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Asymptomatic carotid

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https://www.readbyqxmd.com/read/28095924/sonolysis-in-prevention-of-brain-infarctions-during-internal-carotid-endarterectomy-sonobirdie-trial-study-protocol-for-a-randomized-controlled-trial
#1
Tomáš Hrbáč, David Netuka, Vladimír Beneš, Vladimír Nosáľ, Petra Kešnerová, Aleš Tomek, Táňa Fadrná, Vladimír Beneš, Jiří Fiedler, Vladimír Přibáň, Miroslav Brozman, Kateřina Langová, Roman Herzig, David Školoudík
BACKGROUND: Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe with maximal diagnostic energy on the reduction of the incidence of stroke, transient ischemic attack (TIA) and brain infarction detected using magnetic resonance imaging (MRI) by the activation of the endogenous fibrinolytic system during CEA...
January 17, 2017: Trials
https://www.readbyqxmd.com/read/28095449/does-antiplatelet-therapy-during-bridging-thrombolysis-increase-rates-of-intracerebral-hemorrhage-in-stroke-patients
#2
Anne Broeg-Morvay, Pasquale Mordasini, Agnieszka Slezak, Kai Liesirova, Julia Meisterernst, Gerhard Schroth, Marcel Arnold, Simon Jung, Heinrich P Mattle, Jan Gralla, Urs Fischer
BACKGROUND: Symptomatic intracerebral hemorrhage (sICH) after bridging thrombolysis for acute ischemic stroke is a devastating complication. We aimed to assess whether the additional administration of aspirin during endovascular intervention increases bleeding rates. METHODS: We retrospectively compared bleeding complications and outcome in stroke patients who received bridging thrombolysis with (tPA+ASA) and without (tPA-ASA) aspirin during endovascular intervention between November 2008 and March 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28094166/carotid-stenting-prior-to-coronary-bypass-surgery-an-updated-systematic-review-and-meta-analysis
#3
REVIEW
K I Paraskevas, S Nduwayo, A N Saratzis, A R Naylor
OBJECTIVES: The aim was to determine 30-day outcomes in patients with concurrent carotid and cardiac disease who underwent carotid artery stenting (CAS) followed by coronary artery bypass grafting (CABG). METHODS: This was a systematic review with searches of PubMed/Medline, Embase, and Cochrane databases. "Same-day" procedures involved CAS + CABG being performed on the same day, and "staged" interventions involved at least 1 day's delay between undergoing CAS and then CABG...
January 13, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28089254/volumetric-analysis-of-carotid-plaque-components-and-cerebral-microbleeds-a-correlative-study
#4
Luca Saba, Roberto Sanfilippo, Michele di Martino, Michele Porcu, Roberto Montisci, Pierleone Lucatelli, Michele Anzidei, Marco Francone, Jasjit S Suri
PURPOSE: The purpose of this work was to explore the association between carotid plaque volume (total and the subcomponents) and cerebral microbleeds (CMBs). MATERIALS AND METHODS: Seventy-two consecutive (male 53; median age 64) patients were retrospectively analyzed. Carotid arteries were studied by using a 16-detector-row computed tomography scanner whereas brain was explored with a 1.5 Tesla system. CMBs were studied using a T2*-weighted gradient-recalled echo sequence...
January 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28078914/appropriate-patient-selection-for-carotid-revascularization-procedures-is-urgently-needed
#5
Kosmas I Paraskevas, Frank J Veith, Dimitri P Mikhailidis, Christos D Liapis
The identification/selection of appropriate patient subgroups with asymptomatic carotid artery stenosis and the performance of prophylactic carotid endarterectomy (CEA)/carotid artery stenting (CAS) exclusively on these asymptomatic patient subgroups is currently one of the "hottest" topics in vascular surgery. It is now clear that offering CEA/CAS to asymptomatic carotid patients based only on the degree of carotid stenosis is unjustified and scientifically flawed. On the other hand, offering only best medical therapy to every asymptomatic patient, irrespective of certain high-risk criteria (such as the detection of microemboli by transcranial Doppler, intraplaque hemorrhage, silent embolic infarcts on brain computed tomography/magnetic resonance imaging, elevated biomarkers, family history), is equally wrong...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28078510/relationship-between-framingham-risk-score-and-subclinical-atherosclerosis-in-carotid-plaques-an-in-vivo-study-using-multi-contrast-mri
#6
Feiyu Li, Xiaoying Wang
The assessment and management of early-stage atherosclerosis are important for the prevention of cardiovascular disease (CVD). In this study, we used multi-contrast magnetic resonance imaging (MRI) to investigate the carotid plaque feature in asymptomatic, at-risk subjects; we also evaluated the correlation between MRI findings and Framingham risk score (FRS). One hundred sixty-six asymptomatic individuals with risk factors for CVD underwent multi-contrast MRI. After the arterial morphology and plaque components were outlined, the differences in carotid plaque burden among the various risk categories were analyzed...
