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https://www.readbyqxmd.com/read/29349384/acute-hemifacial-ischemia-as-a-late-complication-of-carotid-stenting
#1
Maurizio Domanin, Maurizio Isalberti, Silvia Romagnoli, Antonio Rolli, Simona Sommaruga
Concerns about carotid artery stenting (CAS) center primarily on procedural complications like acute occlusion, stroke, and long-term intrastent restenosis. External carotid artery (ECA) thrombosis is observed during CAS follow-up, but it often remains asymptomatic or, at worst, results in jaw claudication. We report here a case of late occlusion of the ECA after CAS with symptoms of acute homolateral facial ischemia as well as pain, cyanosis, tongue numbness, and skin coldness. The patient was submitted to local thrombolysis and balloon angioplasty with regression of symptoms after recanalization...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29334161/the-role-of-neurosonology-in-the-diagnosis-and-management-of-patients-with-carotid-artery-disease-a-review
#2
REVIEW
Odysseas Kargiotis, Apostolos Safouris, Georgios Magoufis, Maria Georgala, Andromachi Roussopoulou, Eleftherios Stamboulis, Konstantinos G Moulakakis, Andreas Lazaris, George Geroulakos, Spyros Vasdekis, Georgios Tsivgoulis
Carotid artery disease (CAD) is a common cause of ischemic stroke with high rates of recurrence. Carotid endarterectomy (CEA) or carotid artery stenting (CAS) are highly recommended for the secondary prevention of symptomatic CAD during the first 14 days following the index event of transient ischemic attack or minor stroke. CEA or CAS may also be offered in selected cases with severe asymptomatic stenosis. Herein, we review the utility of neurosonology in the diagnosis and pre-/peri-interventional assessment of CAD patients who undergo carotid revascularization procedures...
January 15, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29331613/internal-carotid-artery-web-as-the-cause-of-recurrent-cryptogenic-ischemic-stroke
#3
Jon Antigüedad-Muñoz, Patricia de la Riva, Gorka Arenaza Choperena, Amaia Muñoz Lopetegi, Naiara Andrés Marín, Gorka Fernández-Eulate, Manuel Moreno Valladares, Maite Martínez Zabaleta
Carotid artery web is considered an exceptional cause of recurrent ischemic strokes in the affected arterial territory. The underlying pathology proposed for this entity is an atypical fibromuscular dysplasia. We present the case of a 43-year-old woman with no cardiovascular risk factors who had experienced 2 cryptogenic ischemic strokes in the same arterial territory within an 11-month period. Although all diagnostic tests initially yielded normal results, detailed analysis of the computed tomography angiography images revealed a carotid web; catheter angiography subsequently confirmed the diagnosis...
January 10, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29329733/association-between-leukoaraiosis-and-cerebral-blood-flow-territory-alteration-in-asymptomatic-internal-carotid-artery-stenosis
#4
Y-F Chen, Y-S Kuo, W-C Wu, S-C Tang, S-F Jiang
AIM: To test the hypothesis that leukoaraiosis (also known as white matter lesion) is associated with cerebral blood flow territory change as revealed by territorial arterial spin-labeling (TASL) magnetic resonance imaging (MRI) in patients with asymptomatic internal carotid artery stenosis (aICAS). MATERIALS AND METHODS: The institutional review board approved this study. Thirty-three patients with aICAS were included prospectively and divided into high-grade (ultrasonographic stenosis ≥70%, n=17) and low-grade (n=16) groups; 16 healthy subjects were also included...
