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carotid artery stenosis

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https://www.readbyqxmd.com/read/28531910/extracranial-carotid-disease-and-effect-of-intra-arterial-treatment-in-patients-with-proximal-anterior-circulation-stroke-in-mr-clean
#1
Olvert A Berkhemer, Jordi Borst, Manon Kappelhof, Albert J Yoo, Lucie A van den Berg, Puck S S Fransen, Debbie Beumer, Wouter J Schonewille, Paul J Nederkoorn, Marieke J H Wermer, Henk A Marquering, Hester F Lingsma, Yvo B W E M Roos, Robert J van Oostenbrugge, Diederik W J Dippel, Wim H van Zwam, Charles B L M Majoie, Bart J Emmer, Aad van der Lugt
Background: The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes a in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and whether it yields improved outcomes remains uncertain. Objective: To examine whether the presence of ECD modified the effect of IAT for intracranial proximal anterior circulation occlusion...
May 23, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28530483/carotidynia-in-high-altitude-travelers
#2
Andrea Parra, Tamuru Okada, Peter H Lin
Background Carotidynia is characterized by focal pain and tenderness of the carotid artery without associated hemodynamic or structural abnormalities. Carotid artery pathology has also been known to occur in high altitude due to aberrant baroreceptor response in the carotid bulb. Case Presentation We herein report two cases of high altitude-related idiopathic carotidynia. The first patient was a geologist who performed oil reserve survey in the Alaska Mountain, while the second patient was hiking in a mountain trail in Peru...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28529262/investigations-of-carotid-stenosis-to-identify-vulnerable-atherosclerotic-plaque-and-determine-individual-stroke-risk
#3
Madieke I Liem, Fiona Kennedy, Leo H Bonati, Aad van der Lugt, Bram F Coolen, Aart J Nederveen, Hans R Jager, Martin M Brown, Paul J Nederkoorn
Selection of patients with atherosclerotic carotid stenosis for revascularization is mainly based on the degree of luminal narrowing of the carotid artery. However, identification of other features of plaque apart from the degree of stenosis could enable better selection for intervention if they are also associated with the occurrence of stroke. Before these risk factors can possibly play a role in treatment decisions, their prognostic value needs to be proven. The purpose of this narrative review is to summarize current knowledge regarding the risk factors for stroke in patients with carotid stenosis, how they can be determined, and to what extent they predict stroke, based on recent literature...
May 20, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28528662/carotid-stenting-in-patients-with-high-risk-versus-standard-risk-for-open-carotid-endarterectomy-real-1-trial
#4
Joaquin De Haro, Ignacio Michel, Silvia Bleda, Cristina Cañibano, Francisco Acin
Carotid stenting (CAS) has been mainly offered to those patients considered at "high risk" for open carotid endarterectomy based on available data from large randomized clinical trials. However, several recent studies have called medical "high risk" into question for CAS indication. The REAL-1 trial evaluated the safety and perioperative and long-term effectiveness in patients with significant carotid artery stenosis with "high-risk" criteria treated with CAS and proximal protection device (MOMA) compared with those with standard surgical-risk features...
April 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28521772/feasibility-and-relevance-of-compound-strain-imaging-in-non-stenotic-arteries-comparison-between-individuals-with-cardiovascular-diseases-and-healthy-controls
#5
Martijn F H Maessen, Thijs M H Eijsvogels, Ayla Grotens, Maria T E Hopman, Dick H J Thijssen, Hendrik H G Hansen
BACKGROUND: Compound strain imaging is a novel method to noninvasively evaluate arterial wall deformation which has recently shown to enable differentiation between fibrous and (fibro-)atheromatous plaques in patients with severe stenosis. We tested the hypothesis that compound strain imaging is feasible in non-stenotic arteries and provides incremental discriminative power to traditional measures of vascular health (i.e., distensibility coefficient (DC), central pulse wave velocity [cPWV], and intima-media thickness [IMT]) for differentiating between participants with and without a history of cardiovascular diseases (CVD)...
