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Asymptomatic carotid stenosis

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https://www.readbyqxmd.com/read/29681577/carotid-artery-stenting-versus-carotid-endarterectomy-for-treatment-of-asymptomatic-carotid-artery-stenosis
#1
Guiyi Yuan, Shuxian Zhou, Wei Wu, Yuling Zhang, Juan Lei, Boshui Huang
Asymptomatic carotid stenosis is common and is associated with increased risk of stroke. The relative efficacy and safety of carotid endarterectomy (CEA) and carotid stenting (CAS) in patients with asymptomatic carotid stenosis remain unclear. Five studies that recruited patients with asymptomatic but significant carotid stenosis, who underwent CEA or CAS, were included in this systematic review and meta-analysis. The analyzed outcomes included risks of stroke, myocardial infarction (MI), and death. Risk ratio (RR) and 95% confidence interval (95% CI) were calculated and pooled for meta-analysis...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29680819/a-single-center-experience-in-the-endovascular-treatment-of-carotid-siphon-aneurysms-using-the-willis-covered-stent-a-retrospective-analysis
#2
Lin Ma, Ji-Chong Xu, Shuo Yan, Hao Feng, Hong-Jie Han, Hua-Qiao Tan, Chun Fang, Hong-En Huang
OBJECTIVE: To report the clinical results and initial clinical experience of endovascular isolation with the Willis covered stent for carotid siphon aneurysms. METHODS: Between November 2013 and December 2016, a total of 57 patients who presented with carotid siphon aneurysms were treated with the Willis covered stent. Results of the procedures, technical events, and complications were recorded. Clinical and imaging follow-ups were performed at 3 months following the endovascular procedures...
April 21, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29656628/cerebral-thromboembolic-events-during-anterior-cervical-spine-surgery-retrospective-case-series-study-with-diffusion-weighted-magnetic-resonance-imaging-follow-up-in-the-immediate-postoperative-period
#3
Seok-Won Chung, Min-Soo Kang, Sang-Ho Lee, Shin-Young Lee, Yong-Hwan Shin, Chan-Hong Park
OBJECTIVE: We evaluated the efficacy of diffusion-weighted magnetic resonance imaging (DW-MRI) in detecting perioperative cerebral thromboembolic events after anterior cervical discectomy and fusion (ACDF). METHODS: This retrospective case series included 51 consecutive patients that underwent ACDF. To assess baseline presence of plaque or stenosis, all patients were assessed for risk factors of cerebrovascular events and underwent carotid ultrasound preoperatively and cerebral DW-MRI was performed in all patients postoperatively, with areas of high signal intensity interpreted as a cerebral thromboembolic event...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29629065/carotid-arterial-stent-implantation-follow-up-and-results-in-50-patients-preliminary-report
#4
Alireza Khosravi, Fereshteh Ziaee Bideh, Farshad Roghani, Mohammad Saadatnia, Fariborz Khorvash, Majid Nejati, Nastaran Khoshpour, Mohaddeseh Behjati
Background: Carotid artery stenting (CAS) is considered as a safe and effective procedure for treatment of carotid artery stenosis. Evaluation of this procedure's complications is essential for proper clinical decision-making. Objective: This study aimed to evaluate the cardiovascular events after CAS among our patients in Isfahan, Iran. Methods: This case-series study was conducted on fifty patients from December 2013 to May 2016. These patients were referred to the cardiology centers of Isfahan, Iran by a neurologist, for stenting of extracranial carotid arteries...
February 2018: Electronic Physician
https://www.readbyqxmd.com/read/29627942/orthostatic-hypotension-acutely-impairs-executive-functions-in-parkinson-s-disease
#5
Michela Sforza, Francesca Assogna, Domiziana Rinaldi, Giuliano Sette, Stefania Tagliente, Francesco E Pontieri
Orthostatic hypotension is a frequent non-motor symptom of Parkinson's disease, with negative prognostic role on cognitive functions. Here we measured the acute effects of orthostatic hypotension on executive functions in Parkinson's disease patients devoid of hypertension, carotid artery stenosis, and significant chronic cerebrovascular pathology. Measurements were carried out during regular visits in outpatient setting. Twenty-eight Parkinson's disease patients were recruited and studied along scheduled outpatient visits...
