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https://www.readbyqxmd.com/read/28727356/-management-of-carotid-artery-stenosis
#1
Francesco Puccinelli, Marco Roffi, Nicolas Murith, Roman Sztajzel
Carotid artery atherosclerosis remains one of the major causes of stroke. The efficacy of carotid artery recanalization has already been established and is considered significant for symptomatic stenosis >70% and moderate for stenosis between 50-69 %. Regarding asymptomatic stenosis, carotid artery recanalization should be reserved for carefully selected patients with a stenosis between 70-90 % and an estimated procedural risk at less than 3 %. Two therapeutic options are currently available : angioplasty with stent placement and endarterectomy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726976/absence-of-transforming-growth-factor-beta-1-in-murine-platelets-reduces-neointima-formation-without-affecting-arterial-thrombosis
#2
Katrin Schaefer, Eva Schütz, Magdalena L Bochenek, Dennis R Riehl, Markus Bosmann, Thomas Münzel, Stavros Konstantinides, Katrin Schäfer
Platelet degranulation at the site of vascular injury prevents bleeding and may affect the chronic vascular wound healing response. Transforming Growth Factor (TGF)-β1 is a major component of platelet α-granules known to accumulating in thrombi. It was our aim to determine the role of TGFβ1 released from activated platelets for neointima formation following arterial injury and thrombosis. Mice with platelet-specific deletion of TGFβ1 (Plt.TGFβ-KO) underwent carotid artery injury. Immunoassays confirmed the absence of active TGFβ1 in platelet releasates and plasma of Plt...
July 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28726649/lipoprotein-associated-phospholipase-a2-as-a-marker-of-vulnerable-atherosclerotic-plaque-in-patients-with-internal-carotid-artery-stenosis
#3
P Štefanič, I Kopolovets, Z Hertelyová, Š Tóth, M Frankovičová
The aim of this study was to compare the concentration of inflammatory vascular markers and morphological structure of atherosclerotic plaque in symptomatic and asymptomatic patients with the stenosis of internal carotid artery (ICA). The research was carried out in 70 patients with hemodynamically significant stenosis of ICA out of which 40 (57%) were asymptomatic patients and 30 (43%) were symptomatic patients, of which 20 patients (66%) have had a stroke, or transient ischemic attack (TIA), 10 patients (33%)...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28724881/effect-of-carotid-endarterectomy-on-retinal-function-in-asymptomatic-patients-with-hemodynamically-significant-carotid-artery-stenosis
#4
Anna Machalińska, Aleksandra Kowalska-Budek, Miłosz Piotr Kawa, Arkadiusz Kazimierczak, Krzysztof Safranow, Marta Kirkiewicz, Paweł Rynio, Grażyna Wilk, Wojciech Lubiński, Piotr Gutowski, Bogusław Machaliński
INTRODUCTION    The corrective effect of carotid endarterectomy (CEA) on disturbed ophthalmic artery flow in patients with a significant internal carotid artery stenosis (ICAS) presenting with ocular ischemic syndrome (i.e., symptomatic patients) is well established. However, no clear evidence exists regarding the efficacy of CEA for improvement of neuro-retinal function in patients without symptoms of ocular ischemic syndrome. OBJECTIVES    We determined the effects of CEA on retinal function in asymptomatic patients with hemodynamically significant internal carotid artery stenosis...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28721152/clinical-syntax-score-a-good-predictor-for-renal-artery-stenosis-in-acute-myocardial-infarction-patients-analysis-from-the-ren-acs-trial
#5
Alexandru Burlacu, Dimitrie Siriopol, Ionut Nistor, Luminita Voroneanu, Igor Nedelciuc, Cristian Statescu, Adrian Covic
INTRODUCTION: In ST-elevation myocardial infarction (STEMI) patients, multisite artery disease represents a serious issue influencing evolution, outcomes and prognosis. We evaluated for the first time the power of the Myocardial Infarction SYNTAX Score (MI SS) and Clinical SYNTAX Score (MI CSS) as predictors for renal artery stenosis (RAS) in STEMI. We also stratified the study population according to the two scores, and identified the variables correlated with the higher score. MATERIAL AND METHODS: We used data from the REN-ACS study, which included 181 consecutive patients prospectively investigated for presence of RAS (through renal angiography), arterial stiffness (carotid-femoral pulse wave velocity, cf-PWV) and hydration status (bioimpedance)...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28720076/prevalence-and-risk-factors-of-intracranial-and-extracranial-artery-stenosis-in-asymptomatic-rural-residents-of-13-villages-in-china
#6
Haiqiang Jin, Qing Peng, Ding Nan, Pu Lv, Ran Liu, Wei Sun, Yuming Teng, Yuanyuan Liu, Chenghe Fan, Haiying Xing, Ke Xu, Yining Huang
BACKGROUND: The present study aimed to investigate the prevalence and risk factors for extracranial carotid artery stenosis (ECAS) and intracranial carotid artery stenosis (ICAS) simultaneously in asymptomatic Chinese pure rural population. METHODS: We analyzed 2589 asymptomatic subjects aged over 30 yr. by ultrasonography and transcranial Doppler simultaneously in 13 isolated villages by door-to-door investigation. Both ECAS and ICAS were defined as more than 50% stenosis...