January 4, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#7
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28049656/hdl-efflux-capacity-hdl-particle-size-and-high-risk-carotid-atherosclerosis-in-a-cohort-of-asymptomatic-older-adults-the-chicago-healthy-aging-study
#8
R Kannan Mutharasan, C Shad Thaxton, Jarett Berry, Martha L Daviglus, Chun Yuan, Jie Sun, Colby Ayers, Donald M Lloyd-Jones, John T Wilkins
HDL efflux capacity and particle size are associated with atherosclerotic cardiovascular disease events in middle age, however it is unclear if these associations are present at older ages. We sampled 402 Chicago Healthy Aging Study participants who underwent carotid MR assessment for lipid rich necrotic core plaque (LRNC). We measured HDL particle size, HDL particle number, and HDL efflux capacity. We quantified the associations between HDL particle size and HDL efflux and the presence of LRNC and HDL particle number, and HDL efflux capacity using adjusted linear and logistic regression models...
January 3, 2017: Journal of Lipid Research
https://www.readbyqxmd.com/read/28012444/carotid-artery-plaques-and-intima-medial-thickness-in-familial-hypercholesteraemic-patients-on-long-term-statin-therapy-a-case-control-study
#9
Sven Bos, Martijne H C Duvekot, Gert-Jan R Ten Kate, Adrie J M Verhoeven, Monique T Mulder, Arend F L Schinkel, Koen Nieman, Gerald F Watts, Eric J G Sijbrands, Jeanine E Roeters van Lennep
BACKGROUND AND AIMS: Statins reduce subclinical atherosclerosis and premature atherosclerotic cardiovascular disease (ASCVD) in patients with familial hypercholesterolemia (FH). However, some FH patients still develop ASCVD despite statin therapy. We compared subclinical atherosclerosis assessed by carotid plaque presence and intima media thickness (C-IMT), in long-term statin-treated FH patients and healthy controls. Furthermore, we analysed whether carotid ultrasonography findings associated with subclinical coronary atherosclerosis...
December 2, 2016: Atherosclerosis
https://www.readbyqxmd.com/read/28010865/the-modified-operative-technique-of-partial-eversion-carotid-endarterectomy
#10
Richard McBride, Johnathan Porter, Haytham Al-Khaffaf
We report a modified operative technique termed partial eversion carotid endarterectomy (PECE). During a 9-year period (2006-2015), 352 patients underwent PECE. Indications for surgery, intraoperative details, and outcomes were recorded. The initial 185 patients had carotid duplex ultrasound imaging at 6 weeks and then at 6, 12, and 24 months. Subsequent patients had carotid imaging at 4 to 6 weeks. Indications included stroke (76), transient ischemic attack (153), and amaurosis fugax (33); 58 patients were asymptomatic, and 32 patients had surgery before cardiac surgery...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28006960/lower-extremity-fibromuscular-dysplasia
#11
Ellen Brinza, Victoria Grabinski, Sridevi Durga, Sarah O'Connor, Sandra L Yesenko, Esther S H Kim, Heather L Gornik
Fibromuscular dysplasia (FMD), a disease well described in the renal and cerebrovascular circulations, also manifests in the lower extremity (LE) arteries. This study reports on the clinical presentation, imaging findings, and treatment of patients with LE FMD seen at a single center. Over a 7-year span, 100 of 449 patients with FMD had imaging of the LE arteries, of which 62 were found to have LE FMD (13.8% of the entire FMD cohort including patients with and without LE imaging). The majority of patients were women (96...
