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Carotid Stenosis

Jing Shi, Jialing Zhang, Meng Yin, Qian Wang, Jun Du
There is a large clinical requirement for novel vascular grafts; however, the development of novel vascular grafts has not been extremely successful to date. The most successful method for the continuous evaluation of vascular grafts in vivo remains unclear. Therefore, an optimal successive, non-invasive imaging modality is necessary for the study of vascular transplantation. In the present study, a common rabbit model of carotid artery defect was utilized. The patency and hemodynamic characteristics of implanted grafts was examined following surgery by color Doppler ultrasound in three modes, including B-mode, color flow map and pulse-Doppler examination...
April 2018: Experimental and Therapeutic Medicine
Chao Fu, Zhongxin Xu, Zhenzhen Hu, Shuai Yao, Fengmin Liu, Baiqi Feng, Conghai Zhao, Weidong Yu
Cerebral hyperperfusion syndrome (CHS) is a well-documented complication after carotid endarterectomy or stenting. In contrast, CHS following vertebral revascularization is extremely rare. Here we present a case of a 77-year-old man with high-grade vertebral stenosis who subsequently underwent balloon angioplasty, complicated by hemorrhagic CHS manifesting as cortical blindness, although strict postoperative blood pressure control was administered. To our knowledge, cortical blindness as a presentation of hemorrhagic CHS has not previously been reported...
March 21, 2018: Journal of Neurointerventional Surgery
W Z Pan, D X Zhou, X C Zhang, L Zhang, L Wei, J B Ge
Objective: To investigate the safety and efficacy of transcatheter aortic valve replacement(TAVR) through transcarotid approach for patients with severe aortic valve stenosis. Methods: The clinical data of 9 symptomatic severe aortic valve stenosis patients who had high or prohibitive risk for surgery and not suitable for TAVR through femoral artery access,and thus received TAVR through transcarotid approach in our hospital from November 2015 to February 2017 were retrospectively analyzed.The patients were followed up to observe the safety and efficacy of the procedure...
March 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Zhengze Dai, Jie Gao, Shun Li, Rongrong Li, Zhaoyao Chen, Meng Liang, Xinfeng Liu, Gelin Xu
BACKGROUND AND PURPOSE: Platelet aggregation plays a vital role in the development of in-stent restenosis (ISR) after carotid angioplasty and stenting (CAS). Mean platelet volume (MPV) has been suggested as an index of platelet reactivity. This study aimed to investigate the association between MPV and ISR in CAS patients. METHODS: A total of 261 patients with CAS were enrolled. MPV was measured before CAS procedure. Digital subtraction angiography, computed tomographic angiography, or duplex ultrasonography was performed at 6 months and annually after the procedure...
March 20, 2018: Stroke; a Journal of Cerebral Circulation
Likun Cui, Yanshuo Han, Shuai Zhang, Xun Liu, Jian Zhang
OBJECTIVE/BACKGROUND: A meta-analysis of recently published randomised controlled trials (RCTs) was performed to evaluate the safety of carotid artery stenting (CAS) versus carotid endarterectomy (CEA) for asymptomatic carotid stenosis with average risk. METHODS: The MEDLINE, Embase, and Cochrane Library databases were systematically searched for RCTs that compared CAS with CEA for asymptomatic carotid stenosis. These publications reported clinical outcomes after revascularisation in patients with asymptomatic carotid stenosis during their primary intervention...
March 17, 2018: European Journal of Vascular and Endovascular Surgery
Chi-Hung Liu, Tsong-Hai Lee, Pi-Yueh Chang, Chien-Hung Chang, Hsiu-Chuan Wu, Ting-Yu Chang, Kuo-Lun Huang, Chih-Kuang Cheng, Yeu-Jhy Chang
BACKGROUND: We hypothesized the inflammatory markers (IM) could be independent predictors of carotid stenosis progression (CSP) after carotid artery stenting (CAS). METHODS: Between 2010 and 2012, 122 patients undergoing cervicocranial revascularization in our hospital were prospectively recruited. Patients undergoing revascularizations other than CAS were excluded. Carotid duplex ultrasonography was performed before and at 1 week, 6 months (6M), 1 year, and 2 years after CAS...
March 19, 2018: Current Neurovascular Research
Hee Jin Kwon, Jae Hyeong Park, Jae Hwan Lee, Hye Seon Jeong, Hee Jung Song, Jei Kim, Mijoo Kim, In Sun Kwon, In Whan Seong
BACKGROUND AND OBJECTIVES: Neurologic intolerance (NI) is defined as the occurrence of neurological symptoms during carotid artery stenting (CAS). Because NI is inevitable problem, it may be helpful to anticipate its occurrence. So, we studied factors associated with NI during proximal protected CAS. METHODS: We retrospectively analyzed all consecutive patients underwent proximal protected CAS from August 2012 to January 2017. RESULTS: We included total 123 patients (109 males, 72±8 years old)...
