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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/27907041/carotid-atherosclerosis-cerebrospinal-fluid-pressure-and-retinal-vessel-diameters-the-asymptomatic-polyvascular-abnormalities-in-community-study
#4
Jing Yan Yang, Xuan Yang, Yang Li, Jie Xu, Yong Zhou, An Xin Wang, Xiang Gao, Liang Xu, Shou Ling Wu, Wen Bin Wei, Xing Quan Zhao, Jost B Jonas
PURPOSE: To assess relationships between carotid artery atherosclerosis and retinal arteriolar and venular diameters. METHODS: The community-based longitudinal Asymptomatic Polyvascular Abnormalities Community Study (APAC) included a sub-population of the Kailuan study which consisted of 101,510 employees and retirees of a coal mining industry. Based on the Chinese National Census 2010 and excluding individuals with history of cerebrovascular ischemic events, 4004 individuals were included into the APAC...
2016: PloS One
https://www.readbyqxmd.com/read/27905692/remote-pre-procedural-ischemic-stroke-was-the-strongest-risk-for-stroke-and-death-associated-with-carotid-stenting-a-single-center-experience
#5
Mária Rašiová, Ľubomír Špak, Ľudmila Farkašová, Štefan Pataky, Martin Koščo, Marek Hudák, Matej Moščovič, Norbert Leško
BACKGROUND: The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. Patient selection for carotid procedure who benefit from procedure and who is the procedure hazardous for is important. Remote ischemic stroke is known risk factor for stroke reccurence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) between patients with remote pre- procedural ischemic stroke and without it; to analyse periprocedural risk in other specific patient subgroups treated with CAS and to determine the impact of observed variables on all- cause mortality during long-term follow-up...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27904029/coronary-artery-calcium-and-carotid-artery-intima-media-thickness-and-plaque-clinical-use-in-need-of-clarification
#6
Maryam Zaid, Akira Fujiyoshi, Aya Kadota, Robert D Abbott, Katsuyuki Miura
Atherosclerosis begins in early life and has a long latent period prior to onset of clinical disease. Measures of subclinical atherosclerosis, therefore, may have important implications for research and clinical practice of atherosclerotic cardiovascular disease (ASCVD). In this review, we focus on coronary artery calcium (CAC) and carotid artery intima-media thickness (cIMT) and plaque as many population-based studies have investigated these measures due to their non-invasive features and ease of administration...
December 1, 2016: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/27904004/delayed-diagnosis-of-blunt-carotid-trauma-in-a-seat-belt-syndrome-with-associated-abdominal-wall-injury-a-case-report
#7
Savino Occhionorelli, Dario Andreotti, Daniela Tartarini, Lorenzo Cappellari, Rocco Stano, Lucia Morganti, Giorgio Vasquez
: The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, involved in a traffic accident, arrived to Emergency Room hemodynamically stable, with a Glasgow Coma Scale of 15, complaining abdominal pain, without any neurological signs. She underwent Computed Tomography (CT) scan that showed a complete disruption of left abdominal wall muscles, associated with massive bowel loops herniation...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27901325/asymptomatic-carotid-artery-stenosis-who-should-be-screened-who-should-be-treated-and-how-should-we-treat-them
#8
Djurre D DE Waard, Dylan Morris, Gert J DE Borst, Richard Bulbulia, Alison Halliday
Although stopping smoking, lowering blood pressure and reducing lipid levels will reduce global stroke risk and cardiovascular mortality, these remain leading causes of death and disability especially in ageing populations. Further prevention strategies are needed and, in the first part of this review, we explore the potential benefits of appropriate screening for carotid artery disease to reduce stroke and identify those who may have related cardiac disease. Although whole-population carotid screening is an inefficient and costly means of identifying candidates with tight carotid stenosis who might warrant intervention, it can identify many people with lower levels of stenosis who may benefit from cardiovascular risk reducing medications...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27899750/circulating-micrornas-as-novel-biomarkers-of-stenosis-progression-in-asymptomatic-carotid-stenosis
#9
Sandra Dolz, David Górriz, José Ignacio Tembl, Dolors Sánchez, Gerardo Fortea, Vera Parkhutik, Aida Lago
BACKGROUND AND PURPOSE: Progression of asymptomatic carotid artery stenosis (ACAS) in patients with >50% luminal narrowing is considered a potential risk factor for ischemic stroke; however, subclinical molecular biomarkers of ACAS progression are lacking. Recent studies suggest a regulatory function for several microRNAs (miRNAs) on the evolution of carotid plaque, but its role in ACAS progression is mostly unknown. The aim of our study was to investigate a wide miRNA panel in peripheral blood exosomes from patients with ACAS to associate circulating miRNA expression profiles with stenosis progression...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27898402/recent-update-on-carotid-endarterectomy-versus-carotid-artery-stenting
#10
Raywat Noiphithak, Anusak Liengudom
Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS...
