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Carotid artery stenting

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https://www.readbyqxmd.com/read/28828544/vasculogenic-hyperprolactinemia-severe-prolactin-excess-in-association-with-internal-carotid-artery-aneurysms
#1
Sunita M C De Sousa, Emily J Meyer, Wayne Rankin, Peter J Brautigan, Morton G Burt, David J Torpy
PURPOSE: Internal carotid artery (ICA) aneurysms have rarely been found in association with marked hyperprolactinemia in the absence of prolactinoma; the cause of hyperprolactinemia has never been investigated. We aimed to determine if the observed hyperprolactinemia is due to a vascular-derived or known prolactin secretagogue from the injured ICA, analogous to pregnancy-associated hyperprolactinemia putatively due to placental factors. METHODS: We conducted a case series and literature review of individuals with severe hyperprolactinemia in association with ICA aneurysms...
August 21, 2017: Pituitary
https://www.readbyqxmd.com/read/28826570/effect-of-longitudinal-anatomical-mismatch-of-stenting-on-the-mechanical-environment-in-human-carotid-artery-with-atherosclerotic-plaques
#2
Zhenmin Fan, Xiao Liu, Anqiang Sun, Nan Zhang, Zhanming Fan, Yubo Fan, Xiaoyan Deng
Longitudinal anatomic mismatch (LAM) of stenting (i.e., a stenotic artery segment is not fully covered by a deployed stent) worsens the mechanical environment in the treated artery, which most likely is the cause for the associated high risks of restenosis, myocardial infarction and stent thrombosis. To probe the possibility, we constructed a patient-specific carotid model with two components of plaques (lipid and calcified plaque) based on MRI images; we numerically compared three different stenting scenarios in terms of von Mises stress (VMS) distribution in the treated arteries, namely, the short stenting (LAM), the medium stenting and the long stenting...
August 17, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28819696/what-are-the-treatment-options-for-blister-like-aneurysms
#3
REVIEW
Torstein R Meling
Treatment of blood blister-like aneurysms (BBAs) of the supraclinoidal internal carotid artery (ICA) is challenging and the optimal treatment is yet to be defined. The treatment options for ICA BBAS are microsurgery, endovascular therapy, or a combination of the two. The microsurgical armamentarium consists mainly of direct aneurysm clipping with or without protective EC-IC bypass, clip-wrapping, or trap ligation with ICA sacrifice with or without EC-IC bypass. The endovascular treatment options are mainly endovascular ICA ligation, multiple overlapping stents (≥ 3) with or without coiling, covered stents, or flow diverters...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28818261/contemporary-medical-therapies-of-atherosclerotic-carotid-artery-disease
#4
Suk F Cheng, Martin M Brown
Contemporary medical therapy consists of identification and treatment of all patient-modifiable vascular risk factors. Specific atherosclerotic disease therapies are designed to reduce the risk of thrombosis, and the disease progression in order to reduce the risk of future cardiovascular events. Contemporary medical management emphasizes the need to support the patient in achieving lifestyle modifications and to adjust medication to achieve individualized target values for specific quantifiable risk factors...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818260/transcranial-doppler-monitoring-for-microemboli-a-marker-of-a-high-risk-carotid-plaque
#5
J David Spence
In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (approximately 2% per year) with risks of intervention with carotid artery stenting (CAS) versus carotid endarterectomy in recent trials that did not have a medical arm. Such extrapolations are, simply put, invalid...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818256/will-mesh-covered-stents-help-reduce-stroke-associated-with-carotid-stent-angioplasty
#6
Carly N Richards, Peter A Schneider
Carotid stent angioplasty (CAS) has been shown to protect patient from future stroke long-term efficacy similar to carotid endarterectomy (CEA). The risk of minor stroke in the perioperative period is higher than with CEA and not related to cerebral protection during the CAS procedure since a significant portion of the neurologic events occur between 1 and 30 days following stent deployment. This observation suggests mechanisms integral to the stent itself may be pertinent such as plaque embolization thru the stent struts may occur...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818255/clinical-need-design-and-goals-for-the-carotid-revascularization-and-medical-management-for-asymptomatic-carotid-stenosis-trial
#7
Brajesh K Lal, James F Meschia, Thomas G Brott
Prior clinical trials produced evidence-based treatment recommendations for patients with asymptomatic carotid stenosis that may not be appropriate for clinical decision-making today. High-quality patient outcomes data to allow informed decision making regarding the optimal management of high-grade asymptomatic internal carotid artery stenosis is lacking. The results of the Asymptomatic Carotid Atherosclerosis Study were published in 1995 based on a randomized patient enrollment in the 1990s. Outcomes after endarterectomy, stenting, and medical treatment for these patients have all improved in the subsequent 2 decades...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28816615/in-stent-hypodense-area-at-two-weeks-following-carotid-artery-stenting-predicts-neointimal-hyperplasia-after-two-years
#8
Kentaro Yamashita, Jouji Kokuzawa, Tatsuya Kuroda, Satoru Murase, Morio Kumagai, Yasuhiko Kaku
Introduction It has not been reported how long the follow-up study after carotid artery stenting (CAS) should be continued. The purpose of the present study is to clarify the dynamic change of the in-stent neointimal layer and residual arterial lumen by two years following CAS using three-dimensional computed tomography angiography (3D CTA) with volume rendering. Methods Thirty-six stented carotid arteries in 34 consecutive patients were examined by 3D CTA with volume rendering at two weeks and 3, 6, 12, 24 months of follow-up...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28815338/prolonged-hypotension-after-carotid-artery-stenting-incidence-predictors-and-consequences
#9
Elif Gökçal, Elvin Niftaliyev, Çiğdem Deniz, Mehmet Ergelen, Vildan Güzel, Ömer Göktekin, Talip Asil
BACKGROUND: Hemodynamic changes frequently occur after carotid artery stenting (CAS), and in some patients these changes, particularly hypotension, may be prolonged. There are discrepant results for predicting patients at high risk for these prolonged hemodynamic changes and identifying the effect on clinical outcome. In this study, we aimed to determine the frequency, predictors and consequences associated with prolonged hypotension (PH) after CAS in our center. METHODS: We retrospectively analyzed the demographics, risk factors, nature of carotid disease, degree of stenosis of both internal carotid arteries, stent diameter and site of dilatation during stenting in 137 CAS procedures...
