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https://www.readbyqxmd.com/read/28818261/contemporary-medical-therapies-of-atherosclerotic-carotid-artery-disease
#1
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
#2
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/28818259/imaging-of-the-high-risk-carotid-plaque-magnetic-resonance-imaging
#3
William S Kerwin, Zach Miller, Chun Yuan
The emergence of the concept of high-risk atherosclerotic plaque has led to considerable interest in noninvasive imaging techniques to identify high-risk features before clinical sequelae. For plaques in the carotid arteries, magnetic resonance imaging has undergone considerable histologic validation to link imaging features to indicators of plaque instability, including plaque burden, intraplaque hemorrhage, fibrous cap disruption, lipid rich necrotic core, and calcification. Recently introduced imaging technologies, especially those focused on three-dimensional imaging sequences, are now poised for integration into the clinical workup of patients with suspected carotid atherosclerosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818258/imaging-of-high-risk-carotid-plaques-ultrasound
#4
Rafael S Cires-Drouet, Mahvash Mozafarian, Amir Ali, Siddhartha Sikdar, Brajesh K Lal
Duplex ultrasonography has a well-established role in the assessment of the degree of stenosis caused by carotid atherosclerosis. This assessment is derived from Doppler velocity changes induced by the narrowing lumen of the artery. New research into the mechanisms for plaque rupture and atheroembolic stroke indicates that the degree of narrowing is an imperfect predictor of stroke risk, and that other factors, such as plaque composition and remodeling and biomechanical forces acting on the plaque, can play a role...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818257/high-risk-carotid-plaque-lessons-learned-from-histopathology
#5
Frank D Kolodgie, Kazuyuki Yahagi, Hiroyoshi Mori, Maria E Romero, Hugh H Trout, Aloke V Finn, Renu Virmani
The pathophysiology and natural history of atherosclerotic carotid disease is predicated on a more extensive knowledge of lesion progression gained in the studies conducted in the coronary arteries, and these will be reviewed. While the precise sequence of lesion progression leading to carotid plaque vulnerability and cerebrovascular events remain less well understood, specific early and more advanced progressive lesion morphologies associated with stroke risk have been characterized. Of late, there has been a conscious effort for stroke prevention in symptomatic and asymptomatic patients to move beyond luminal stenosis as the only guidance to predict future cerebrovascular events...
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/28807750/high-resolution-simultaneous-imaging-of-intracranial-and-extracranial-arterial-wall-with-improved-cerebrospinal-fluid-suppression
#7
Lei Zhang, Na Zhang, Jun Wu, Xin Liu, Yiu-Cho Chung
PURPOSE: To develop a technique for three dimensional (3D) high resolution joint imaging of intracranial and extracranial arterial walls with improved cerebrospinal fluid (CSF) suppression and good blood suppression based on T1 weighted sampling perfection with application optimized contrast using different angle evolutions (T1w-SPACE) and to compare this technique (hereafter, iSPACE) with alternating with nutation for tailored excitation (DANTE) prepared SPACE sequence (DANTE-SPACE) for their CSF suppression performance around the mid cerebral arteries (MCA) and blood suppression at carotid arteries...
August 11, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28804624/carotid-endarterectomy-for-in-stent-restenosis-a-case-report-and-literature-review
#8
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/28802734/adding-markers-of-organ-damage-to-risk-score-models-improves-cardiovascular-risk-assessment-prospective-analysis-of-a-large-cohort-of-adult-outpatients
#9
Giuliano Tocci, Ilaria Figliuzzi, Vivianne Presta, Nadia Attalla El Halabieh, Barbara Citoni, Roberta Coluccia, Allegra Battistoni, Andrea Ferrucci, Massimo Volpe
INTRODUCTION: Global cardiovascular (CV) risk stratification is recommended in all outpatients. Risk score charts, however, do not include markers of organ damage (OD). AIM: To evaluate the potential added value of including different markers of subclinical OD to US Framingham, European SCORE and Italian Cuore risk score calculators. METHODS: We prospectively evaluated adult outpatients, who underwent blood pressure (BP) assessment and global CV risk stratification...