January 9, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29328001/gamma-knife-radiosurgery-of-saccular-aneurysms-in-a-rabbit-model
#5
Mark D Meadowcroft, Timothy K Cooper, Sebastian Rupprecht, Thaddeus C Wright, Elizabeth E Neely, Michele Ferenci, Weimin Kang, Qing X Yang, Robert E Harbaugh, James R Connor, James McInerney
OBJECTIVE Intracranial aneurysms are vascular abnormalities associated with neurological morbidity and mortality due to risk of rupture. In addition, many aneurysm treatments have associated risk profiles that can preclude the prophylactic treatment of asymptomatic lesions. Gamma Knife radiosurgery (GKRS) is a standard treatment for trigeminal neuralgia, tumors, and arteriovenous malformations. Aneurysms associated with arteriovenous malformations have been noted to resolve after treatment of the malformation...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29326378/the-casper-stent-system-for-carotid-artery-stenosis
#6
Sebastian J Mutzenbach, Katharina Millesi, Cornelia Roesler, Erasmia Broussalis, Slaven Pikija, Johann Sellner, Lukas Machegger, Christoph J Griessenauer, Monika Killer-Oberpfalzer
PURPOSE: To report the results of a retrospective analysis of prospectively collected data evaluating the safety and efficacy of a double layer stent engineered for carotid artery occlusive disease. METHODS: Between January 2014 and February 2017, 138 patients (25.4% women; median age 71 years) underwent Casper stent implantation for carotid artery stenosis. Eligibility criteria included stenosis >70% of vessel diameter (or >50% diameter with ulceration) in symptomatic patients or asymptomatic patients with >80% stenosis at the carotid bifurcation or in the proximal internal carotid artery...
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29317141/serum-levels-of-osteopontin-predict-major-adverse-cardiovascular-events-in-patients-with-severe-carotid-artery-stenosis
#7
Federico Carbone, Fabio Rigamonti, Fabienne Burger, Aline Roth, Maria Bertolotto, Giovanni Spinella, Bianca Pane, Domenico Palombo, Aldo Pende, Aldo Bonaventura, Luca Liberale, Alessandra Vecchié, Franco Dallegri, François Mach, Fabrizio Montecucco
BACKGROUND: Inflammatory mediators in the blood stream and within plaques are key determinants in atherogenesis. Here, we investigated serum osteopontin (OPN) as a potential predictor of poor outcome in patients with severe carotid atherosclerosis. METHODS: Carotid plaques and serum were collected from patients asymptomatic (n=185) or symptomatic (n=40) for ischemic stroke. Plaques were stained for lipids, smooth muscle cells, neutrophils, M1 and M2 macrophage subsets and matrix metallopropteinase-9 (MMP-9)...
January 5, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29315509/carotid-plaque-volume-in-patients-undergoing-carotid-endarterectomy
#8
S Ball, S Rogers, K Kanesalingam, R Taylor, E Katsogridakis, C McCollum
BACKGROUND: The main indication for carotid endarterectomy (CEA) is severity of carotid artery stenosis, even though most strokes in carotid disease are embolic. The relationship between carotid plaque volume (CPV) and symptoms of cerebral ischaemia, and the measurement of CPV by minimally invasive tomographic ultrasound imaging, were investigated. METHODS: The volume of the endarterectomy specimen was measured using a validated saline suspension technique in patients undergoing CEA...
January 8, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29280189/adiponectin-concentration-data-improve-the-estimation-of-atherosclerotic-risk-in-normal-and-in-overweight-subjects
#9
Adriana Bertolami, José C de Lima-Júnior, Riobaldo M Cintra, Luiz S Carvalho, Carolina de C Gonzaga, Martha L Sulzbach, Ana C G P Petisco, José E M Barbosa, André A Faludi, Jorge Plutzky, Marcelo C Bertolami, Andrei C Sposito
BACKGROUND: The combinations of adipokines and body mass parameters to estimate carotid atherosclerotic disease have not been completely delineated. OBJECTIVE: To test the combinations of well-established, easily accessible body mass indices and circulating biomarkers to identify increased carotid intima-media thickness (cIMT) in a primary prevention setting. DESIGN AND PATIENTS: In a cross-sectional analysis of 339 asymptomatic individuals with no history of cardiovascular events, inflammatory and insulin sensitivity biomarkers as well as adipokine levels were measured and combined with body mass parameters to evaluate the best marker for increased cIMT...