August 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28814168/deterioration-of-heart-rate-recovery-index-in-patients-after-carotid-artery-stenting
#10
Emrah Aytac, Murat Gonen, Orhan Dogdu, Mehmet Balin
Objective Although carotid artery stenting (CAS) is an effective treatment for severe carotid stenosis, it has been associated with alterations in autonomic functions long term after the procedure. Patients with CAS have been reported to have autonomic nervous system (ANS) dysfunction. This study aimed to evaluate heart rate recovery (HRR) indices and exercise test parameters after CAS. Methods Patients (10 male, 11 female) suitable for CAS, without a history of hypertension, diabetes mellitus, severe coronary artery or valvular heart disease, were enrolled in our study...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28804624/carotid-endarterectomy-for-in-stent-restenosis-a-case-report-and-literature-review
#11
Baofeng Xu, Rui Liu, Liqun Jiao, Jinlu Yu
It is relatively difficult to treat restenosis when restenosis occurs following carotid artery stenting. Endarterectomy with simultaneous stent removal is an effective approach when restenosis occurs. The treatment method is still not well known. The present paper reports a case of restenosis after stenting that was treated with endarterectomy with a satisfactory treatment outcome. The patient, a 74-year-old male, underwent stenting 10 months before he was re-hospitalized. He seemed to recover well after stenting until one month before he was re-hospitalized, when he presented symptoms of cerebral ischemia...
August 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28803173/ruptured-vertebral-artery-dissecting-aneurysm-concurrent-with-spontaneous-cervical-internal-carotid-artery-dissection-a-report-of-three-cases-and-literature-review
#12
Yosuke Akamatsu, Kenichi Sato, Hidenori Endo, Yasushi Matsumoto, Teiji Tominaga
BACKGROUND: Multiple dissections rarely occur with ruptured vertebral artery dissecting aneurysms (VADAs). Here, we report three cases of ruptured VADA concurrent with spontaneous cervical internal carotid artery (ICA) dissection. CASE DESCRIPTION: None of the three patients had a history of vasculopathy or trauma. All ruptured VADAs were treated with internal coil trapping in the acute stage of subarachnoid hemorrhage (SAH). Rebleeding was not observed in any patients after the treatment...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28798785/simultaneous-vertebral-and-subclavian-artery-stenting
#13
Damian R Maciejewski, Łukasz Tekieli, Roman Machnik, Anna Kabłak-Ziembicka, Tadeusz Przewłocki, Piotr Paluszek, Mariusz Trystuła, Robert Musiał, Karolina Dzierwa, Piotr Pieniążek
INTRODUCTION: Vertebrobasilar territory ischemia leads to disabling neurological symptoms and may be caused both by vertebral artery (VA) and subclavian artery (SA) stenosis. The coexisting symptomatic ipsilateral VA and proximal SA stenosis should be considered as a true bifurcation lesion for percutaneous treatment. AIM: To evaluate the safety and efficacy of simultaneous angioplasty of vertebral and subclavian stenosis. MATERIAL AND METHODS: Fifteen patients (age 69...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28798784/comparison-of-closed-cell-and-hybrid-cell-stent-designs-in-carotid-artery-stenting-clinical-and-procedural-outcomes
#14
Ersan Tatli, Alptug Tokatli, Mehmet Bulent Vatan, Mustafa Tarik Agac, Huseyin Gunduz, Ramazan Akdemir, Harun Kilic
INTRODUCTION: Carotid artery stenting (CAS) is a promising alternative to surgery in high-risk patients. However, the impact of stent cell design on outcomes in CAS is a matter of continued debate. AIM: To compare the periprocedural and clinical outcomes of different stent designs for CAS with distal protection devices. MATERIAL AND METHODS: All CAS procedures with both closed- and hybrid-cell stents performed at our institution between February 2010 and December 2015 were analyzed retrospectively...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28798783/mesh-covered-roadsaver-stent-as-a-new-treatment-modality-for-symptomatic-or-high-risk-carotid-stenosis
#15
Roman Machnik, Piotr Paluszek, Łukasz Tekieli, Karolina Dzierwa, Damian Maciejewski, Mariusz Trystuła, Andrzej Brzychczy, Krzysztof Banaszkiewicz, Robert Musiał, Piotr Pieniążek