May 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28521653/matrix-metalloproteinase-3-gene-polymorphism-rs3025058-affects-markers-atherosclerosis-in-type-2-diabetes-mellitus
#6
Aleš Pleskovič, Marija Šantl Letonja, Andreja Cokan Vujkovac, Jovana Nikolajević Starčević, Martin Caprnda, Eduard Curilla, Ioana Mozos, Peter Kruzliak, Robert Prosecky, Daniel Petrovič
BACKGROUND: The study was designed to test the possible association between either polymorphisms of the matrix metalloproteinase-9 (MMP-9) gene (rs17576, rs3918242) or the MMP-3 5A/6A gene polymorphism (rs3025058) with markers of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The second aim of the study was to demonstrate an association between either the rs17576, rs3918242 or rs3025058 and subclinical markers of coronary artery disease in the same subset of patients with T2DM...
May 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28521359/quantitative-comparison-of-the-intraoperative-utility-of-indocyanine-green-and-fluorescein-videoangiographies-in-cerebrovascular-surgery
#7
Fumihiro Matano, Takayuki Mizunari, Yasuo Murai, Asami Kubota, Yu Fujiki, Shiro Kobayashi, Akio Morita
BACKGROUND: A quantitative analysis comparing indocyanine green videoangiography (ICG-VAG) and fluorescein videoangiography (FL-VAG) in cerebrovascular surgery has not been reported so far. OBJECTIVE: To clear the differences of characteristics of ICG-VAG and FL-VAG by quantitative assessment. METHODS: We prospectively analyzed results from 23 patients (3 males; mean age at surgery: 60.9 years, range: 14-75 years) at our hospital from August 2014 to July 2015...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28516094/combined-transapical-transcatheter-aortic-valve-replacement-and-thoracic-endovascular-aortic-repair-for-severe-aortic-stenosis-and-arch-aneurysm
#8
Yuanjia Zhu, Eric E Roselli, Jay J Idrees, Samir Kapadia, Lars G Svensson
An 83-year-old male with multiple comorbidities presented with critical aortic stenosis and a saccular aortic arch aneurysm. Through a mini thoracotomy, a balloon expandable transcatheter aortic valve was delivered transapically. A thoracic stent graft was then delivered through the prosthetic valve and deployed in the arch, while a covered stent was deployed in the left common carotid artery. Three-year postoperative computed tomography showed a thrombosed arch aneurysm with decreased size. This case demonstrates the feasibility of using combined transapical transcatheter technologies to treat multicomponent disease in a high-risk patient during a single operation...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28514842/gender-difference-in-radiotherapy-induced-carotid-stenosis
#9
Y Yang, W Yang, T J Wang
Radiotherapy (RT) is often the first choice of treatment for cancer of the larynx. Studies have shown that the incidence of carotid stenosis (CS) after radiotherapy of laryngeal cancer is increasing, and that gender difference in radiotherapy-induced side effects exist. Thus, we examined the gender difference in the incidence of CS and the impact of microinflammatory factors after radiotherapy. We reported this study on patients who received radiotherapy as part of the treatment for laryngeal cancer in the Jilin Province in China...
