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Carotid angioplasty

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https://www.readbyqxmd.com/read/28192264/balloon-angioplasty-for-in-stent-restenosis-resulting-in-carotid-stent-fracture-with-literature-review-of-stent-in-stent-technique-as-a-viable-therapeutic-option
#1
Abdul-Haseeb Naeem, Ghaya Al-Rumaihi, Amirpouyan Namavarian, Manas Sharma, Melfort Boulton
BACKGROUND: Carotid stent fractures are rare and multiple etiologies have been proposed to explain their occurrence. We present a patient with a internal carotid artery (ICA) stent who developed in-stent restenosis. We performed balloon angioplasty to address in-stent restenosis but post-procedure he developed a carotid stent fracture. To our knowledge, balloon angioplasty has not been reported to cause stent fractures and we report the first case report. CASE DESCRIPTION: 72-year-old male underwent stenting for symptomatic left ICA stenosis with post-stenting residual stenosis of 55%...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#2
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28188949/one-stage-angioplasty-and-stenting-of-ostium-of-left-common-carotid-artery-and-stenting-of-left-internal-carotid-artery
#3
Massoud Ghasemi, Maryam Mehrpooya, Farshad Ghasemi, Fatemeh Shahbazi
Our aim was to report techniques and our experience in One-stage angioplasty and stenting of ostium of left common carotid and left internal carotid arteries in an octogenarian man with transient ischemic attack, who was completely recovered from neurologic insults short time after the procedure. An 81-year-old man presented with a transient ischemic attack. Neurologic examination showed left side transient visual obscuration or amaurosis fugax and right hemiparesis. Carotid duplex imaging revealed an 80% stenosis of the left internal carotid artery (LICA) and 95 % of the ostium of left common carotid artery (left CCA)...
January 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28157058/fibromuscular-dysplasia-results-of-a-multicentre-study-in-flanders
#4
Marie De Groote, Patricia Van der Niepen, Dimitri Hemelsoet, Bert Callewaert, Frank Vermassen, Jean-Marie Billiouw, An De Vriese, Jan Donck, Tine De Backer
BACKGROUND: Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic vascular disease, resulting in focal narrowing of small and medium-sized arteries. Systematic recording of clinical data in central databases as in the US and France provided new insights into FMD. The main objectives of this multicentre study were to explore the epidemiology, pattern of vascular involvement, clinical manifestations, and management of FMD patients in Flanders. PATIENTS AND METHODS: Multicentre, retrospective registry of patients diagnosed with FMD based on medical imaging...
February 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28154099/stroke-caused-by-extracranial-disease
#5
Kevin M Barrett, Thomas G Brott
Extracranial internal carotid artery atherosclerotic occlusive disease is a common ischemic stroke mechanism. Vascular risk factor control remains the cornerstone of stroke prevention in patients with both asymptomatic and symptomatic carotid occlusive diseases. Intensive medical therapy refers to the contemporary approach of antiplatelet therapy, blood pressure control, low-density lipoprotein reduction, and lifestyle modification to reduce stroke risk. Carotid revascularization with endarterectomy or angioplasty and stenting are established treatments for patients with symptomatic carotid stenosis ≥70%...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28108499/relay-balloon-technique-for-recanalization-of-acute-symptomatic-proximal-internal-carotid-artery-occlusion-with-short-balloon-tipped-guiding-catheter-landing-zone
#6
Sang Hun Lee, Dong Geun Lee, Sun U Kwon, Deok Hee Lee
BACKGROUND: Endovascular recanalization of a completely occluded proximal internal carotid artery (ICA) with underlying stenosis may be challenging owing to a possible thrombotic component. This is especially true when the landing zone for a balloon-tipped guiding catheter (BGC) at the bulb portion is insufficient. Sequential application of the balloons of a BGC and an angioplasty catheter may prevent thromboembolism during revascularization. This study analyzed the safety and effectiveness of this relay-balloon technique...
January 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28069505/end-point-immobilization-of-heparin-on-plasma-treated-surface-of-electrospun-polycarbonate-urethane-vascular-graft
#7
Xuefeng Qiu, Benjamin Li-Ping Lee, Xinghai Ning, Niren Murthy, Nianguo Dong, Song Li
: Small-diameter synthetic vascular grafts have high failure rate due to primarily surface thrombogenicity, and effective surface chemical modification is critical to maintain the patency of the grafts. In this study, we engineered a small-diameter, elastic synthetic vascular graft with off-the-shelf availability and anti-thrombogenic activity. Polycarbonate-urethane (PCU), was electrospun to produce nanofibrous grafts that closely mimicked a native blood vessel in terms of structural and mechanical strength...