INTRODUCTION: Prevention of periprocedural stroke has a crucial role in carotid artery stenting (CAS) procedures. AIM: To assess retrospectively 30-day safety and effectiveness of 41 procedures of internal and common carotid artery stenting using the Roadsaver double nitinol layer micromesh stent in 40 non-consecutive patients with symptomatic or high-risk carotid artery stenosis. MATERIAL AND METHODS: The patients were men (n = 31) and women (n = 9); mean age was 67...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28798779/one-swallow-does-not-a-summer-make-but-many-swallows-do-accumulating-clinical-evidence-for-nearly-eliminated-peri-procedural-and-30-day-complications-with-mesh-covered-stents-transforms-the-carotid-revascularisation-field
#16
REVIEW
Piotr Musiałek, L Nelson Hopkins, Adnan H Siddiqui
Atherosclerotic carotid artery stenosis (CS) continues to be a common cause of acute ischaemic stroke. Optimised medical therapy (OMT), the first-line treatment modality in CS, may reduce or delay - but it does not abolish - CS-related strokes. As per current AHA/ASA and ESC/ESVS/ESO guidelines, carotid artery stenting (CAS) is a less-invasive alternative to carotid endarterectomy (CEA) for CS revascularisation in primary and secondary stroke prevention. Ten-year follow-up from the CREST trial in patients with symptomatic and asymptomatic CS confirmed equipoise of CAS and CEA in the primary endpoint...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28790270/-severe-carotid-artery-disease-preoperative-assessment-and-perioperative-management
#17
Kaoru Matsuura, Goro Matsumiya
Cerebrovascular complication is the one of the most dreadful complication after open heart surgery which leads to significant decrease of quality of life even if the patients survived. To decrease these complications, carotid doppler echo as one of the non-invasive carotid screening modalities is effective. Carotid artery stenosis is common in the patients with coronary artery disease, and it is more frequent in the patients with more complexed coronary artery lesions. The more the patients indicated for coronary artery bypass grafting has complexed lesions these days, the more the patients have carotid artery lesions...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790213/-surgical-treatment-of-cervical-carotid-artery-aneurysm
#18
Ryo Hamasaki, Toshiharu Yanagisawa, Yusuke Takahashi, Hiroaki Shimizu
Cervical carotid aneurysms are rare, and surgical treatment should be planned for each patient. The authors report 9 cases of cervical carotid aneurysm in 9 patients(mean age, 53.7 years;5 men)who were treated surgically between 2005 and 2014. The aneurysm was located in the internal carotid artery in 6 patients, the common carotid artery in 2 patients, and the carotid bifurcation in 1 patient. Four aneurysms were recurrences after a previous endovascular intervention(parent artery coil embolization, covered stent placement, or stent with coil embolization)...
August 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28783225/meta-analysis-of-the-costs-of-carotid-artery-stenting-and-carotid-endarterectomy
#19
REVIEW
E E de Vries, V G M Baldew, H M den Ruijter, G J de Borst
BACKGROUND: Carotid artery stenting (CAS) is currently associated with an increased risk of 30-day stroke compared with carotid endarterectomy (CEA), whereas both interventions seem equally durable beyond the periprocedural period. Although the clinical outcomes continue to be scrutinized, there are few data summarizing the costs of both techniques. METHODS: A systematic search was conducted in MEDLINE, Embase and Cochrane databases in August 2016 identifying articles comparing the costs or cost-effectiveness of CAS and CEA in patients with carotid artery stenosis...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28782689/flow-diverter-treatment-of-tandem-intracranial-aneurysms
#20
Seby John, Mark Bain, Russell Cerejo, Andrew Bauer, Thomas Masaryk, Muhammad S Hussain, Peter Rasmussen, Gabor Toth
OBJECTIVE: The application of flow diversion (FD) for treatment of multiple, tandem intracranial aneurysms has not been well studied. We sought to assess technical success, and clinical and imaging outcomes of FD treatment for tandem intracranial aneurysms. METHODS: Retrospective analysis of patients treated with FD for tandem intracranial aneurysms. RESULTS: Twenty female patients were included with a mean (± SD) age of 60 ±12 years. Only one patient was treated after subarachnoid hemorrhage...
August 3, 2017: World Neurosurgery
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