June 30, 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28513115/endarterectomy-or-stenting-in-severe-asymptomatic-carotid-stenosis
#10
Dallit Mannheim, Batla Falah, Ron Karmeli
BACKGROUND: Stroke is a major cause of death in the western world, and carotid endarterectomy has been shown to be effective in treating both symptomatic and asymptomatic carotid stenosis. Carotid stenting is a relatively new form of treatment for carotid stenosis and few studies have looked specifically at asymptomatic patients. OBJECTIVES: To retrospectively examine short- and long-term results in the treatment of asymptomatic carotid artery stenosis with surgery or stenting...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28511475/colour-doppler-evaluation-of-extracranial-carotid-artery-in-patients-presenting-with-acute-ischemic-stroke-and-correlation-with-various-risk-factors
#11
Samrin Haq, Manoj Mathur, Jasvir Singh, Navkiran Kaur, Raminderpal Singh Sibia, Rajesh Badhan
INTRODUCTION: Stroke is defined as an abrupt onset of neurologic deficit due to vascular cause. It is one of the leading causes of mortality and morbidity all over the world making early diagnosis and treatment inevitable. Lesions of extra cranial carotid arteries are implicated in majority of cases of acute ischemic stroke. Carotid Doppler is a non-invasive imaging technique, with sensitivity approaching that of angiography. Computed Tomography (CT) plays a major role to assess the site and nature of the lesion in patients with acute ischemic stroke...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28502547/carotid-artery-stenting-is-associated-with-a-higher-incidence-of-major-adverse-clinical-events-than-carotid-endarterectomy-in-female-patients
#12
Kyla M Bennett, John E Scarborough
BACKGROUND: The optimal approach to carotid revascularization in female patients with carotid artery stenosis is widely debated. Information available is largely derived from clinical trials that include only highly selected patients. The goal of this study was to compare the early clinical outcomes in women who undergo carotid artery stenting (CAS) vs carotid endarterectomy (CEA). METHODS: Female patients undergoing CAS or CEA between January 1, 2012 and December 31, 2015, and who were included in the Procedure Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for their incidence of early postoperative complications...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502543/the-association-of-carotid-revascularization-endarterectomy-versus-stent-trial-crest-and-centers-for-medicare-and-medicaid-services-carotid-guideline-publication-on-utilization-and-outcomes-of-carotid-stenting-among-high-risk-patients
#13
Gregory G Salzler, Alik Farber, Denis V Rybin, Gheorghe Doros, Jeffrey J Siracuse, Mohammad H Eslami
OBJECTIVE: Since the 2004 approval by the United States Food and Drug Administration of carotid artery stenting (CAS), there have been two seminal publications about CAS reimbursement (Centers for Medicare and Medicaid Services guidelines; 2008) and clinical outcomes (Carotid Revascularization Endarterectomy versus Stent Trial [CREST]; 2010). We explored the association between these publications and national trends in CAS use among high-risk symptomatic patients. METHODS: The most recent congruent data sets of the Nationwide Inpatient Sample (NIS) were queried for patients undergoing carotid revascularization...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501967/plaque-tissue-morphology-based-stroke-risk-stratification-using-carotid-ultrasound-a-polling-based-pca-learning-paradigm
#14
Luca Saba, Pankaj K Jain, Harman S Suri, Nobutaka Ikeda, Tadashi Araki, Bikesh K Singh, Andrew Nicolaides, Shoaib Shafique, Ajay Gupta, John R Laird, Jasjit S Suri
Severe atherosclerosis disease in carotid arteries causes stenosis which in turn leads to stroke. Machine learning systems have been previously developed for plaque wall risk assessment using morphology-based characterization. The fundamental assumption in such systems is the extraction of the grayscale features of the plaque region. Even though these systems have the ability to perform risk stratification, they lack the ability to achieve higher performance due their inability to select and retain dominant features...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28500763/cross-talk-between-enzymes-matrix-metalloproteinsese-2-and-9-and-regulatory-t-cell-immunity-in-the-global-burden-of-atherosclerosis
#15
Andrica Lekic, Zdrinko Brekalo, Ante Kvesic, Miljenko Kovacevic, Zdenka Baricev-Novakovic, Ivana Sutic, Aleksandar Bulog, Ingrid Sutic, Valentino Pavisic, Ines Mrakovcic-Sutić
Changes in immune and inflammatory responses may play a crucial role in the development and progression of atherosclerosis, as an autoimmune, chronic and progressive inflammatory disease. Immunological activity and vascular inflammation during atherosclerosis can be modulated by autoimmune responses against self-antigens, according to changeable risk factors (cholesterol, oxidized low-density lipoprotein (ox-LDL) in the vascular wall, fatty acids, etc.) and accompanied by accumulation of leucocytes and proinflammatory cytokines, which stimulate the transcription of matrix-metalloproteinases (MMPs), whose concentration are increased in foam cell rich regions...
