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Carotid angioplasty

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https://www.readbyqxmd.com/read/28918014/artificial-zinc-finger-transcription-factor-of-a20-suppresses-restenosis-in-sprague-dawley-rats-after-carotid-injury-via-the-ppar%C3%AE-pathway
#1
Zhaoyou Meng, Pan Gao, Lin Chen, Jing Peng, Jialu Huang, Min Wu, Kangning Chen, Zhenhua Zhou
The inhibition of inflammation and vascular smooth muscle cell (VSMC) proliferation is an ideal strategy to suppress intimal hyperplasia after percutaneous transluminal angioplasty (PTA). Evidence has indicated that overexpression of A20 suppresses neointima formation, but its low transfection efficiency limits its application. Hence, we upregulated A20 expression via transfection of rAd.ATF (recombinant adenovirus vector of artificial transcription factor) and rAd.A20 in rat carotid arteries after balloon dilatation (in vivo) and isolated VSMCs (in vitro)...
September 15, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28916863/intracerebral-hemorrhage-as-a-manifestation-of-cerebral-hyperperfusion-syndrome-after-carotid-revascularization-systematic-review-and-meta-analysis
#2
REVIEW
Pedro Abreu, Jerina Nogueira, Filipe Brogueira Rodrigues, Ana Nascimento, Mariana Carvalho, Ana Marreiros, Hipólito Nzwalo
BACKGROUND: Intracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. METHODS: We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization...
September 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28904796/endovascular-management-of-symptomatic-cerebral-aneurysm-thromboembolism-due-to-pre-aneurysmal-arterial-stenosis
#3
Torin Karsonovich, Ajeet Gordhan
BACKGROUND: Pre-aneurysmal internal carotid steno-occlusive disease resulting in cerebral intra-aneurysmal thrombosis and subsequent embolic infarction has not been previously described. CONCLUSION: Antithrombotic treatment for dissolution of the thrombus and pre-aneurysmal stent angioplasty followed by Pipeline embolization flow diverter placement through the aneurysm is a safe and feasible management option.
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28902823/-comparing-the-risks-for-the-development-of-perioperative-complications-in-carotid-endarterectomy-and-carotid-angioplasty
#4
R A Vinogradov, K A Lashevich, V S Pykhteev
The article is a literature review presenting a comparative analysis of 30-day risks of mortality and complications after carotid endarterectomy and carotid angioplasty with stenting. The risks studied were as follows: myocardial infarction, stroke, transitory ischaemic attacks, bradycardia, hypotension, postoperative haematomas, and damages to the craniocerebral nerves. The authors analysed a series of recently published foreign studies and meta-analyses dedicated to the problem concerned. The obtained findings revealed that carotid endarterectomy turned out to be associated with a higher perioperative risk for the development of myocardial infarction, postoperative haematomas and damages to the craniocerebral nerves, whereas carotid angioplasty with stenting appeared to be associated with an increased risk for the development of stroke, bradycardia and hypotension within the first 30 postoperative days...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28893763/pea-15-phosphoprotein-enriched-in-astrocytes-15-is-a-protective-mediator-in-the-vasculature-and-is-regulated-during-neointimal-hyperplasia
#5
Fiona H Greig, Simon Kennedy, George Gibson, Joe W Ramos, Graeme F Nixon
BACKGROUND: Neointimal hyperplasia following angioplasty occurs via vascular smooth muscle cell proliferation. The mechanisms involved are not fully understood but include mitogen-activated protein kinases ERK1/2 (extracellular signal-regulated kinases 1 and 2). We recently identified the intracellular mediator PEA-15 (phosphoprotein enriched in astrocytes 15) in vascular smooth muscle cells as a regulator of ERK1/2-dependent proliferation in vitro. PEA-15 acts as a cytoplasmic anchor for ERK1/2, preventing nuclear localization and thereby reducing ERK1/2-dependent gene expression...