April 7, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29568679/immediate-and-late-outcomes-of-stenting-for-severe-extracranial-internal-carotid-artery-stenosis-in-octogenarian-patients
#6
Jin-Hai Duan, Shu-Wen Xu, Chengbo Dai, Hao Xiao, Jiayi Zhong, Faxin Ma, Jian-Wei Mo, Shuyuan Wang, Xiong Zhang, Zhanyi Lin
Background: Multiple studies suggest that internal carotid artery stenting can be performed safely in octogenarians with low periprocedural complication rates. However, great concern still exists as to whether these patients will gain long-term benefits from this procedure given their advanced age and uncertain life expectancy. We decided to conduct a retrospective study to determine short-and long-term clinical outcomes and to analyze survival duration in this population. Methods and Results: Sixty-nine consecutive elderly patients with either symptomatic or asymptomatic stenosis ≥70% underwent 86 procedures...
January 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29559195/safety-of-stenting-and-endarterectomy-for-asymptomatic-carotid-artery-stenosis-a-meta-analysis-of-randomised-controlled-trials
#7
REVIEW
Likun Cui, Yanshuo Han, Shuai Zhang, Xun Liu, Jian Zhang
OBJECTIVE/BACKGROUND: A meta-analysis of recently published randomised controlled trials (RCTs) was performed to evaluate the safety of carotid artery stenting (CAS) versus carotid endarterectomy (CEA) for asymptomatic carotid stenosis with average risk. METHODS: The MEDLINE, Embase, and Cochrane Library databases were systematically searched for RCTs that compared CAS with CEA for asymptomatic carotid stenosis. These publications reported clinical outcomes after revascularisation in patients with asymptomatic carotid stenosis during their primary intervention...
March 17, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29549324/risk-of-major-adverse-cardiovascular-events-in-subjects-with-asymptomatic-mild-carotid-artery-stenosis
#8
Hyunwook Kwon, Hong-Kyu Kim, Sun U Kwon, Seung-Whan Lee, Min-Ju Kim, Jee Won Park, Minsu Noh, Youngjin Han, Tae-Won Kwon, Yong-Pil Cho
This study aimed to test the hypothesis that the risk of major adverse cardiovascular events (MACE) is similar for subjects with asymptomatic mild and moderate carotid artery stenosis (CAS). We enrolled a total of 453 subjects with asymptomatic CAS (30-69%) detected on baseline screening Doppler ultrasound (DUS) examination between January 2008 and December 2010. The follow-up DUS findings and MACE occurrence (fatal or nonfatal myocardial infarction or stroke and all-cause mortality) were compared between subjects with mild (30-49%) and moderate (50-69%) CAS during the 8-year follow-up period...
March 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29530025/carotid-dsa-based-cfd-simulation-in-assessing-the-patient-with-asymptomatic-carotid-stenosis-a-preliminary-study
#9
Dong Zhang, Pengcheng Xu, Hongyu Qiao, Xin Liu, Liangping Luo, Wenhua Huang, Heye Zhang, Changzheng Shi
BACKGROUND: Cerebrovascular events are frequently associated with hemodynamic disturbance caused by internal carotid artery (ICA) stenosis. It is challenging to determine the ischemia-related carotid stenosis during the intervention only using digital subtracted angiography (DSA). Inspired by the performance of well-established FFRct technique in hemodynamic assessment of significant coronary stenosis, we introduced a pressure-based carotid arterial functional assessment (CAFA) index generated from computational fluid dynamic (CFD) simulation in DSA data, and investigated its feasibility in the assessment of hemodynamic disturbance preliminarily using pressure-wired measurement and arterial spin labeling (ASL) MRI as references...
March 12, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29503003/quantitative-analysis-and-predictors-of-embolic-filter-debris-load-during-carotid-artery-stenting-in-asymptomatic-patients
#10
Michele Piazza, Francesco Squizzato, Chiara Chincarini, Marny Fedrigo, Chiara Castellani, Annalisa Angelini, Franco Grego, Michele Antonello
OBJECTIVE: The objective of this study was to perform a quantitative analysis and to identify predictors of embolic filter debris (EFD) load during carotid artery stenting (CAS) in asymptomatic patients. METHODS: All patients with asymptomatic carotid stenosis >70% undergoing CAS between 2008 and 2016 were included in a prospective database. A distal filter protection device was used in all patients. At the end of the procedure, the filter was fixed in formalin and then analyzed with a stereomicroscope...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29501517/intraoperative-hypoglossal-nerve-mapping-during-carotid-endarterectomy-technical-note
#11
Atsuhiro Kojima, Isako Saga, Mami Ishikawa
BACKGROUND: Hypoglossal nerve deficit is a possible complication caused by carotid endarterectomy (CEA). The accidental injury of the hypoglossal nerve during surgery is one of the major reasons for permanent hypoglossal nerve palsy. In this study, we investigated the usefulness of intraoperative mapping of the hypoglossal nerve to identify this nerve during CEA. METHODS: Five consecutive patients who underwent CEA for the treatment of symptomatic or asymptomatic carotid artery stenosis were studied...
