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Asymptomatic carotid stenosis

Kunakorn Atchaneeyasakul, Priyank Khandelwal, Sudheer Ambekar, Kevin Ramdas, Luis Guada, Dileep Yavagal
BACKGROUND: Embolic protection devices can prevent atherosclerotic emboli during carotid stenting. Newer proximal protection devices reverse flow in the internal carotid artery (ICA), leading to reduction in perioperative microemboli. The risk of stroke is high for carotid stenting of ICA lesions with a length >10 mm and/or angiographic string sign. OBJECTIVE: We aimed to evaluate the safety outcomes of proximal embolic protection device usage in this high-risk group...
September 2016: Interventional Neurology
Derek Klarin, Robert T Lancaster, Emel Ergul, Daniel Bertges, Philip Goodney, Marc L Schermerhorn, Richard P Cambria, Virendra I Patel
OBJECTIVE: Chronic kidney disease (CKD) increases morbidity and mortality after vascular procedures and adversely affects late survival of patients. The presence of CKD also confers increased risk of stroke in patients with asymptomatic carotid stenosis. Patients undergoing carotid intervention in the Vascular Study Group of New England database were stratified by CKD status referable to periprocedural and late outcomes. METHODS: All carotid artery stenting and carotid endarterectomies (CEAs) performed from 2003 to 2013 were stratified by CKD severity as mild (estimated glomerular filtration rate [eGFR] >60 mL/min/1...
November 2016: Journal of Vascular Surgery
K Rosenfield, J S Matsumura, S Chaturvedi
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Mattia Cattaneo, Daniel Staub, Alessandra P Porretta, Jeanne Marie Gallino, Paolo Santini, Costanzo Limoni, Rolf Wyttenbach, Augusto Gallino
Here we provide the correlation among different carotid ultrasound (US) variables to assess echogenicity n standard carotid US and to assess intraplaque neovascularization on contrast enhanced US. We recruited 45 consecutive subjects with an asymptomatic≥50% carotid artery stenosis. Carotid plaque echogenicity at standard US was visually graded according to Gray-Weale classification (GW) and measured by the greyscale median (GSM), a semi-automated computerized measurement performed by Adobe Photoshop(®)...
December 2016: Data in Brief
Enrico Ammirati, Francesco Moroni, Marco Magnoni, Simona Di Terlizzi, Chiara Villa, Federico Sizzano, Alessio Palini, Katia Garlaschelli, Fernanda Tripiciano, Isabella Scotti, Alberico Luigi Catapano, Angelo A Manfredi, Giuseppe Danilo Norata, Paolo G Camici
BACKGROUND AND AIMS: Monocytes are known to play a key role in the initiation and progression of atherosclerosis and contribute to plaque destabilization through the generation of signals that promote inflammation and neoangiogenesis. In humans, studies investigating the features of circulating monocytes in advanced atherosclerotic lesions are lacking. METHODS: Patients (mean age 69 years, 56% males) with intermediate asymptomatic carotid stenosis (40-70% in diameter) were evaluated for maximal stenosis in common carotid artery, carotid bulb and internal carotid artery, overall disease burden as estimated with total plaque area (TPA), greyscale and neovascularization in 244 advanced carotid plaques...
October 6, 2016: Atherosclerosis
Flavia Del Porto, Noemi Cifani, Maria Proietta, Danilo Toni, Maurizio Taurino
OBJECTIVE: The aim of this study was to evaluate the levels of matrix metalloproteinase-12 (MMP-12) and tissue inhibitors of metalloproteinases (TIMP)-1, TIMP-2, TIMP-3, and TIMP-4 in patients with symptomatic and asymptomatic critical carotid artery stenosis (CAS). METHODS: We enrolled 10 patients affected by symptomatic CAS within 12 hours from onset of stroke (S group) and 30 patients with asymptomatic CAS (CAS group); 31 patients matched for age, sex, and traditional cardiovascular risk factors were used as controls (RF group)...
