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https://www.readbyqxmd.com/read/28646330/-imaging-of-vessels-supplying-the-brain
#1
REVIEW
S M Schellong, N Abolmaali, B Voigts, C Stelzner
Nowadays, several technically validated modalities are available for imaging both the extracranial and intracranial segments of arteries supplying blood to the brain. In the acute stroke setting, computed tomography (CT) angiography is of utmost importance because it provides the key diagnostic criteria indicative for the use of catheter-based recanalization techniques. Ultrasound imaging of extracranial arteries is most suitable for detecting an underlying stenosis of the internal carotid artery (ICA) in patients with stroke, transient ischemic attacks (TIA), retinal vessel occlusion and amaurosis fugax...
June 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28645797/transcranial-doppler-and-microemboli-detection-relationships-to-symptomatic-status-and-histopathology-findings
#2
Carol C Mitchell, Stephanie M Wilbrand, Bornali Kundu, Catherine N Steffel, Tomy Varghese, Nirvedh H Meshram, Geng Li, Thomas D Cook, M Shahriar Salamat, Robert J Dempsey
The purpose of this study was to determine the relationship between symptomatic status, transcranial Doppler (TCD) microemboli presence and plaque histopathology findings. TCD was performed on 60 patients (37 symptomatic, 23 asymptomatic) before undergoing clinically indicated carotid endarterectomy. The frequency of microemboli signals was not significantly different between symptomatic and asymptomatic subject groups (p = 0.88) and there were no differences observed in the macroscopic or histopathology scoring of these plaques (p-values all > 0...
June 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28641848/the-use-of-embolic-protection-devices-is-associated-with-a-lower-stroke-and-death-rate-after-carotid-stenting
#3
Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVES: The aim of this study was to analyze the association between intraprocedural and periprocedural variables and in-hospital stroke or death rate after carotid artery stenting. BACKGROUND: In Germany, all open surgical and endovascular procedures on the extracranial carotid artery must be documented in a statutory nationwide quality assurance database. METHODS: A total of 13,086 carotid artery stenting procedures for asymptomatic (63...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28625670/carotid-occlusion-is-associated-with-more-frequent-neurovascular-events-than-moderately-severe-carotid-stenosis
#4
Matthew Janko, Ryan Moore, Ann H Kim, Andrew J Shevitz, Katherine L Morrow, David J Johnson, Vikram S Kashyap
OBJECTIVE: Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asymptomatic carotid artery stenosis (CS). METHODS: A prospectively maintained database was queried to identify patients with CO and CS with at least >50% carotid stenosis by duplex...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28623378/carotid-stenting-in-neuroradiology-a%C3%A2-short-journey-from-the-past-to-current-debates
#5
REVIEW
Joachim Berkefeld, Marlies Wagner, Richard du Mesnil
After a period of stagnation due to negative results of randomized trials for patients with symptomatic stenosis, the relevance of carotid artery stenting (CAS) is increasing again. CAS has become an important and evidence-based part of interventional stroke treatment. Our ability to manage acute recanalization of carotid occlusions and other niche indications properly led some skeptical neurologists to trust in carotid intervention for elective cases as well. The evolution of CAS from initial euphoria to more realistic views under consideration of trial results and guidelines is reviewed...
June 16, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28623250/adamts-7-is-associated-with-a-high-risk-plaque-phenotype-in-human-atherosclerosis
#6
Eva Bengtsson, Karin Hultman, Pontus Dunér, Giuseppe Asciutto, Peter Almgren, Marju Orho-Melander, Olle Melander, Jan Nilsson, Anna Hultgårdh-Nilsson, Isabel Gonçalves
Several large-scale genome-wide association studies have identified single-nucleotide polymorphisms in the genomic region of A Disintegrin And Metalloproteinase with ThromboSpondin type 1 repeats (ADAMTS)-7 and associations to coronary artery disease. Experimental studies have provided evidence for a functional role of ADAMTS-7 in both injury-induced vascular neointima formation and development of atherosclerotic lesions. However, whether ADAMTS-7 is associated with a specific plaque phenotype in humans has not been investigated...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28623117/open-heart-surgery-does-not-increase-the-incidence-of-ipsilateral-ischemic-stroke-in-patients-with-asymptomatic-severe-carotid-stenosis
#7
John E Castaldo, Hussam A Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny
BACKGROUND AND PURPOSE: We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. METHODS: In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28615715/rnaseq-based-transcriptomics-study-of-smcs-from-carotid-atherosclerotic-plaque-bmp2-and-ids-proteins-are-crucial-regulators-of-plaque-stability
#8
Iraide Alloza, Haize Goikuria, Juan Luis Idro, Juan Carlos Triviño, José María Fernández Velasco, Elena Elizagaray, María García-Barcina, Genoveva Montoya-Murillo, Esther Sarasola, Reyes Vega Manrique, Maria Del Mar Freijo, Koen Vandenbroeck
Carotid artery atherosclerosis is a risk factor to develop cerebrovascular disease. Atheroma plaque can become instable and provoke a cerebrovascular event or else remain stable as asymptomatic type. The exact mechanism involved in plaque destabilization is not known but includes among other events smooth muscle cell (SMC) differentiation. The goal of this study was to perform thorough analysis of gene expression differences in SMCs isolated from carotid symptomatic versus asymptomatic plaques. Comparative transcriptomics analysis of SMCs based on RNAseq technology identified 67 significant differentially expressed genes and 143 significant differentially expressed isoforms in symptomatic SMCs compared with asymptomatic...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28610589/high-sensitivity-cardiac-troponin-t-is-a-biomarker-for-atherosclerosis-in-systemic-lupus-erythematous-patients-a-cross-sectional-controlled-study
#9
Gillian Divard, Rachid Abbas, Camille Chenevier-Gobeaux, Noémie Chanson, Brigitte Escoubet, Marie-Paule Chauveheid, Antoine Dossier, Thomas Papo, Monique Dehoux, Karim Sacre
BACKGROUND: Cardiovascular disease (CVD) is the main cause of death in systemic lupus erythematous (SLE) patients. The Framingham score underestimates the risk for CVD in this population. Our study aimed to determine whether serum high-sensitivity cardiac troponin T (HS-cTnT) might help to identify SLE patients at risk for CVD. METHODS: The presence of carotid plaques was prospectively assessed by ultrasound in 63 consecutive SLE patients asymptomatic for CVD and 18 controls...