February 28, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29499924/usefulness-of-carotid-plaques-as-predictors-of-obstructive-coronary-artery-disease-and-cardiovascular-events-in-asymptomatic-individuals-with-diabetes-mellitus
#12
Anand Jeevarethinam, Shreenidhi Venuraju, Alain Dumo, Sherezade Ruano, Miranda Rosenthal, Devaki Nair, Mark Cohen, Daniel Darko, Avijit Lahiri, Roby Rakhit
Carotid intima-media thickness (CIMT) measurement and carotid plaque detection by B-mode ultrasound are frequently used as surrogates to predict coronary artery disease (CAD). However, their systematic use in routine clinical management of asymptomatic patients with diabetes mellitus (DM) has not been studied. The aim of the study was to identify carotid parameters that predict cardiovascular events in patients with asymptomatic type 2 DM by evaluating the relation between carotid disease and CAD. This multicenter, observational, prospective study included 259 asymptomatic patients with type 2 DM followed-up for 34 months after measurement of CIMT and carotid plaque with carotid ultrasound, and CAD assessment with computed tomography coronary angiography...
February 27, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29485097/increased-expression-of-interleukin-18-mrna-is-associated-with-carotid-artery-stenosis
#13
Berk Arapi, Burcu Bayoğlu, Müjgan Cengiz, Ahmet Dirican, Serkan Burç Deser, Yerik Junusbekov, Caner Arslan
BACKGROUND: Carotid artery stenosis (CAS) is the atherosclerotic narrowing of the proximal internal carotid artery (ICA) and one of the main causes of stroke. Elevated expression of the pleiotropic proinflammatory cytokine, interleukin-18 (IL18), has been shown in human atherosclerotic plaques. AIMS: To investigate whether IL18 and interleukin-18 binding protein (IL18BP) mRNA expression and IL18 -137 G/C (rs187238) variants are associated with CAS development. STUDY DESIGN: Case-control study...
February 27, 2018: Balkan Medical Journal
https://www.readbyqxmd.com/read/29479382/early-diagnosis-and-treatment-of-coronary-heart-disease-in-asymptomatic-subjects-with-advanced-vascular-atherosclerosis-of-the-carotid-artery-type-iii-and-iv-b-findings-using-ultrasound-and-risk-factors
#14
Ansgar Adams, Waldemar Bojara, Klaus Schunk
Background: A study was conducted as to whether the early diagnosis of coronary heart disease in asymptomatic subjects with advanced atherosclerosis of the carotid artery which additionally shows at least one risk factor is successful using ultrasound technology. Methods: Within the scope of an occupational screening program using subjects from diverse employment sectors, people were given the opportunity to determine their risk of heart attack. During the study the total plaque area (TPA), the maximum plaque thickness in the carotid artery and the PROCAM-Scores of 3,748 healthy men and 2,260 healthy women between the ages of 20 and 64 years were determined...
February 2018: Cardiology Research
https://www.readbyqxmd.com/read/29476243/increased-platelet-count-and-reticulated-platelets-in-recently-symptomatic-versus-asymptomatic-carotid-artery-stenosis-and-in-cerebral-microembolic-signal-negative-patient-subgroups-results-from-the-haemostasis-in-carotid-stenosis-heist-study
#15
S J X Murphy, S T Lim, J A Kinsella, D Murphy, H M Enright, Dominick J H McCabe
BACKGROUND: The pathophysiological mechanisms responsible for the disparity in stroke risk between asymptomatic and symptomatic carotid stenosis patients are not fully understood. The functionally important reticulated platelet fraction and reticulocytes could play a role. OBJECTIVES: We performed a prospective, multi-centre, observational analytical study comparing full blood count parameters and platelet production/turnover/activation markers in patients with asymptomatic versus recently symptomatic moderate (≥ 50-69%) or severe (≥ 70-99%) carotid stenosis...