July 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28802699/relationship-between-limited-joint-mobility-of-hand-and-carotid-atherosclerosis-in-patients-with-type-2-diabetes
#10
Yusuke Mineoka, Michiyo Ishii, Yoshitaka Hashimoto, Muhei Tanaka, Naoto Nakamura, Yasukazu Katsumi, Motohide Isono, Michiaki Fukui
AIM: Limited joint mobility (LJM) of hand, which is one of a complication of diabetic hand, has a close association with diabetic microangiopathy. However, it remains to be elucidated about the relationships between LJM of hand and subclinical atherosclerosis in patients with type 2 diabetes. Therefore, we conducted a cross-sectional study to evaluate the relationships between LJM of hand and carotid intima-media thickness (IMT) and plaque score in patients with type 2 diabetes. METHODS: We evaluated the relationships between LJM of hand, and carotid IMT and plaque score, evaluated by carotid ultrasound examination, in 341 consecutive patients with type 2 diabetes...
July 20, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28798867/effect-of-intraplaque-angiogenesis-to-atherosclerotic-rupture-prone-plaque-induced-by-high-shear-stress-in-rabbit-model
#11
Juhui Qiu, Daoxi Lei, Jianjun Hu, Tieying Yin, Kang Zhang, Donghong Yu, Guixue Wang
Atherosclerotic prone-rupture plaque is mainly localized in the region of the entrance to the stenosis with high shear stress and the reasons are largely unknown. Our hypothesis is that such a distribution of cells in atherosclerotic plaque may depend on the angiogenesis. Silastic collars induced regions of high shear stress (20.68 ± 5.27 dynes/cm(2)) in the upstream flow and low shear stress (12.25 ± 1.28 dynes/cm(2)) in the downstream flow in carotid arteries. Compared with the low shear stress region, plaques in the high shear stress region showed more intraplaque haemorrhaging, less collagen and higher apoptotic rates of vascular smooth muscle cells; endothelial cells (ECs) in the high shear stress region were characterized with integrity and high endothelial nitric oxide synthase (eNOS) expression (1570...
August 2017: Regenerative Biomaterials
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
#12
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/28792167/study-of-carotid-artery-intimomedial-thickness-in-patients-with-rheumatoid-arthritis-and-its-co-relation-with-severity-of-the-disease
#13
L A Gauri, Q Fatima, S Diggi, A Khan, A Liyakat, K Nagar
INTRODUCTION: RA is a chronic inflammatory state, predisposing for atherosclerosis as it is an immunoinflammatory process. This study focuses on use of Carotid artery intimomedial thickness (CIMT) as a marker for subclinical atherosclerosis. OBJECTIVE: To study the assessment of atherosclerosis by Carotid Intimo-Medial Thickness (CIMT) in patients with rheumatoid arthritis and Correlation of ultrasonographic findings with severity of disease (using DAS-28 score)...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28789657/neutrophil-gelatinase-associated-lipocalin-ngal-is-elevated-in-type-2-diabetics-with-carotid-artery-stenosis-and-reduced-under-metformin-treatment
#14
W Eilenberg, S Stojkovic, A Piechota-Polanczyk, A Kaider, N Kozakowski, W J Weninger, J Nanobachvili, J Wojta, I Huk, S Demyanets, C Neumayer
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL), an acute phase protein released by neutrophils, has been described as biomarker of inflammatory states. Type 2 diabetes mellitus (T2DM) is characterized by increased inflammation and an elevated risk for embolization of carotid artery stenosis (CAS). We aimed to explore the role of NGAL systemically and in plaques of diabetics undergoing carotid endarterectomy. Moreover, the potential anti-inflammatory effect of metformin on NGAL was addressed in diabetics...
August 8, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28782610/anti-connective-tissue-growth-factor-detects-and-reduces-plaque-inflammation-in-early-stage-carotid-atherosclerotic-lesions
#15
Yuyu Yao, Bing Li, Fu Cong, Gaojun Teng, Genshan Ma, Naifeng Liu
This study explored connective tissue growth factor (CTGF)-targeted ultrasmall superparamagnetic iron oxides (USPIOs) for noninvasive MRI of CTGF within carotid atherosclerotic lesions in apoE-deficient (apoE(-/-)) mice. Anti-CTGF polyclonal and nonspecific IgG antibodies were conjugated to polyethylene glycol-coated USPIOs, and apoE(-/-) carotid partial ligation-model mice were imaged via MRI before and after contrast administration. ApoE(-/-) mice were treated with CTGF-neutralizing antibodies for 3 weeks...