September 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28887238/emergent-carotid-stent-removal-after-carotid-stent-thrombosis-surgical-technique
#6
Konstantinos G Moulakakis, Andreas Lazaris
OBJECTIVE: To present the technique for emergent removal of the thrombosed stent in acute carotid stent thrombosis in patients undergoing carotid artery angioplasty-stenting (CAS) BACKGROUND: Acute carotid stent thrombosis in patients undergoing CAS is a relatively rare and potentially devastating complication influencing significantly the quality of life. With the increasing use of stenting in clinical practice, it is expected to represent a more often encountered complication for physicians performing CAS...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28866638/prediction-of-hyperperfusion-phenomenon-after-carotid-artery-stenting-and-carotid-angioplasty-using-quantitative-dsa-with-cerebral-circulation-time-imaging
#7
Keita Yamauchi, Yukiko Enomoto, Katharina Otani, Yusuke Egashira, Toru Iwama
BACKGROUND: Hyperperfusion syndrome after carotid interventions has a low incidence but it can lead to morbidity and mortality. OBJECTIVE: To evaluate the usefulness of quantitative DSA for predicting hyperperfusion phenomenon (HPP) after carotid artery stenting and angioplasty. METHODS: Thirty-three consecutive patients with carotid stenosis treated with carotid artery stenting or angioplasty between February 2014 and August 2016 were included...
September 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28865944/false-ischaemic-penumbras-in-ct-perfusion-in-patients-with-carotid-artery-stenosis-and-changes-following-angioplasty-and-stenting
#8
A J Mosqueira, J M Pumar, S Arias, M Rodríguez-Yáñez, M Blanco Ulla, F Vázquez Herrero, J Castillo
INTRODUCTION: Carotid artery stenosis influences CT perfusion (CTP) studies, sometimes manifesting as a false ischaemic penumbra (FIP). This study aims to estimate the incidence of FIP in patients with carotid artery stenosis, establish their relationship with the degree of stenosis, and measure quantitative and qualitative changes in CTP after carotid angioplasty and stenting (CAS). METHODS: Between October 2013 and June 2015, we prospectively selected 26 patients with carotid stenosis who underwent CAS, with CTP being performed 2-10 days before and after CAS...
August 30, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28851839/inhibition-of-p110%C3%AE-pi3k-prevents-inflammatory-response-and-restenosis-after-artery-injury
#9
Antonio Bilancio, Barbara Rinaldi, Maria Antonietta Oliviero, Maria Donniacuo, Maria Gaia Monti, Amedeo Boscaino, Irene Marino, Lori Friedman, Francesco Rossi, Bart Vanhaesebroeck, Antimo Migliaccio
Inflammatory cells play key roles in restenosis upon vascular surgical procedures such as bypass grafts, angioplasty and stent deployment but the molecular mechanisms by which these cells affect restenosis remain unclear. The p110δ isoform of phosphoinositide 3-kinase (PI3K) is mainly expressed in white blood cells. Here, we have investigated whether p110δ PI3K is involved in the pathogenesis of restenosis in a mouse model of carotid injury, which mimics the damage following arterial grafts. We used mice in which p110δ kinase activity has been disabled by a knock-in (KI) point mutation in its ATP-binding site (p110δ(D910A/D910A) PI3K mice)...
August 29, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28832561/stent-based-delivery-of-adeno-associated-viral-vectors-with-sustained-vascular-transduction-and-inos-mediated-inhibition-of-in-stent-restenosis
#10
I Fishbein, D T Guerrero, I S Alferiev, J B Foster, N G Minutolo, M Chorny, A M Monteys, K H Driesbaugh, C Nagaswami, R J Levy
In-stent restenosis remains an important clinical problem in the era of drug eluting stents. Development of clinical gene therapy protocols for the prevention and treatment of in-stent restenosis is hampered by the lack of adequate local delivery systems. Herein we describe a novel stent-based gene delivery platform capable of providing local arterial gene transfer with adeno-associated viral (AAV) vectors. This system exploits the natural affinity of protein G (PrG) to bind to the Fc region of mammalian IgG, making PrG a universal adaptor for surface immobilization of vector-capturing antibodies (Ab)...