February 23, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29432486/fractal-analysis-of-plaque-border-a-novel-method-for-the-quantification-of-atherosclerotic-plaque-contour-irregularity-is-associated-with-pro-atherogenic-plasma-lipid-profile-in-subjects-with-non-obstructive-carotid-stenoses
#16
Francesco Moroni, Marco Magnoni, Vittoria Vergani, Enrico Ammirati, Paolo G Camici
BACKGROUND AND AIMS: Plaque border irregularity is a known imaging characteristic of vulnerable plaques, but its evaluation heavily relies on subjective evaluation and operator expertise. Aim of the present work is to propose a novel fractal-analysis based method for the quantification of atherosclerotic plaque border irregularity and assess its relation with cardiovascular risk factors. METHODS AND RESULTS: Forty-two asymptomatic subjects with carotid stenosis underwent ultrasound evaluation and assessment of cardiovascular risk factors...
2018: PloS One
https://www.readbyqxmd.com/read/29424477/association-of-lipoprotein-associated-phospholipase-a2-mass-with-asymptomatic-cerebral-artery-stenosis
#17
Youxin Wang, Bin Zhou, Pingan Zhou, Yan Yao, Qinghua Cui, Yingping Liu, Jichun Yang, Shouling Wu, Xingquan Zhao, Yong Zhou
Cerebral artery stenosis (CAS) is the most important causes of ischaemic stroke. Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays 2 diverse roles in atherosclerosis (pro-inflammatory and anti-inflammatory), and the association between Lp-PLA2 mass and cardiovascular or cerebrovascular events is inconsistent among previous studies. A cross-sectional study including 2012 North Chinese adults aged ≥40 years was performed in 2010-2011 to investigate whether Lp-PLA2 mass is associated with asymptomatic cerebral artery stenosis (ACAS)...
February 9, 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29421416/primary-stenting-of-right-sided-subclavian-artery-stenosis-presenting-as-subclavian-steal-syndrome-report-of-three-cases-and-literature-review
#18
Georgios Sahsamanis, Georgios Vourliotakis, Konstantinos Pirgakis, Anastasios Lekkas, Ioannis Kantounakis, Alexandra Terzoglou, Vasileios Tzilalis
BACKGROUND: Right-sided subclavian artery stenosis is a rare cerebrovascular disease involving the upper extremities. Considering an endovascular approach for its management requires increased endovascular and catheterization skills, when compared to the left side, due to the close approximation of the right subclavian artery origin, vertebral and common carotid arteries. METHODS: Three patients suffering from proximal right sided subclavian artery stenosis were treated in our center through primary stenting...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29397311/cerebral-neuromonitoring-during-carotid-endarterectomy-and-impact-of-contralateral-internal-carotid-occlusion
#19
Davorin Sef, Andrija Skopljanac-Macina, Milan Milosevic, Anita Skrtic, Vinko Vidjak
BACKGROUND: The aim of this study was to identify the reliability of carotid artery stump pressure (SP) in predicting the neurologic changes and correlation with contralateral internal carotid artery (ICA) occlusion in patients undergoing eversion carotid endarterectomy (CEA). The optimal method for monitoring cerebral perfusion during CEA, performed under either local or general anesthesia, is still controversial. METHODS: We prospectively analyzed 118 consecutive patients undergoing eversion CEA under local anesthesia...
January 31, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29393758/risk-of-intracranial-hemorrhage-after-carotid-artery-stenting-versus-endarterectomy-a-population-based-study
#20
Mohamad A Hussain, Aziz S Alali, Muhammad Mamdani, Jack V Tu, Gustavo Saposnik, Konard Salata, Avery B Nathens, Charles de Mestral, Deepak L Bhatt, Subodh Verma, Mohammed Al-Omran
OBJECTIVE Intracranial hemorrhage (ICH) associated with cerebral hyperperfusion syndrome is a rare but major complication of carotid artery revascularization. The objective of this study was to compare the rate of ICH after carotid artery stenting (CAS) with that after endarterectomy (CEA). METHODS The authors performed a retrospective population-based cohort study of patients who underwent carotid artery revascularization in the province of Ontario, Canada, between 2002 and 2015. The primary outcome was the rate of ICH that occurred within 90 days after carotid artery intervention among patients who underwent CAS versus that of those who underwent CEA...
February 2, 2018: Journal of Neurosurgery
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