May 13, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28500300/alterations-of-cerebral-perfusion-in-asymptomatic-internal-carotid-artery-steno-occlusive-disease
#16
Ya-Fang Chen, Sung-Chun Tang, Wen-Chau Wu, Hsien-Li Kao, Yen-Shu Kuo, Shun-Chung Yang
Patients with asymptomatic occlusion in the internal carotid arteries (ICA) have been shown to have a better preserved hemodynamic status of the brain as compared to patients with symptoms. This study was aimed to explore the cerebral perfusion alterations in asymptomatic patients using multi-parametric arterial spin-labeling (ASL) magnetic resonance (MR) imaging. Forty-two patients diagnosed with asymptomatic ICA stenosis/occlusion were prospectively included and divided into high-grade (ultrasonographic stenosis ≥70%, N = 20) and low-grade groups (N = 22)...
May 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28497668/potential-brain-dead-organ-donation-in-neurocritical-care-mortality
#17
Vera Spatenkova, Ondrej Bradac, Petr Suchomel
BACKGROUND: Mortality is a marker of quality in neurocritical care, but it also provides potential for donors after brain death (DBD) following irreversible acute brain damage. The aim of this study was to analyse the neurointensive care unit (NICU) mortality rate and recovery of potential DBD. METHODS: We performed a 10-year prospective observational cohort computer database analysis of 6138 acute neurological and neurosurgical patients (pts, 58.2% male, mean: age 55...
May 11, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28495179/impact-of-hypertriglyceridemia-on-carotid-stenosis-progression-under-normal-low-density-lipoprotein-cholesterol-levels
#18
Masayuki Kitagami, Ryuta Yasuda, Naoki Toma, Masato Shiba, Mai Nampei, Yoko Yamamoto, Yoshinari Nakatsuka, Hiroshi Sakaida, Hidenori Suzuki
BACKGROUND: Dyslipidemia is a well-known risk factor for carotid stenosis progression, but triglycerides have attracted little attention. The aim of this study was to assess if serum triglycerides affect progression of carotid stenosis in patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels. METHODS: This is a retrospective study in a single hospital consisting of 71 Japanese patients with internal carotid artery stenosis greater than or equal to 50% and normal serum LDL-C levels who underwent angiographic examination with or without the resultant carotid artery stenting or endarterectomy from 2007 to 2011, and were subsequently followed up for 4 years...
May 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28493931/asymptomatic-carotid-artery-stenosis-and-retinal-nerve-fiber-layer-thickness-a-community-based-observational-study
#19
Dandan Wang, Yang Li, Yong Zhou, Cheng Jin, Qi Zhao, Anxin Wang, Shouling Wu, Wen Bin Wei, Xingquan Zhao, Jost B Jonas
PURPOSE: To examine whether an abnormally thin retinal nerve fiber layer (RNFL) is associated with cerebrovascular insufficiency. DESIGN: Community-based study. METHODS: The Asymptomatic Polyvascular Abnormalities in Community Study included Chinese aged 40+ years and without histories of cerebrovascular incidents or coronary heart disease. Using transcranial Doppler and carotid duplex ultrasound examination, we assessed presence and degree of an intracranial arterial stenosis (ICAS) and extracranial carotid arterial stenosis (ECAS) and we measured the RNFL thickness by spectral-domain optical coherence tomography...
2017: PloS One
https://www.readbyqxmd.com/read/28491467/association-between-asymptomatic-unilateral-internal-carotid-artery-stenosis-and-electrophysiological-function-of-the-retina-and-optic-nerve
#20
Anna Machalińska, Aleksandra Kowalska-Budek, Miłosz Piotr Kawa, Arkadiusz Kazimierczak, Krzysztof Safranow, Marta Kirkiewicz, Grażyna Wilk, Wojciech Lubiński, Piotr Gutowski, Bogusław Machaliński
Purpose. This study was designed to assess retinal and optic nerve bioelectrical function in patients with unilateral asymptomatic but hemodynamically significant internal carotid artery stenosis (ICAS). Methods. Forty-two subjects with a diagnosis of unilateral ICAS and 34 controls were analyzed. Full-field electroretinogram (ERG), pattern electroretinogram (PERG), and pattern visual-evoked potentials, as well as optical coherence tomography and ophthalmological examination, were performed. Data analysis included eyes ipsilateral to ICAS (EIS) and eyes contralateral to ICAS (ECS)...
2017: Journal of Ophthalmology
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