June 13, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28603515/factors-influencing-decision-making-for-carotid-endarterectomy-versus-stenting-in-the-very-elderly
#10
REVIEW
Sung Hyuk Heo, Cheryl D Bushnell
As the population ages worldwide, the number of elderly patients with carotid stenosis is also increasing. There have been many large clinical trials comparing carotid endarterectomy (CAE) versus stenting, but the inclusion criteria (i.e., symptomatic or asymptomatic), stenting methods (i.e., protection device), and primary end point (i.e., the definition of myocardial infarction and follow-up period) were different between trials. Therefore, the interpretation of those results is difficult and requires attention...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28597323/stent-induced-flow-disturbances-in-the-ipsilateral-external-carotid-artery-following-internal-carotid-artery-stenting-a%C3%A2-temporary-cause-of-jaw-claudication
#11
Georgiana-Aura Giurgea, Markus Haumer, Irene Mlekusch, Schila Sabeti-Sandor, Petra Dick, Martin Schillinger, Erich Minar, Wolfgang Mlekusch
BACKGROUND: We hypothesize that stenting of the internal carotid artery can immediately impede blood flow to the external carotid artery by either plaque shift or stent coverage of the ostium, and thereby cause ischemic symptoms like ipsilateral jaw claudication. METHODS: Thirty-three patients with high-grade asymptomatic stenosis of the internal carotid artery who underwent endovascular treatment were examined by ultrasound of the external carotid artery and performed an exercise test by chewing chewing gum synchronously to an electronic metronome for 3 min...
June 9, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28596038/predictors-of-30-day-postoperative-major-adverse-clinical-events-after-carotid-artery-stenting-an-analysis-of-the-procedure-targeted-american-college-of-surgeons-national-surgical-quality-improvement-program
#12
Kyla M Bennett, John R Hoch, John E Scarborough
BACKGROUND: Information about carotid artery stenting (CAS) is largely derived from clinical trials, consensus statements, and outcomes comparisons between CAS and carotid endarterectomy. Given these limitations, the goal of this study was to identify risk factors for adverse outcomes after CAS among hospitals participating in the CAS-targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). METHODS: Our study sample consisted of patients from the 2012 to 2015 CAS-targeted ACS NSQIP data set...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28594333/quantification-of-carotid-artery-plaque-stability-with-multiple-region-of-interest-based-ultrasound-strain-indices-and-relationship-with-cognition
#13
Nirvedh Meshram, Tomy Varghese, Carol Mitchell, Daren Jackson, Stephanie Wilbrand, Bruce Hermann, Robert Dempsey
Vulnerability and instability in carotid artery plaque has been assessed based on strain variations using noninvasive ultrasound imaging. We previously demonstrated that carotid plaques with higher strain indices in a region of interest (ROI) correlated to patients with lower cognition, probably due to cerebrovascular emboli arising from these unstable plaques. This work attempts to characterize the strain distribution throughout the entire plaque region instead of being restricted to a single localized ROI...
June 8, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28585065/the-right-vertebral-artery-originating-from-the-right-occipital-artery-and-the-absence-of-the-transverse-foramen-a-rare-anatomical-variation
#14
Zülal Öner, Serkan Öner, Ayşegül Sağır Kahraman
Variations in the origin of the vertebral artery (VA) is a congenital anomaly that occurs during embryological development. Multiple variations related to VA origin have been reported in the literature. Abnormal VA origin is usually determined as incidental findings during angiographic or postmortem anatomical studies. Although most of the cases are asymptomatic, in patients with VA anomaly symptoms such as dizziness have been described. The anomalous variation in the origin of the right VA is rare and separated into three categories: (1) originating from the aorta, (2) originating from the carotid arteries, (3) duplicated origin...