January 6, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28008262/kinetics-of-circulating-endothelial-progenitor-cells-in-patients-undergoing-carotid-artery-surgery
#8
Günay Kalender, Angela Kornberger, Milan Lisy, Andres Beiras-Fernandez, Ulrich A Stock
AIM: Endothelial progenitor cells (EPCs) are primitive cells found in the bone marrow and peripheral blood (PB). In particular, the potential of EPCs to differentiate into mature endothelial cells remains of high interest for clinical applications such as bio-functionalized patches for autologous seeding after implantation. The objective of this study was to determine EPCs' kinetics in patients undergoing carotid artery thromboendarterectomy (CTEA) and patch angioplasty. METHODS: Twenty CTEA patients were included (15 male, mean age 76 years)...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28004899/evidence-overview-benefit-of-cerebral-protection-devices-during-carotid-artery-stenting
#9
Jan A Vos
Embolic Protection Devices (EPD's) are often used during Carotid Angioplasty and Stenting (CAS) to reduce procedural cerebral emboli. This manuscript seeks to present an overview of evidence on EPD's during CAS. There are three categories of EPD's: Distal Occlusion (DO-EPD), Filter (F-EPD) and Proximal Occlusion (PO-EPD). DO and F-EPD's have the disadvantage that the device has to be advanced through the stenosis, without protection and that the device may damage the distal internal carotid artery (ICA). F-EPD's have the advantage of maintaining antegrade flow throughout the procedure...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27979488/testosterone-replacement-attenuates-intimal-hyperplasia-development-in-an-androgen-deficient-model-of-vascular-injury
#10
Brian M Freeman, Junior Univers, Richard K Fisher, Stacy S Kirkpatrick, Frederick A Klein, Michael B Freeman, Deidra J H Mountain, Oscar H Grandas
BACKGROUND: Androgen deficiency (AD) is associated with increased risk of vascular disease. Dysfunctional remodeling of the vessel wall and atypical proliferative potential of vascular smooth muscle cells (VSMCs) are fundamental processes in the development of intimal hyperplasia (IH). We have demonstrated an inverse relationship between dihydrotestosterone (DHT) levels, matrix metalloproteinase activity, and VSMC migration and proliferation in vitro. Here, we investigated the role of AD and testosterone (TST) replacement in IH development in an animal model of vascular injury to elucidate mechanisms modulated by AD that could be playing a role in the development of vascular pathogenesis...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27922251/endovascular-prevention-and-treatment-of-stroke-related-to-extracranial-carotid-artery-disease
#11
REVIEW
Leonardo Rangel-Castilla, Gary B Rajah, Hakeem J Shakir, Jason M Davies, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy, L Nelson Hopkins
Acute ischemic stroke (AIS) is the leading cause of premature mortality and morbidity worldwide for both men and women. Extracranial carotid artery stenosis/occlusion is responsible for approximately 11.5% of ischemic strokes, whereas extracranial large vessel disease comprises roughly 16.6% of ischemic strokes. Carotid artery disease has been the source of significant debate among neurovascular and cardiovascular specialists, as well as vascular surgeons, as to the best method of revascularization, surgical reconstruction versus endovascular recanalization...
February 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27916638/therapeutical-options-in-the-management-of-carotid-dissection
#12
Ombretta Martinelli, Salvatore Venosi, Jamila BenHamida, Alban Malaj, Cristina Belli, Francesco Giosue' Irace, Roberto Gattuso, Giacomo Frati, Bruno Gossetti, Luigi Irace
BACKGROUND: The best management of carotid artery dissection (CAD) is still controversial ranging from antiplatelet medication to open surgery or endovascular treatment. In this retrospective study, we assessed the safety and efficacy of endovascular stent angioplasty for the treatment of CAD. METHODS: From February 2006 to February 2016, 44 patients (28 women and 16 men, age range 25-65 years, mean 42) with CAD were included in this study. The internal carotid artery dissection was spontaneous in 32 patients and posttraumatic in the remaining 12 (in 1 case, it was bilateral)...