August 23, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28818824/clinical-impact-of-flat-panel-volume-ct-angiography-in-evaluating-the-accurate-intraoperative-deployment-of-flow-diverter-stents
#11
F Clarençon, F Di Maria, J Gabrieli, E Shotar, V Degos, A Nouet, A Biondi, N-A Sourour
BACKGROUND AND PURPOSE: The deployment of flow-diverter stents may be difficult to analyse on regular DSA. The purpose of our study was to investigate the clinical impact of stent-dedicated flat panel volume CT angiography to evaluate intraoperatively the satisfactory deployment of flow-diverter stents. MATERIALS AND METHODS: From January 2009 to April 2015, 83 consecutive patients (mean age, 51 years; 62 women) were treated in our institution with flow-diverter stents...
August 17, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28818256/will-mesh-covered-stents-help-reduce-stroke-associated-with-carotid-stent-angioplasty
#12
REVIEW
Carly N Richards, Peter A Schneider
Carotid stent angioplasty (CAS) has been shown to protect patient from future stroke long-term efficacy similar to carotid endarterectomy (CEA). The risk of minor stroke in the perioperative period is higher than with CEA and not related to cerebral protection during the CAS procedure since a significant portion of the neurologic events occur between 1 and 30 days following stent deployment. This observation suggests mechanisms integral to the stent itself may be pertinent such as plaque embolization thru the stent struts may occur...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28798785/simultaneous-vertebral-and-subclavian-artery-stenting
#13
Damian R Maciejewski, Łukasz Tekieli, Roman Machnik, Anna Kabłak-Ziembicka, Tadeusz Przewłocki, Piotr Paluszek, Mariusz Trystuła, Robert Musiał, Karolina Dzierwa, Piotr Pieniążek
INTRODUCTION: Vertebrobasilar territory ischemia leads to disabling neurological symptoms and may be caused both by vertebral artery (VA) and subclavian artery (SA) stenosis. The coexisting symptomatic ipsilateral VA and proximal SA stenosis should be considered as a true bifurcation lesion for percutaneous treatment. AIM: To evaluate the safety and efficacy of simultaneous angioplasty of vertebral and subclavian stenosis. MATERIAL AND METHODS: Fifteen patients (age 69...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28798140/the-hemoglobin-homolog-cytoglobin-in-smooth-muscle-inhibits-apoptosis-and-regulates-vascular-remodeling
#14
Frances L Jourd'heuil, Haiyan Xu, Timothy Reilly, Keneta McKellar, Chaymae El Alaoui, Julia Steppich, Yong Feng Liu, Wen Zhao, Roman Ginnan, David Conti, Reynold Lopez-Soler, Arif Asif, Rebecca K Keller, John J Schwarz, Le Thi Thanh Thuy, Norifumi Kawada, Xiaochun Long, Harold A Singer, David Jourd'heuil
OBJECTIVE: The role of hemoglobin and myoglobin in the cardiovascular system is well established, yet other globins in this context are poorly characterized. Here, we examined the expression and function of cytoglobin (CYGB) during vascular injury. APPROACH AND RESULTS: We characterized CYGB content in intact vessels and primary vascular smooth muscle (VSM) cells and used 2 different vascular injury models to examine the functional significance of CYGB in vivo. We found that CYGB was strongly expressed in medial arterial VSM and human veins...
August 10, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28797613/visual-aids-for-improving-patient-decision-making-in-severe-symptomatic-carotid-stenosis
#15
Sebastian Fridman, Gustavo Saposnik, Luciano A Sposato
BACKGROUND: Because of the large amount of information to process and the limited time of a clinical consult, choosing between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS) can be confusing for patients with severe symptomatic internal carotid stenosis (ICA). GOAL: We aim to develop a visual aid tool to help clinicians and patients in the decision-making process of selecting between CEA and CAS. MATERIALS AND METHODS: Based on pooled analysis from randomized controlled trials including patients with symptomatic and severe ICA (SSICA), we generated visual plots comparing CEA with CAS for 3 prespecified postprocedural time points: (1) any stroke or death at 4 months, and (2) any stroke or death in the first 30 days and ipsilateral stroke thereafter at 5 years and (3) at 10 years...