October 13, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Tuba Akinci, Eda Derle, Seda Kibaroğlu, Ali Harman, Feride Kural, Pınar Cınar, Munire Kilinc, Hakki T Akay, Ufuk Can, Ulku S Benli
OBJECTIVE: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). METHODS: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (>/=70%) or symptomatic stenosis (>/=50%). Demographic data, procedural details, and clinical outcomes were recorded...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Joshua T Chai, Luca Biasiolli, Linqing Li, Mohammad Alkhalil, Francesca Galassi, Chris Darby, Alison W Halliday, Linda Hands, Timothy Magee, Jeremy Perkins, Ed Sideso, Ashok Handa, Peter Jezzard, Matthew D Robson, Robin P Choudhury
OBJECTIVES: The aim of this study was to: 1) provide tissue validation of quantitative T2 mapping to measure plaque lipid content; and 2) investigate whether this technique could discern differences in plaque characteristics between symptom-related and non-symptom-related carotid plaques. BACKGROUND: Noninvasive plaque lipid quantification is appealing both for stratification in treatment selection and as a possible predictor of future plaque rupture. However, current cardiovascular magnetic resonance (CMR) methods are insensitive, require a coalesced mass of lipid core, and rely on multicontrast acquisition with contrast media and extensive post-processing...
October 6, 2016: JACC. Cardiovascular Imaging
Taizen Nakase, Tatsuya Ishikawa, Hajime Miyata
Fragility of atheromatous plaque in the internal carotid artery can be a risk of brain infarction. The activation of macrophages by oxidative stress and the vulnerability of vascular endothelial cells have been reported to participate in the fragility of atheromatous plaque. Therefore, from the view point of prevention of brain infarction, we investigated the pathological factors which may influence the stabilization of atheromatous plaque. Patients undertaking carotid endoarterectomy (CEA) were continuously screened...
October 13, 2016: Neuropathology: Official Journal of the Japanese Society of Neuropathology
İsa Öner Yüksel, Erkan Köklü, Şakir Arslan, Göksel Çağırcı, Eylem Özaydın Göksu, Pınar Koç, Serkan Çay, Filiz Kızılırmak
BACKGROUND AND OBJECTIVES: Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR). SUBJECTS AND METHODS: A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study...
September 2016: Korean Circulation Journal
Fatih Yılmaz, Erkan Köklü, Filiz Kizilirmak Yilmaz, Elif Sarıönder Gencer, Ahmet Şükrü Alparslan, Özlem Yıldırımtürk
BACKGROUND: Platelets play a significant role in the pathogenesis of atherosclerosis. In atherosclerotic plaques, the risk of plaque rupture is more crucial than the severity of stenosis they cause. Non-calcified carotid artery plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism and consequently, stroke. AIM: Purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to mean platelet volume (MPV) and platelet distribution width (PDW)...
October 7, 2016: Kardiologia Polska
Grace J Wang, Adam W Beck, Randall R DeMartino, Philip P Goodney, Caron B Rockman, Ronald M Fairman
BACKGROUND: Cerebral hyperperfusion syndrome (CHS), characterized by severe ipsilateral headache, seizures, and intracranial hemorrhage, is a rare, poorly understood complication that can be fatal following carotid endarterectomy (CEA). The purpose of the study was to determine the factors associated with CHS as captured in the Vascular Quality Initiative. METHODS: Analysis was conducted on 51,001 procedures captured from the CEA module of the Vascular Quality Initiative from 2003 to 2015...
October 1, 2016: Journal of Vascular Surgery
Gilles Soulat, Nadjia Kachenoura, Emilie Bollache, Ludivine Perdrix, Benoit Diebold, Valentina Zhygalina, Christian Latremouille, Stephane Laurent, Jean-Noel Fabiani, Elie Mousseaux
PURPOSE: Valvuloarterial impedance (ZVA ), estimating left ventricle (LV) afterload, has been proposed in transthoracic echocardiography (TTE) as a predictor of mortality in aortic valve stenosis (AVS). However, its calculation differs from arterial characteristic impedance (ZC ). Our aim was to apply the concept of ZC calculation to estimate ZVA from MR with carotid tonometry and to evaluate these indices through their associations with symptoms, LV diastolic function and aortic stiffness...