January 1, 2016: Angiology
https://www.readbyqxmd.com/read/28005656/skeletal-changes-of-an-osteomyocutaneous-facial-allograft-five-years-following-transplantation
#12
Bahar Bassiri Gharb, Antonio Rampazzo, Gaby Doumit, Steven Bernard, Maria Siemionow, Francis Papay, Risal Djohan
BACKGROUND: More than 30 face transplantations have been performed worldwide, most including part of the facial skeletal framework. In this study, the modifications of the skeletal component of a facial allograft were evaluated. METHODS: Standard head computed tomography (CT) scans, CT angiogram, and bone mineral densitometry were evaluated. Cephalometric analysis was performed. The pre and postoperative CT images were overlapped and the skeletal changes were expressed in a numeric and color-coded scale...
December 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28002752/coronary-atherosclerosis-burden-by-coronary-computed-tomography-in-type-ii-diabetes-with-preclinical-non-obstructive-carotid-atherosclerosis-and-without-inducible-myocardial-ischemia
#13
Vittorio Palmieri, Enzo Gravino, Cesare Russo, Armenio Salvati, Carmelo Lombardi, Rosario Sauro, Giuseppe Rosato
AIMS: To quantify cardiovascular risk in persons with type-2 diabetes (DM) and established carotid atherosclerosis, without inducible myocardial ischemia by stress imaging. METHODS: We selected clinically healthy DM and subjects without DM (nonDM, controls) with non-obstructive carotid atherosclerosis and without significant coronary artery disease (CAD) by stress echocardiography. Coronary flow velocity reserve (CFR) was assessed during stress echocardiography...
December 5, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27998650/identification-of-hemodynamically-compromised-regions-by-means-of-cerebral-blood-volume-mapping-utilizing-computed-tomography-perfusion-imaging
#14
Satoshi Takahashi, Yoshio Tanizaki, Kazunori Akaji, Hiroaki Kimura, Takehiro Katano, Kentaro Suzuki, Yoichi Mochizuki, Satoka Shidoh, Masaki Nakazawa, Kazunari Yoshida, Ban Mihara
The aim of the study was to evaluate the potential role of computed tomography perfusion (CTP) imaging in identifying hemodynamically compromised regions in patients with occlusive cerebrovascular disease. Twelve patients diagnosed with either occlusion or severe stenosis of the internal carotid artery or the M1 portion of the middle cerebral artery underwent CTP imaging. The data was analyzed by an automated ROI-determining software. Patients were classified into two subgroups: an asymptomatic group consisting of three patients in whom perfusion pressure distal to the site of occlusion/stenosis (PPdis) could be maintained in spite of the arterial occlusion/stenosis, and a symptomatic group consisting of nine patients in whom PPdis could not be maintained enough to avoid watershed infarction...
December 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27932558/petct-imaging-of-unstable-carotid-plaque-with-ga-68-labelled-somatostatin-receptor-ligand
#15
Ming Young Simon Wan, Raymond Endozo, Sofia Michopoulou, Robert Shortman, Manuel Rodriguez-Justo, Leon Menezes, Syed Yusuf, Toby Richards, Damian Wild, Beatrice Waser, Jean Claude Reubi, Ashley Groves
BACKGROUND: Ga68 labelled somatostatin receptor ligand PET imaging has recently been shown in preclinical and early human studies to have a potential role in the evaluation of vulnerable arterial plaques. We prospectively evaluated carotid plaque Ga68-DOTATATE uptake in patients with recent carotid events, assessed inter- and intra- observer variability of such measurements, and explored the mechanism of any plaque DOTATATE activity with immunohistochemistry in resected specimens. MATERIALS & METHODS: 20 consecutively consenting patients with recent symptomatic carotid events (transient ischaemic attack [TIA], stroke or amaurosis fugax), due for carotid endarterectomy were prospectively recruited...