November 30, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27881699/multicenter-experience-of-surgical-explantation-of-carotid-stents-for-recurrent-stenosis
#11
Jesse A Columbo, John C McCallum, Philip P Goodney, Thomas C Bower, Marc L Schermerhorn, Richard J Powell, Randall R DeMartino
OBJECTIVE: A significant cohort of patients who have undergone carotid artery stenting (CAS) will have in-stent restenosis (ISR). The optimal management of symptomatic or severe ISR remains poorly defined. The purpose of this study was to describe the indications, treatment, and mid- to long-term outcomes of patients undergoing CAS explantation for ISR. METHODS: All patients undergoing internal carotid artery stent explantation with carotid artery reconstruction at Mayo Clinic Rochester, Dartmouth-Hitchcock Medical Center, and Beth-Israel Deaconess Medical Center from 2003 to 2013 were retrospectively reviewed...
November 22, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27881360/an-observational-registry-of-carotid-endarterectomy-and-carotid-artery-stenting-in-brazil-study-protocol
#12
Edwaldo Edner Joviliano, Winston Bonetti Yoshida, Marcone Lima Sobreira, Regina Moura, Ana Terezinha Guillaumon, Selma Regina De Oliveira Raymundo, Daniel Gustavo Miquelin, Ludvig Hafner, Marcelo Jose Almeida
BACKGROUND: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. CEA has been considered the first-line treatment for carotid stenosis worldwide, and the safety and efficacy of CAS compared to CEA remains in question. OBJECTIVE: The purpose of this study is to compare the practice and outcomes of CAS and CEA in a real-world setting within public university hospitals in Brazil...
November 23, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27875340/which-patients-with-asymptomatic-carotid-stenosis-benefit-from-revascularization
#13
A Ross Naylor
PURPOSE OF THE REVIEW: To summarize why there are polarized opinions regarding the management of patients with asymptomatic carotid disease and whether it is possible to identify patients who might benefit from carotid interventions. RECENT FINDINGS: Carotid Revascularization Endarterectomy Versus Stenting Trial and Asymptomatic Carotid Trial 1 (ACT-1) recently concluded that outcomes after carotid endarterectomy and carotid stenting were not significantly different in asymptomatic patients and that procedural risks were below the accepted 3% threshold...
November 21, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27872105/multiethnic-exome-wide-association-study-of-subclinical-atherosclerosis
#14
Pradeep Natarajan, Joshua C Bis, Lawrence F Bielak, Amanda J Cox, Marcus Dörr, Mary F Feitosa, Nora Franceschini, Xiuqing Guo, Shih-Jen Hwang, Aaron Isaacs, Min A Jhun, Maryam Kavousi, Ruifang Li-Gao, Leo-Pekka Lyytikäinen, Riccardo E Marioni, Ulf Schminke, Nathan O Stitziel, Hayato Tada, Jessica van Setten, Albert V Smith, Dina Vojinovic, Lisa R Yanek, Jie Yao, Laura M Yerges-Armstrong, Najaf Amin, Usman Baber, Ingrid B Borecki, J Jeffrey Carr, Yii-Der Ida Chen, L Adrienne Cupples, Pim A de Jong, Harry de Koning, Bob D de Vos, Ayse Demirkan, Valentin Fuster, Oscar H Franco, Mark O Goodarzi, Tamara B Harris, Susan R Heckbert, Gerardo Heiss, Udo Hoffmann, Albert Hofman, Ivana Išgum, J Wouter Jukema, Mika Kähönen, Sharon L R Kardia, Brian G Kral, Lenore J Launer, Joseph Massaro, Roxana Mehran, Braxton D Mitchell, Thomas H Mosley, Renée de Mutsert, Anne B Newman, Khanh-Dung Nguyen, Kari E North, Jeffrey R O'Connell, Matthijs Oudkerk, James S Pankow, Gina M Peloso, Wendy Post, Michael A Province, Laura M Raffield, Olli T Raitakari, Dermot F Reilly, Fernando Rivadeneira, Frits Rosendaal, Samantha Sartori, Kent D Taylor, Alexander Teumer, Stella Trompet, Stephen T Turner, André G Uitterlinden, Dhananjay Vaidya, Aad van der Lugt, Uwe Völker, Joanna M Wardlaw, Christina L Wassel, Stefan Weiss, Mary K Wojczynski, Diane M Becker, Lewis C Becker, Eric Boerwinkle, Donald W Bowden, Ian J Deary, Abbas Dehghan, Stephan B Felix, Vilmundur Gudnason, Terho Lehtimäki, Rasika Mathias, Dennis O Mook-Kanamori, Bruce M Psaty, Daniel J Rader, Jerome I Rotter, James G Wilson, Cornelia M van Duijn, Henry Völzke, Sekar Kathiresan, Patricia A Peyser, Christopher J O'Donnell
BACKGROUND: -The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease (CHD). We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the risk of subsequent CHD. METHODS AND RESULTS: -We studied a total of 25,109 European ancestry and African-American participants with coronary artery calcification (CAC) measured by cardiac computed tomography and 52,869 with common carotid intima media thickness (CIMT) measured by ultrasonography within the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium...