July 18, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28719802/cerebral-hypoperfusion-is-not-associated-with-an-increase-in-%C3%AE-amyloid-pathology-in-middle-aged-or-elderly-people
#7
O Hansson, S Palmqvist, H Ljung, T Cronberg, D van Westen, R Smith
INTRODUCTION: It is hypothesized that cerebral hypoperfusion promotes the development of Alzheimer pathology. We therefore studied whether longstanding cerebral hypoperfusion is associated with Alzheimer pathology in nondemented humans. METHODS: Cerebral blood flow and β-amyloid ((18)F-Flutemetamol) positron emission tomography retention were assessed in eleven patients with unilateral occlusion of precerebral arteries resulting in chronic and uneven hypoperfusion...
July 15, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28716586/comparison-of-three-dimensional-t1-weighted-magnetic-resonance-and-contrast-enhanced-ultrasound-plaque-images-for-severe-stenosis-of-the-cervical-carotid-artery
#8
Yasuyoshi Shimada, Kohki Oikawa, Shunrou Fujiwara, Yasushi Ogasawara, Yuiko Sato, Shinsuke Narumi, Tadayoshi Kato, Kazumasa Oura, Yasuo Terayama, Makoto Sasaki, Kentaro Fujimoto, Jun Yoshida, Kuniaki Ogasawara
BACKGROUND AND PURPOSE: Magnetic resonance (MR) and contrast-enhanced ultrasound assess characteristics and neovascularization, respectively, of the carotid plaque. The purpose of the present study was to clarify how findings of contrast-enhanced ultrasound plaque imaging are related to those of 3-dimensional (3D) fast spin echo (FSE) T1-weighted MR plaque imaging (WI) in severe stenosis (≥70%) of the cervical carotid artery. METHODS: Fifty-three patients underwent 3D FSE T1-WI and contrast-enhanced ultrasound...
July 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28716303/early-results-of-endovascular-treatment-of-patients-with-bilateral-stenoses-of-the-internal-carotid-arteries-using-proximal-protection-systems-at-30-day-follow-up
#9
Paweł Latacz, Marian Simka, Tadeusz Popiela, Marek Kazibudzki, Tomasz Mrowiecki
BACKGROUND: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, carotid artery stenting (CAS) with use of proximal protection systems (PPS) plays an very important role as alternative treatment modality, especially in patients with critical, symptomatic lesions. This study was single-centre study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic and asymptomatic carotid stenosis in patients with bilateral, advanced lesions of carotid arteries (bilateral stenoses or stenosis and occlusion)...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28715090/learning-based-automated-segmentation-of-the-carotid-artery-vessel-wall-in-dual-sequence-mri-using-subdivision-surface-fitting
#10
Shan Gao, Ronald Van't Klooster, Pieter H Kitslaar, Bram F Coolen, Alexandra M van den Berg, Loek P Smits, Rahil Shahzad, Denis P Shamonin, Patrick J H de Koning, Aart J Nederveen, Rob J van der Geest
PURPOSE: The quantification of vessel wall morphology and plaque burden requires vessel segmentation, which is generally performed by manual delineations. The purpose of our work is to develop and evaluate a new 3D model-based approach for carotid artery wall segmentation from dual-sequence MRI. METHODS: The proposed method segments the lumen and outer wall surfaces including the bifurcation region by fitting a subdivision surface constructed hierarchical-tree model to the image data...
July 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28712899/iatrogenic-ascending-pharyngeal-artery-injury-by-pre-dilation-balloon-inflation-during-carotid-artery-stenting-with-flow-reversal
#11
Junpei Koge, Tomonori Iwata, Shigehisa Mizuta, Yukihiko Nakamura, Shun-Ichi Matsumoto, Takeshi Yamada
BACKGROUND: The ascending pharyngeal artery (APA) may rarely arise from the common carotid artery bifurcation. We herein report an injury to the APA as an unusual complication of pre-dilation balloon inflation during carotid artery stenting (CAS) with flow reversal. CASE DESCRIPTION: A 73-year-old man presented with symptomatic severe left cervical internal carotid artery (ICA) stenosis. The left APA arose from the common carotid artery bifurcation. We performed CAS with flow reversal to decrease the risk of distal embolization...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28712815/asymptomatic-carotid-stenosis-is-associated-with-cognitive%C3%A2-impairment
#12
Brajesh K Lal, Moira C Dux, Siddhartha Sikdar, Carly Goldstein, Amir A Khan, John Yokemick, Limin Zhao
BACKGROUND: Cerebrovascular risk factors (eg, hypertension, coronary artery disease) and stroke can lead to vascular cognitive impairment. The Asymptomatic Carotid Stenosis and Cognitive Function study evaluated the isolated impact of asymptomatic carotid stenosis (no prior ipsilateral or contralateral stroke or transient ischemic attack) on cognitive function. Cerebrovascular hemodynamic and carotid plaque characteristics were analyzed to elucidate potential mechanisms affecting cognition...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28712642/a-rare-case-of-febrile-abdominal-pain-revealing-horton-s-disease
#13
Arnaud Chaudet, Jean-Michel Goujon, Aiham Daniel Ghazali
BACKGROUND: Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. CASE PRESENTATION: A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28708869/long-term-efficacy-and-safety-of-carotid-artery-stenting-versus-endarterectomy-a-meta-analysis-of-randomized-controlled-trials
#14
Yang Li, Jing-Jing Yang, Su-Hui Zhu, Biao Xu, Lian Wang
BACKGROUND: Many recent trials have investigated the long-term efficacy and safety of endarterectomy versus stenting in treating patients with carotid artery stenosis. We aimed to determine the long-term comparative efficacy and safety of both procedures by pooling this evidence in a meta-analysis. METHODS: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published until May 6, 2016. Randomized controlled trials, which reported outcomes of interest with a median follow-up of at least 4-year, were included...