August 7, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28768800/factors-associated-with-time-to-site-activation-randomization-and-enrollment-performance-in-a-stroke-prevention-trial
#16
Bart M Demaerschalk, Robert D Brown, Gary S Roubin, Virginia J Howard, Eldina Cesko, Kevin M Barrett, Mary E Longbottom, Jenifer H Voeks, Seemant Chaturvedi, Thomas G Brott, Brajesh K Lal, James F Meschia, George Howard
BACKGROUND AND PURPOSE: Multicenter clinical trials attempt to select sites that can move rapidly to randomization and enroll sufficient numbers of patients. However, there are few assessments of the success of site selection. METHODS: In the CREST-2 (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trials), we assess factors associated with the time between site selection and authorization to randomize, the time between authorization to randomize and the first randomization, and the average number of randomizations per site per month...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28767806/extracranial-carotid-stenosis-evidence-based-review
#17
Carolina Dutra Queiroz Flumignan, Ronald Luiz Gomes Flumignan, Túlio Pinho Navarro
Extracranial cerebrovascular disease is one of the most important causes of death and disability worldwide and its treatment is based on clinical and surgical strategies, the latter being performed by conventional or endovascular techniques. The management of stenosis of the carotid bifurcation is mainly aimed at preventing stroke and has been the subject of extensive investigation. The role of clinical treatment has been re-emphasized, but carotid endarterectomy remains the first-line treatment for symptomatic patients with 50% to 99% stenosis and for asymptomatic patients with 60% to 99% stenosis...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28759844/circulating-soluble-receptor-for-advanced-glycation-end-product-cross-sectional-associations-with-cardiac-markers-and-subclinical-vascular-disease-in-older-men-with-and-without-diabetes
#18
S Goya Wannamethee, Paul Welsh, Olia Papacosta, Elizabeth A Ellins, Julian P J Halcox, Peter H Whincup, Naveed Sattar
BACKGROUND AND AIMS: The soluble receptor for advanced glycation end products (sRAGE) has been implicated in diabetic vascular complications. We have examined the association between sRAGE and cardiac markers [NT-proBNP and cardiac troponin T (cTnT)] and subclinical vascular markers in older men with and without diabetes. METHODS: We performed a cross-sectional study of 1159 men aged 71-92 years with no history of cardiovascular disease (myocardial infarction, stroke, heart failure, coronary artery bypass graft operation or angioplasty)...
September 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28739521/effective-intraluminal-shunt-in-carotid-endarterectomy-for-carotid-artery-near-occlusion-a-technical-report
#19
Yoichiro Kawamura, Daisuke Maruyama, Yojiro Akagi, Koji Iihara
BACKGROUND: Carotid artery near occlusion is a critical degree of stenosis whereby blood flow is decreased and the distal cervical and intracranial internal carotid arteries (ICAs) are prone to collapse. Considering the diminished perfusion and the risk of progression to total occlusion and periocclusive embolism, we performed carotid endarterectomy (CEA) for carotid artery near occlusion. METHODS: Accurate evaluation of tandem stenosis or patency of the post-stenotic ICA in carotid artery near occlusion is often difficult preoperatively...
July 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735256/comparison-of-multimodal-intra-arterial-treatment-versus-intravenous-thrombolysis-for-hypertensive-patients-with-severe-large-vessel-cerebral-infarction
#20
Zuojun Tian, Geng Liao, Shaoming Li, Yuechun Shen, Changbing Chen, Lei Liu, Yiheng Li
Since intravenous thrombolysis (IVT) is often associated with poor outcomes in hypertensive patients with severe acute cerebral infarction (ACI) due to occlusions of the internal carotid, basilar, or proximal middle cerebral artery, we evaluated whether multimodal intra-arterial treatment (IAT) might improve functional outcomes in this patient population. We retrospectively reviewed the charts of eligible patients who underwent multimodal IAT including intra-arterial thrombolysis, mechanical thrombectomy, balloon and/or stent angioplasty (IAT group) or IVT alone (IVT group)...
July 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
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