October 3, 2016: Journal of Magnetic Resonance Imaging: JMRI
Nicolas K Khattar, Robert M Friedlander, Rabih A Chaer, Efthymios D Avgerinos, Eric S Kretz, Jeffrey R Balzer, Donald J Crammond, Miguel H Habeych, Parthasarathy D Thirumala
BACKGROUND: Carotid endarterectomy (CEA) is the procedure of choice for reducing the risk of stroke in both symptomatic and asymptomatic carotid artery stenoses. Stroke is associated with significant morbidity and mortality peri-operatively (2-3 %). Our primary aim is to evaluate the etiology of these strokes after CEA and their impact on morbidity by comparing the length of stay in the hospital. METHODS: A total of 584 patients with documented neurological status evaluations who underwent CEAs were included in the study...
September 30, 2016: Acta Neurochirurgica
Flavia Del Porto, Noemi Cifani, Maria Proietta, Sara Perrotta, Raffaele Dito, Cira di Gioia, Raffaella Carletti, Luigi Rizzo, Gianluigi Orgera, Michele Rossi, Livia Ferri, Luigi Tritapepe, Maurizio Taurino
BACKGROUND: Atherosclerosis is a multifactorial disease characterized by an immune-inflammatory remodeling of the arterial wall. Tregs and Th17 subpopulations are detectable inside atherosclerotic plaque, however their behavior in symptomatic carotid artery stenosis (CAS) is not fully elucidated. The aim of this study was to evaluate Th17 and Tregs subsets and their ratio in patients affected by symptomatic and asymptomatic CAS. METHODS: 14 patients with symptomatic CAS (CAS-S group), 41 patients with asymptomatic CAS (CAS-A group), 32 subjects with traditional cardiovascular risk factors (RF group) and 10 healthy subjects (HS group) were enrolled...
October 3, 2016: Annals of Medicine
Seemant Chaturvedi, Marc Chimowitz, Robert D Brown, Brajesh K Lal, James F Meschia
Asymptomatic extracranial internal carotid artery atherosclerotic stenosis increases with age and is more common in men. Studies performed more than 2 decades ago showed that carotid endarterectomy reduced the rate of stroke in carefully selected patients with asymptomatic carotid stenosis compared with medical therapy in the long term. Those trials were completed more than 20 years ago and with advances in the treatment of atherosclerotic disease, the question has been raised to as to whether endarterectomy is still of value for patients with asymptomatic narrowing...
September 28, 2016: Neurology
Dandan Wang, Jing Wang, Cheng Jin, Ruijun Ji, Anxin Wang, Xin Li, Xiang Gao, Shouling Wu, Yong Zhou, Xingquan Zhao
Asymptomatic extracranial artery stenosis (ECAS) is a well-known risk factor for stroke events, but it remains unclear whether it has the same role in predicting cardiovascular and cerebrovascular diseases, especially in China. We investigated the potential associations between ECAS, carotid plaque and carotid intima-media thickness and the new occurrence of cardiovascular and cerebrovascular diseases in the study. Out of 5440 study participants, 364 showed an asymptomatic ECAS at baseline, and 185 had come up to the final vascular events (brain infarction, intracerebral hemorrhage, subarachnoid hemorrhage, coronary heart disease and death due to the vascular diseases)...
September 21, 2016: Scientific Reports
Marine Gaudry, Jean-Michel Bartoli, Laurence Bal, Roch Giorgi, Mariangela De Masi, Pierre-Edouard Magnan, Philippe Piquet
BACKGROUND: Carotid artery stenting (CAS) has been advocated as an alternative to redo surgery for the treatment of post-carotid endarterectomy (CEA) stenosis. This study analyzed the efficacy of CAS for post-CEA restenosis, focusing on an analysis of technical and anatomical predictive factors for in-stent restenosis. METHODS: We performed a retrospective monocentric study. We included all patients who underwent CAS for post-CEA restenosis at our institution from July 1997 to November 2013...
2016: PloS One
Przemyslaw Puz, Anetta Lasek-Bal, Tomasz Urbanek, Zofia Kazibutowska
AIM: Carotid artery stenosis can result in the brain tissue injury related to the intracranial aterial flow disturbances as well as microembolic complications. The choice of the proper therapy in patients with carotid artery stenosis, especially asymptomatic, remains still a significant clinical problem. The study aim was an assessment of the cerebral embolism and brain vascular reserve parameters in patients with carotid artery stenosis regarding the occurrence of the clinical symptoms, the degree of stenosis as well as plaque morphology...
2016: Neurologia i Neurochirurgia Polska
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