December 1, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27881699/multicenter-experience-of-surgical-explantation-of-carotid-stents-for-recurrent-stenosis
#13
MULTICENTER STUDY
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 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27871494/current-surgical-management-of-carotid-body-tumors
#14
Victor J Davila, James M Chang, William M Stone, Richard J Fowl, Thomas C Bower, Michael L Hinni, Samuel R Money
BACKGROUND: Carotid body tumors (CBTs) are rare. Management guidelines may include genetic testing for succinate dehydrogenase (SDH) mutations. We performed an institutional review of the surgical management of CBT. METHODS: A retrospective analysis (1994-2015) of CBT excisions at our institution was performed. Data obtained included demographics, genetic testing (if performed), intraoperative details, postoperative morbidity, and long-term outcomes. Data from the first CBT excision were included in patients with bilateral tumors...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27834754/impact-of-clinical-trial-results-on-the-temporal-trends-of-carotid-endarterectomy-and-stenting-from-2002-to-2014
#15
Mohamad A Hussain, Muhammad Mamdani, Jack V Tu, Gustavo Saposnik, Zeyad Khoushhal, Badr Aljabri, Subdoh Verma, Mohammed Al-Omran
BACKGROUND AND PURPOSE: Randomized trials provide conflicting data for the efficacy of carotid-artery stenting compared with endarterectomy. The purpose of this study was to examine the impact of conflicting clinical trial publications on the utilization rates of carotid revascularization procedures. METHODS: We conducted a population-level time-series analysis of all individuals who underwent carotid endarterectomy and stenting in Ontario, Canada (2002-2014). The primary analysis examined temporal changes in the rates of carotid revascularization procedures after publications of major randomized trials...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27827286/-hypertension-due-to-fibromuscular-dysplasia-look-for-additional-disease-sites
#16
M L Maas, J M Kroese, S J H Bredie, C T Postma, F E de Leeuw, L J Schultze Kool, N P Riksen
Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic vasculopathy that can lead to arterial stenosis, occlusion, aneurysms, and dissection. FMD of the renal arteries can lead to renovascular hypertension. Percutaneous angioplasty of the renal arteries (PTRA) can lead to normalization of blood pressure in 45% of patients with renal artery stenosis caused by FMD, particularly in younger patients and patients with a short history of hypertension. A considerable number of the patients with renovascular FMD also have cervical FMD, which can lead to ischaemic or haemorrhagic stroke...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27802835/evaluation-of-bilateral-central-retinal-artery-occlusions-with-optical-coherence-tomography-based-microangiography-a-case-report
#17
Aaron Y Lee, Qinqin Zhang, Douglas M Baughman, Raghu Mudumbai, Ruikang K Wang, Cecilia S Lee
BACKGROUND: We report a case of bilateral central retinal artery occlusion and the evaluation of retinal vasculature and capillaries by using optical coherence tomography angiography. CASE PRESENTATION: A 75-year-old white man presented with central retinal artery occlusion in one eye and underwent a carotid angioplasty. Upon discontinuing anticoagulant, he had a subsequent central retinal artery occlusion in the other eye. Optical coherence tomography angiography images were obtained to compare the retinal microvasculature in both eyes...
November 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27798328/cerebral-venous-sinuses-thrombosis-in-both-transverse-sinus-and-torcula-multistep-endovascular-treatment-and-stenting
#18
G Cabral de Andrade, A Lesczynsky, V M Clímaco, E R Pereira, P O Marcelino, Aoc Franco, D F De Almeida
Purpose Cerebral venous sinus thrombosis (CVST) is an unusual and potentially life-threatening condition with variable and nonspecific clinical symptoms and high morbimortality rates. Standard therapy consists of systemic anticoagulation; although there is no clear evidence about the best choice for treatment, intravenous heparin is used as the first-line treatment modality. Intravenous sinus thrombolysis can be an effective and relatively safe treatment for acutely deteriorating patients who have not responded to conventional therapy...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27792753/chemerin-stimulates-vascular-smooth-muscle-cell-proliferation-and-carotid-neointimal-hyperplasia-by-activating-mitogen-activated-protein-kinase-signaling
#19
Wei Xiong, Yu Luo, Lin Wu, Feng Liu, Huadong Liu, Jianghua Li, Bihong Liao, Shaohong Dong
Vascular neointimal hyperplasia and remodeling arising from local inflammation are characteristic pathogeneses of proliferative cardiovascular diseases, such as atherosclerosis and post angioplasty restenosis. The molecular mechanisms behind these pathological processes have not been fully determined. The adipokine chemerin is associated with obesity, metabolism, and control of inflammation. Recently, chemerin has gained increased attention as it was found to play a critical role in the development of cardiovascular diseases...
2016: PloS One
https://www.readbyqxmd.com/read/27777162/safety-and-efficacy-of-non-compliant-balloon-angioplasty-for-the-treatment-of-subarachnoid-hemorrhage-induced-vasospasm-a-multicenter-study
#20
Apar S Patel, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Paul M Foreman, Hussain Shallwani, Justin M Moore, Mark R Harrigan, Adnan H Siddiqui, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Cerebral vasospasm following subarachnoid hemorrhage (SAH) is the single most important cause of neurological decline following successful treatment of the ruptured aneurysm. Here, we report safety and efficacy of non-compliant balloon angioplasty for the treatment of cerebral vasospasm. METHODS: Three major academic institutions in the United States provided data on cerebral vasospasm treated with non-compliant balloon angioplasty between October 2004 and February 2016...
October 21, 2016: World Neurosurgery
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