December 8, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27931554/a-study-to-derive-distribution-of-carotid-intima-media-thickness-and-to-determine-its-correlation-with-cardiovascular-risk-factors-in-asymptomatic-nationwide-indian-population-score-india
#16
Ravi R Kasliwal, Manish Bansal, Nagaraj Desai, Bhavesh Kotak, Ammar Raza, Hardik Vasnawala, Amit Kumar
BACKGROUND: There is presently no data to describe normal distribution of carotid intima-media thickness (CIMT), an established measure of subclinical atherosclerosis, in Indian subjects. METHODS: In this multi-centric study, 1229 subjects with age ≥30 years and no previous cardiovascular disease (CVD) underwent CVD risk factor assessment and CIMT measurement. Mean far wall common carotid artery IMT was measured on both sides and averaged. RESULTS: Mean age of the subjects was 48...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27930582/renal-volume-and-cardiovascular-risk-assessment-in-normotensive-autosomal-dominant-polycystic-kidney-disease-patients
#17
Laia Sans, Julio Pascual, Aleksandar Radosevic, Claudia Quintian, Mireia Ble, Lluís Molina, Sergi Mojal, José A Ballarin, Roser Torra, Patricia Fernández-Llama
Cardiovascular disease, closely related to an early appearance of hypertension, is the most common mortality cause among autosomal dominant polycystic kidney disease patients (ADPKD). The development of hypertension is related to an increase in renal volume. Whether the increasing in the renal volume before the onset of hypertension leads to a major cardiovascular risk in ADPKD patients remains unknown.Observational and cross-sectional study of 62 normotensive ADPKD patients with normal renal function and a group of 28 healthy controls...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27922252/update-on-new-stents-and-protection-devices-for-carotid-artery-stenting-what-we-know-what-we-learnt-recently-and-what-we-need-to-know
#18
Dimitrios N Nikas, Xenofon Makos, Tomoyuki Umemoto, George Liappas, Andrea Pacchioni, Narek Zakarian, Bernhard Reimers
Carotid artery stenting (CAS) is considered an alternative option to carotid endarterectomy (CEA) for significant carotid stenosis, in both symptomatic and asymptomatic patients. Comparing to CEA, CAS offers significant advantages. The most important arise from the minimally invasive nature of the procedure, which reduces the surgical complications and adds significant comfort to the patient, without compromising the efficacy. Nowadays, CAS can achieve acute and long-term outcome results comparable to CEA, maintaining low rates of periprocedural embolic events...
December 6, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27915126/stroke-risk-stratification-and-its-validation-using-ultrasonic-echolucent-carotid-wall-plaque-morphology-a-machine-learning-paradigm
#19
Tadashi Araki, Pankaj K Jain, Harman S Suri, Narendra D Londhe, Nobutaka Ikeda, Ayman El-Baz, Vimal K Shrivastava, Luca Saba, Andrew Nicolaides, Shoaib Shafique, John R Laird, Ajay Gupta, Jasjit S Suri
Stroke risk stratification based on grayscale morphology of the ultrasound carotid wall has recently been shown to have a promise in classification of high risk versus low risk plaque or symptomatic versus asymptomatic plaques. In previous studies, this stratification has been mainly based on analysis of the far wall of the carotid artery. Due to the multifocal nature of atherosclerotic disease, the plaque growth is not restricted to the far wall alone. This paper presents a new approach for stroke risk assessment by integrating assessment of both the near and far walls of the carotid artery using grayscale morphology of the plaque...
November 27, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27913124/lower-expression-of-genes-involved-in-protection-against-oxidative-stress-in-symptomatic-carotid-atherosclerosis
#20
Nuria Zamora-González, Jesús Crespo-Sanjuán, M Dolores Calvo-Nieves, Diego Sánchez, M Dolores Ganfornina, Gerardo Martínez, Beatriz Aguirre-Gervás, J Antonio González-Fajardo
OBJECTIVE: Oxidative stress is increased in atherosclerosis, manifested both in blood and tissue (atherosclerotic plaque). We aim at describing the expression of a number of genes related to oxidative stress response in carotid atherosclerotic plaques and their relation to symtomatic state. MATERIALS AND METHODS: We have studied the mRNA expression levels for genes related to oxidative stress in a population of 44 patients undergoing carotid endarterectomy, according to the presence (24 patients) or absence (20 patients) of symptoms...
November 29, 2016: Annals of Vascular Surgery
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