November 21, 2016: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/27869549/carotid-artery-stenting-with-double-cerebral-embolic-protection-in-asymptomatic-patients-a-diffusion-weighted-mri-controlled-study
#15
Ertan Vuruskan, Erhan Saracoglu, Ugur Ergun, Fatih Poyraz, İrfan Veysel Duzen
BACKGROUND: The aim of this study was to compare the simultaneous double-protection method (proximal balloon plus distal filter) with distal-filter protection or proximal-balloon protection alone in asymptomatic patients during carotid artery stenting. PATIENTS AND METHODS: 119 consecutive patients were investigated for carotid artery stentings in the extracranial internal carotid artery with the use of distal filters (n = 41, 34.4 %), proximal balloon (MoMa) protection (n = 40, 33...
November 24, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27869211/homocysteine-and-its-relationship-to-asymptomatic-carotid-stenosis-in-a-chinese-community-population
#16
Jiaokun Jia, Anxin Wang, Jing Wang, Jianwei Wu, Xiujuan Yan, Yong Zhou, Shengyun Chen, Xingquan Zhao
Little is known about the association between homocysteine (Hcy) and asymptomatic CAS in the healthy population. The purpose of this study was to investigate the relationship between Hcy levels and asymptomatic CAS in a Chinese community population. The current study included 5393 participants who were age of 40 years or older, and free of stroke, transient ischemic attack, and coronary artery disease. Demographic and clinical variables were investigated, and the presence of CAS was assessed by Color Doppler Ultrasound...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27861368/comparison-of-extracranial-artery-stenosis-and-cerebral-blood-flow-assessed-by-quantitative-magnetic-resonance-using-digital-subtraction-angiography-as-the-reference-standard
#17
Jingjing Cai, Dan Wu, Yongqian Mo, Anxin Wang, Shiyu Hu, Lijie Ren
Extracranial arteriosclerosis usually indicates a high risk of ischemic stroke. In the past, a clinical decision following diagnosis was dependent on the percentage of vessel stenosis determined by an invasive technique. We aimed to develop a quantitative magnetic resonance (QMR) technique to evaluate artery structure and cerebral hemodynamics noninvasively.QMR and digital subtraction angiography (DSA) were performed in 67 patients with suspected cerebral vascular disease at our hospital. Accuracy, sensitivity, positive predictive values (PPVs), negative predictive values (NPVs), and Pearson correlation coefficient of QMR were calculated and compared for the detection and measurement of vascular stenoses using DSA as a gold standard...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27853491/dissection-of-extracranial-internal-carotid-artery-due-to-balloon-guiding-catheter-resulting-in-asymptomatic-internal-carotid-artery-occlusion
#18
Suha Akpinar, Guliz Yilmaz
Dissection of the internal carotid artery (ICA) is a rare condition that accounts for a significant proportion of ischemic strokes in young adults. Iatrogenic dissection as a complication of neurointerventional procedures is a traumatic dissection which has been reported relatively rare in the literature. In this report, a case of dissection of the ICA is reported that was caused by repetitive movement of the balloon guiding catheter during stent-assisted thrombectomy (SAT), resulting in occlusion of the ICA...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27831484/dynamic-respiratory-tortuosity-of-the-vertebral-artery-ostium
#19
Xiaobin Tang, Feng Tang, Chang Hu, Qian Wang, Whitney Long, Lei Li
PURPOSE: To determine the prevalence of dynamic respiratory tortuosity (DRT) of the vertebral artery ostium (VAO) as well as to evaluate its correlation with in-stent restenosis (ISR) and stent fracture. METHODS: From March 2012 to June 2015, 178 consecutive patients (mean age 65.2±5.8 years; 124 men) with symptoms of atherosclerotic vertebrobasilar ischemia underwent angiography prior to stent implantation in the vertebral, subclavian, and/or carotid arteries...
November 9, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27829964/safety-of-dual-antiplatelet-therapy-after-carotid-endarterectomy-for-prevention-of-restenosis-a-single-center-experience
#20
Miguel A Barboza, José Chang, Alvaro Hernández, Emmanuel Martínez, Huberth Fernández, Gerardo Quirós, Johanna Salazar, Allan Ramos-Esquivel, Alberto Maud
INTRODUCTION: The incidence of recurrent carotid stenosis after carotid endarterectomy varies from 1% to 37% with only 0-8% symptomatic restenosis. Safety of short-term (30 days) dual-antiplatelet therapy has not been established in this type of procedure. AIMS: To investigate the safety of dual antiplatelet therapy after carotid endarterectomy to prevent restenosis. METHODS: We retrospectively identified all the patients who underwent carotid endarterectomy (symptomatic or asymptomatic) treated at our center between July 2010 and July 2013 according to local protocols...
October 2016: Journal of Vascular and Interventional Neurology
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