December 27, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/29279888/prevalence-of-systemic-atherosclerosis-burdens-and-overlapping-stroke-etiologies-and-their-associations-with-long-term-vascular-prognosis-in-stroke-with-intracranial-atherosclerotic-disease
#10
Takao Hoshino, Leila Sissani, Julien Labreuche, Gregory Ducrocq, Philippa C Lavallée, Elena Meseguer, Céline Guidoux, Lucie Cabrejo, Cristina Hobeanu, Fernando Gongora-Rivera, Pierre-Jean Touboul, Philippe Gabriel Steg, Pierre Amarenco
Importance: Patients who have experienced stroke with intracranial atherosclerotic disease (ICAD) may also have concomitant atherosclerosis in different arterial beds and other possible causes for ischemic stroke. However, little is known about the frequency and prognostic effect of such overlapping diseases. Objectives: To describe the prevalence of systemic atherosclerotic burdens and overlapping stroke etiologies and their contributions to long-term prognoses among patients who have experienced stroke with ICAD...
December 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29273535/primary-versus-secondary-mechanical-thrombectomy-for-anterior-circulation-stroke-in-children-an-update
#11
REVIEW
Manuel Cappellari, Giuseppe Moretto, Andrea Grazioli, Giuseppe Kenneth Ricciardi, Paolo Bovi, Elisa Francesca Maria Ciceri
This review of the literature on the use of mechanical thrombectomy (MT) in children with acute ischemic stroke from occlusion of the internal carotid artery and the proximal middle cerebral artery (MCA) compares the efficacy and safety of primary and secondary MT. We analyzed the data reported for 24 case reports from 20 relevant articles published up to 31 December 2016 and the data of a patient treated at our institution. Eighteen cases received primary MT and 7 received secondary MT. The proportions of complete MCA recanalization, small infarcts, and asymptomatic intracranial hemorrhage were similar in both MT groups (73% [11/15] vs...
December 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29246640/computational-fluid-dynamic-comparison-between-patch-based-and-primary-closure-techniques-after-carotid-endarterectomy
#12
Maurizio Domanin, Daniele Bissacco, Davide Le Van, Christian Vergara
OBJECTIVE: The aim of the study was to provide, by means of computational fluid dynamics, a comparative analysis after carotid endarterectomy (CEA) between patch graft (PG) and primary closure (PC) techniques performed in real carotid geometries to identify disturbed flow conditions potentially involved in the development of restenosis. METHODS: Eight carotid geometries in seven asymptomatic patients who underwent CEA were analyzed. In six cases (A-F), CEA was performed using PG closure; in two cases (G and H), PC was performed...
December 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29240808/altered-cerebral-hemodyamics-and-cortical-thinning-in-asymptomatic-carotid-artery-stenosis
#13
Randolph S Marshall, Iris Asllani, Marykay A Pavol, Ying-Kuen Cheung, Ronald M Lazar
Cortical thinning is a potentially important biomarker, but the pathophysiology in cerebrovascular disease is unknown. We investigated the association between regional cortical blood flow and regional cortical thickness in patients with asymptomatic unilateral high-grade internal carotid artery disease without stroke. Twenty-nine patients underwent high resolution anatomical and single-delay, pseudocontinuous arterial spin labeling magnetic resonance imaging with partial volume correction to assess gray matter baseline flow...
2017: PloS One
https://www.readbyqxmd.com/read/29239051/coronary-and-carotid-atherosclerosis-in-asymptomatic-male-marathon-runners
#14
Christof Burgstahler, Hans Cipowicz, Christoph Thomas, Christoph Schabel, Stefanie Mangold, Dominik Ketelsen, Claus D Claussen, Andreas M Niess, Ilias Tsiflikas
The aim of the study was to evaluate the diagnostic accuracy of carotid ultrasound (CU) to predict coronary atherosclerosis in asymptomatic male marathon runners. A total of 49 male marathon runners older than 45 years(mean age 53.3±7.2 years, range 45-74 years) received CU and cardiac CT angiography(CTA) including calcium scoring(CS). Results of CU and CTA were classified binary: 1. Absence of atherosclerosis and 2. presence of atherosclerosis. The extend of atherosclerosis was not primary end-point of the study...