August 3, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/28782187/sensitive-three-dimensional-ultrasound-assessment-of-carotid-atherosclerosis-by-weighted-average-of-local-vessel-wall-and-plaque-thickness-change
#16
Jieyu Cheng, Eranga Ukwatta, Shadi Shavakh, Tommy W S Chow, Grace Parraga, J David Spence, Bernard Chiu
PURPOSE: Vitamin B deficiency has been identified as a risk factor for vascular events. However, the reduction of vascular events was not shown in large randomized controlled trials evaluating B-Vitamin therapy. There is an important requirement to develop sensitive biomarkers to be used as efficacy targets for B-Vitamin therapy as well as other dietary treatments and lifestyle regimes that are being developed. Carotid vessel-wall-plus-plaque thickness change (VWT-Change) measured from 3D ultrasound has been shown to be sensitive to atorvastatin therapies in previous studies...
August 7, 2017: Medical Physics
https://www.readbyqxmd.com/read/28768751/loss-of-y-chromosome-in-blood-is-associated-with-major-cardiovascular-events-during-follow-up-in-men-after-carotid-endarterectomy
#17
Saskia Haitjema, Daniel Kofink, Jessica van Setten, Sander W van der Laan, Arjan H Schoneveld, James Eales, Maciej Tomaszewski, Saskia C A de Jager, Gerard Pasterkamp, Folkert W Asselbergs, Hester M den Ruijter
BACKGROUND: Recent studies found an immune regulatory role for Y chromosome and a relationship between loss of Y chromosome (LOY) in blood cells and a higher risk of cancer and mortality. Given involvement of immune cells in atherosclerosis, we hypothesized that LOY is associated with the severity of atherosclerotic plaque characteristics and outcome in men undergoing carotid endarterectomy. METHODS AND RESULTS: LOY was quantified in blood and plaque from raw intensity genotyping data in men within the Athero-Express biobank study...
August 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28766810/evaluation-of-carotid-atherosclerotic-plaque-surface-characteristics-utilizing-simultaneous-noncontrast-angiography-and-intraplaque-hemorrhage-snap-technique
#18
Shuo Chen, Huilin Zhao, Jifan Li, Zechen Zhou, Rui Li, Niranjan Balu, Chun Yuan, Huijun Chen, Xihai Zhao
PURPOSE: To evaluate the feasibility of the Simultaneous Noncontrast Angiography and intraPlaque hemorrhage (SNAP) technique in identification of carotid plaque surface characteristics compared with the conventional multicontrast vessel wall imaging protocol. MATERIALS AND METHODS: Thirty symptomatic patients with carotid plaque were recruited and underwent carotid artery magnetic resonance imaging (MRI) (3.0T) using a conventional multicontrast protocol and SNAP sequence...
August 2, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28765521/contrast-enhanced-ultrasound-imaging-quantification-of-adventitial-vasa-vasorum-in-a-rabbit-model-of-varying-degrees-of-atherosclerosis
#19
Xiaoying Li, Ruyou Zhang, Zongmin Li, Chunping Ning, Zhenzhen Wang, Meizheng Dang, Yanqing Peng, Xuesong Han, Litao Sun, Jiawei Tian
This study used an atherosclerotic rabbit model to investigate the feasibility of quantifying adventitial vasa vasorum (VV) via contrast-enhanced ultrasound (CEUS) imaging to identify early atherosclerosis. Recent evidence has linked adventitial VV with atherosclerotic plaque progression and vulnerability. A growth in VV density has been detected preceding intimal thickening and even endothelial dysfunction. In our study, carotid atherosclerosis rabbit models were used, and animals underwent CEUS imaging at the end of the atherosclerotic induction period...
August 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28763875/-a-clinical-study-on-the-effect-of-nattokinase-on-carotid-artery-atherosclerosis-and-hyperlipidaemia
#20
N N Ren, H J Chen, Y Li, G W Mcgowan, Y G Lin
Objective: To evaluate the efficacy of oral nattokinase (NK) in the reduction of common carotid artery intimal medial thickness (CCA-IMT) and carotid artery plaque size and in lowering blood lipids, and to explore the underlying mechanism of actions of NK and its potential clinical use. Methods: All enrolled patients were from the Out-Patient Clinic of the Department of TCM at the 3(rd) Affiliated Hospital of Sun Yat-sen University. Using randomised picking method, all patients were randomly assigned to one of two groups, NK and Statin (ST) group...
July 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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