#19
Bangqing Yuan, Hui Shi, Kuang Zheng, Zulu Su, Hai Su, Ming Zhong, Xuenong He, Changlong Zhou, Hao Chen, Qijiang Xiong, Yi Zhang, Zhao Yang
Microglia activation played a vital role in the pathogenesis of white matter lesions (WMLs) by chronic cerebral hypoperfusion. In addition, hypoxia induced up-regulated expression of MCP-1, promotes the activation of microglia. However, the role of MCP-1-mediated microglia activation in chronic cerebral ischemia is still unknown. To explore that, chronic cerebral hypoperfusion model was established by permanent stenosis of bilateral common carotid artery in mice. The activation of microglia and the related signal pathway p38MAPK/PKC in white matter, and working memory of mice were observed...
January 2017: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/27515061/asymptomatic-bilateral-internal-carotid-artery-aneurysms-with-distal-high-grade-stenosis-in-a-patient-with-type-1-neurofibromatosis
#20
S Taylor, J Krysa
No abstract text is available yet for this article.
October 2016: European Journal of Vascular and Endovascular Surgery
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