June 5, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28583737/development-of-a-validated-model-to-predict-30-day-stroke-and-1-year-survival-after-carotid-endarterectomy-for-asymptomatic-stenosis-using-the-vascular-quality-initiative
#15
Randall R DeMartino, Benjamin S Brooke, Dan Neal, Adam W Beck, Mark F Conrad, Shipra Arya, Sapan Desai, Faisal Aziz, Patrick Ryan, Jack L Cronenwett, Larry W Kraiss
OBJECTIVE: Carotid endarterectomy (CEA) has been shown to be an effective treatment for patients with asymptomatic carotid artery stenosis when perioperative stroke rates are low and patients survive long enough to benefit from the intervention. Our objective was to develop and to validate a simple risk prediction model for 30-day stroke and 1-year mortality to guide optimal selection of patients for CEA. METHODS: Asymptomatic patients undergoing first-time elective CEA within the Vascular Quality Initiative (VQI) from 2010 to 2015 were selected...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28577790/impact-of-provider-characteristics-on-outcomes-of-carotid-endarterectomy-for-asymptomatic-carotid-stenosis-in-new-york-state
#16
Andrew J Meltzer, Christopher Agrusa, Peter H Connolly, Darren B Schneider, Art Sedrakyan
OBJECTIVE: (s)The purpose of this study was to explore the impact of surgeon characteristics (including annual volume, specialty, and years in practice) on outcomes of carotid endarterectomy (CEA) for asymptomatic carotid atherosclerosis in New York State. METHODS: The New York Statewide Planning and Cooperation System (SPARCS) database was utilized to identify patients undergoing CEA from 2004-2011. Provider characteristics were determined by linkage to the New York Office of Professions and National Provider Identification databases...
May 31, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28576528/endovascular-management-of-iatrogenic-cervical-internal-carotid-artery-pseudoaneurysm-in-a-9-year-old-child-case-report-and-literature-review
#17
Martín Pinzón, Nelson Oswaldo Lobelo, María Claudia Rodríguez, Perla Villamor, Ana María Otoya
Extracranial internal carotid artery (ICA) pseudoaneurysms are uncommon in the pediatric population and are usually secondary to direct trauma to the vessel. Treatment options include surgery (ligation), anticoagulation therapy and endovascular treatment. Endovascular covered stents have shown good results in adult populations, resulting in occlusion of the aneurysm and preservation of the artery without significant complications. However, there have been only limited reports in the literature reporting endovascular carotid stent placement in the pediatric population...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28576484/signs-of-subclinical-atherosclerosis-in-asymptomatic-patients-at-increased-risk-of-type-2-diabetes-mellitus
#18
Loretta Zsuzsa Kiss, Zsolt Bagyura, Réka Vadas, Lívia Polgár, Árpád Lux, Eszter Édes, Orsolya Szenczi, Pál Soós, Zsolt Szelid, Dávid Becker, György Jermendy, Béla Merkely
AIMS: We aimed to study carotid intima media thickness (CIMT) in asymptomatic patients with an increased risk of type 2 diabetes mellitus (T2DM) and in a pre-diabetic state. METHODS: Diabetes risk assessment was performed in 2420 participants in a voluntary screening program between 2011 and 2013. The risk of T2DM was estimated by the Findrisc scoring system (FR). A FR≥12 was considered as increased risk. HbA1c% between 5.7 and 6.4% signified a pre-diabetic state...
May 25, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28575478/the-preservation-of-cognition-1-yr-after-carotid-endarterectomy-in-patients-with-prior-cognitive-decline
#19
Robert J Dempsey, Daren C Jackson, Stephanie M Wilbrand, Carol C Mitchell, Sara E Berman, Sterling C Johnson, Nirvedh H Meshram, Tomy Varghese, Bruce P Hermann
BACKGROUND: Vascular cognitive decline is critically important in the course of atherosclerosis and stroke. OBJECTIVE: To explore the hypothesis that carotid endarterectomy (CEA) by removing an unstable plaque may slow the course of vascular cognitive decline in both symptomatic and asymptomatic patients. METHODS: Patients with clinically significant (>60%) carotid stenosis were studied preop and 1 yr post-CEA for clinical symptoms, vascular cognitive decline, instability of carotid plaque-presence of microemboli, brain white matter changes, and medical risk factors...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28566935/variations-in-echogenicity-in-carotid-and-femoral-atherosclerotic-plaques-with-pycnogenol%C3%A2-%C3%A2-centella-asiatica-supplementation
#20
Gianni Belcaro, Umberto Cornelli
This registry study evaluated echogenicity of carotid-femoral plaques in asymptomatic subjects with increased oxidative stress and risk factors (mild hypertension, hypercholesterolemia). Supplementation with the combination Pycnogenol-CA (centella asiatica) on the echogenicity of plaques was assessed at 6 months (79 subjects). A standard management (SM) plan was used in all subjects (control of risk factors, lifestyle changes); 36 subjects used the supplements +SM; 43 SM only. The groups were comparable. High-resolution ultrasound evaluated echogenicity and plaque structure...
June 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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