December 14, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29224941/open-surgery-versus-endovascular-approach-in-treatment-of%C3%A2-extracranial-carotid-artery-aneurysms
#15
Leng Ni, Huiling Weng, Zuo Pu, Yuehong Zheng, Bao Liu, Wei Ye, Rong Zeng, Changwei Liu
OBJECTIVE: The objective of this study was to investigate and to compare the early and long-term results of open surgery with endovascular intervention in the treatment of extracranial carotid artery aneurysms (ECCAs). METHODS: A retrospective review of patients diagnosed with ECCAs who underwent open surgical or endovascular treatment from 1997 to 2017 was performed. Clinical characteristics, aneurysm profile, and treatment outcomes were recorded. Early results (<30 days) were evaluated in terms of mortality, perioperative stroke or transient ischemic attack, and cranial nerve injury...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29217492/the-potential-role-of-ideal-mri-for-identification-of-lipids-and-hemorrhage-in-carotid-artery-plaques
#16
Faisal Khosa, Rachel E Clough, Xiaoen Wang, Ananth J Madhuranthakam, Robert L Greenman
Hemorrhage and lipid deposits contribute to instability in atherosclerotic plaques. Unstable carotid artery plaques can lead to cerebral ischemic events. While MRI studies have shown the ability to identify plaque components, the identification of hemorrhage and lipids has proven to be problematic. The purpose of this study was to quantitatively evaluate the potential of the MRI fat/water separation method known as iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL) to complement and improve existing methods for the identification of hemorrhage and lipids in carotid artery plaques...
December 4, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29217445/factors-that-predict-failure-to-meet-mips-quality-measures-for-asymptomatic-carotid-endarterectomy
#17
Anahita Dua, Steven Koprowski, Fadwa Ali, Sapan S Desai
INTRODUCTION: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services (CMS) financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measures 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008-2012...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29217437/carotid-endarterectomy-performed-before-the-weekend-is-associated-with-increased-length-of-stay
#18
Thomas W Cheng, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Myriam Castagne, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVE: Length of stay (LOS) is commonly used to gauge hospital resource utilization and can affect hospital profit margin. Other fields of surgery have showed that operations performed close to the weekend have longer LOS and higher patient morbidity. Our goal was to investigate whether asymptomatic patients undergoing elective carotid endarterectomy (CEA) earlier in the week had a shorter LOS and improved clinical outcomes compared to those treated before the weekend. METHODS: The Vascular Quality Initiative database was queried for elective weekday CEAs performed for asymptomatic carotid stenosis from 2005 to 2017...
December 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29205297/meta-analysis-of-the-procedural-risks-of-carotid-endarterectomy-and-carotid-artery-stenting-over-time
#19
REVIEW
K Lokuge, D D de Waard, A Halliday, A Gray, R Bulbulia, B Mihaylova
BACKGROUND: Stroke/death rates within 30 days of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in RCTs inform current clinical guidelines. However, the risks may have changed in recent years with wider use of effective stroke prevention therapies, especially statins, improved patient selection and growing operator expertise. The aim of this study was to investigate whether the procedural stroke/death risks from CEA and CAS have changed over time. METHODS: MEDLINE and Embase were searched systematically from inception to May 2016 for observational cohort studies of CEA and CAS...
December 4, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29198413/is-carotid-revascularization-worthwhile-in-patients-waiting-for-kidney-transplantation
#20
REVIEW
Peter Balaz, Petrut Gogalniceanu, Chris Callaghan
Renal failure and haemodialysis are associated with an increased risk of cardiovascular disease. Patients undergoing renal transplantation undergo rigorous pre-operative vascular assessment, including optimisation of risk factors for stroke. The indication for carotid intervention and the threshold for carotid endarterectomy in asymptomatic patients with incidental carotid disease has not been clarified in the context chronic kidney disease (CKD). This review aims to analyse outcomes following carotid endarterectomy in patients with CKD, in order to ascertain whether general guidelines for carotid artery revascularisation apply to this specific cohort...
November 16, 2017: Transplantation Reviews
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