2017: PloS One
https://www.readbyqxmd.com/read/28705843/headache-tia-and-subarachnoid-haemorrhage-dissecting-an-unusual-cause-for-stroke-like-symptoms
#15
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28704454/indocyanine-green-kinetics-with-near-infrared-spectroscopy-predicts-cerebral-hyperperfusion-syndrome-after-carotid-artery-stenting
#16
Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Shuichi Yamada, Yasushi Motoyama, Young Su Park, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: Cerebral hyperperfusion syndrome (HPS) is a potentially life-threatening complication following carotid artery stenting (CAS) and carotid endoarterectomy (CEA). Early prediction and treatment of patients at risk for HPS are required in patients undergoing CAS because HPS occurs significantly earlier after CAS than CEA. Near-infrared spectroscopy (NIRS) is often used for monitoring, and indocyanine green (ICG) kinetics by NIRS (ICG-NIRS) can detect reductions in cerebral perfusion in patients with acute stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28702876/cardiovascular-histopathology-of-a-11-year-old-with-mucopolysaccharidosis-vii-demonstrates-fibrosis-macrophage-infiltration-and-arterial-luminal-stenosis
#17
Valerie Lew, Louis Pena, Robert Edwards, Raymond Y Wang
Mucopolysaccharidosis type VII (MPS VII) is caused by β-glucuronidase deficiency, resulting in lysosomal accumulation of glycosaminoglycans (GAGs) and multisystemic disease. We present cardiovascular gross and histopathology findings from a 11-year-old MPS VII male, who expired after developing ventricular fibrillation following anesthesia induction. Gross anatomic observations were made at autopsy; postmortem formalin-fixed paraffin-embedded samples of the carotid artery, aorta, myocardium, and valves were sectioned and stained with hematoxylin-eosin, Verhoeff-Van Gieson, CD68, and trichrome stains...
July 13, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28702117/balloon-angioplasty-for-intracranial-atherosclerotic-disease-a-multicenter-study
#18
Lakshmi Sudha Prasanna Karanam, Mukesh Sharma, Anand Alurkar, Sridhar Reddy Baddam, Vijaya Pamidimukkala, Raghavasarma Polavarapu
AIM: To evaluate the role and efficacy of the balloon angioplasty in intracranial atherosclerotic disease (ICAD) in patients who presented with acute stroke due to vessel occlusion and in patients with symptomatic disease despite optimum medical management. METHODS: From 2013 to 2016, a total of 39 patients (24 males and 15 females with a mean age of 64.5 years) underwent balloon angioplasty over a period of 2 years and 8 months in three different institutions in India...
June 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28701298/carotid-stenting-for-unilateral-stenosis-can-increase-contralateral-hemispheric-cerebral-blood-flow
#19
Akiyo Sadato, Shingo Maeda, Motoharu Hayakawa, Kazuhide Adachi, Hiroshi Toyama, Ichiro Nakahara, Yuichi Hirose
BACKGROUND: The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. OBJECTIVE: To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. MATERIALS AND METHODS: We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS)...
July 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28700472/a-rare-diaphragm-in-the-common-carotid-artery-a-first-case-report-and-literature-review
#20
Ying Wang, Jian-Chu Li, Ke Lv, Nai-Li Wang, Gao-Wa Sharen, Li Tan
RATIONALE: We present a case of common carotid artery (CCA) diaphragm. To our knowledge, this is the first reported case in the imaging literature. PATIENT CONCERNS: A 33-year-old woman presented herself to an annual health examination without any report of ill health. DIAGNOSES: A stenosis with aneurysm dilation on the proximal part of the right CCA was revealed on ultrasound and CTA, by which a diaphragm-like structure on the stenosis lesion was clearly identified...
July 2017: Medicine (Baltimore)
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