March 2018: Korean Circulation Journal
Kathryn F Kirchoff-Torres, Ekaterina Bakradze
PURPOSE OF REVIEW: Cerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion. RECENT FINDINGS: CHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke...
March 19, 2018: Current Pain and Headache Reports
Yan Zhang, Hong Li, Yingqin Jia, Pengfei Yang, Feng Zhao, Wei Wang, Wenqing Liu, Guisheng Chen, Xiaoqing Zhuang, Juan Li
BACKGROUD: Vascular calcification is currently recognized as an important pathobiological process in atherosclerosis, but the mechanism remains elusive. Given the similarities in vascular calcification and bone formation,18 F-sodium fluoride (18 F-NaF) is now considered a novel marker of vascular calcification. This study aimed to correlate18 F-NaF accumulation with the histological characterization of vascular calcification in carotid plaques. METHODS: A total of 8 patients who were undergoing carotid endarterectomy (CEA) for carotid artery stenosis were recruited...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Concetta Irace, Salvatore De Rosa, Cesare Tripolino, Giuseppe Ambrosio, Caterina Covello, Ennio Abramo, Claudio Carallo, Annalisa Mongiardo, Carmen Spaccarotella, Daniele Torella, Agostino Gnasso, Ciro Indolfi
Endothelial dysfunction, wall thickening and plaque are progressive manifestations of atherosclerosis. Delayed or absent brachial artery dilation after ischemic stimulus has been associated with severity of extracoronary and coronary atherosclerosis. In the current study, we aimed to verify if delayed or absent dilation associates with critical coronary stenosis. We also evaluated the association between coronary stenosis, carotid artery wall thickness and peripheral artery disease. Endothelial function was investigated by flow-mediated dilation of the brachial artery up to 3 min after ischemia, and patients classified as early, late or no dilators...
March 17, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Ximeng Yang, Jun Lu, Junjie Wang, Lijun Wang, Peng Qi, Shen Hu, Kunpeng Chen, Daming Wang
Carotid stenosis (CS) and intracranial aneurysms (IAs) may concur in one person. We studied the prevalence of IAs in CS patients in our retrospectively collected database and systematically reviewed this issue. Five hundred and fifty-seven CS (≥50%) patients confirmed by DSA in our hospital from 2010-06 to 2015-06 were screened for coexistent IAs. After searching the related literatures from English and Chinese journal literature databases, a meta-analysis was performed to pool the prevalence of CS with coexistent IAs...
March 14, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hyunwook Kwon, Hong-Kyu Kim, Sun U Kwon, Seung-Whan Lee, Min-Ju Kim, Jee Won Park, Minsu Noh, Youngjin Han, Tae-Won Kwon, Yong-Pil Cho
This study aimed to test the hypothesis that the risk of major adverse cardiovascular events (MACE) is similar for subjects with asymptomatic mild and moderate carotid artery stenosis (CAS). We enrolled a total of 453 subjects with asymptomatic CAS (30-69%) detected on baseline screening Doppler ultrasound (DUS) examination between January 2008 and December 2010. The follow-up DUS findings and MACE occurrence (fatal or nonfatal myocardial infarction or stroke and all-cause mortality) were compared between subjects with mild (30-49%) and moderate (50-69%) CAS during the 8-year follow-up period...
March 16, 2018: Scientific Reports
Yamaan S Saadeh, Luis E Savastano, Julian L Gendreau, Aditya S Pandey
Optimal management of patients with stroke due to symptomatic carotid artery disease coexistent with bacterial endocarditis is still not well established. We report the case of a patient who presented with multifocal left middle cerebral artery stroke in the setting of Enterococcus faecalis endocarditis and was found to have near-occlusive ipsilateral carotid artery stenosis in stroke workup. Carotid artery endarterectomy was performed, and atheroma material demonstrated complicated plaque with cultures positive for E...
March 15, 2018: BMJ Case Reports
Chuanjie Wu, Chuanhui Li, Wenbo Zhao, Nanchang Xie, Feng Yan, Yajun Lian, Li Zhou, Xiaoya Xu, Yong Liang, Lu Wang, Ming Ren, Sijie Li, Xuan Cheng, Lu Zhang, Qingfeng Ma, Haiqing Song, Ran Meng, Xunming Ji
OBJECTIVES: To investigate whether the plasma level of trimethylamine N -oxide (TMAO), a proatherosclerotic intestinal microbiota metabolite, can be a predictor of ischemic brain injury secondary to carotid artery stenting (CAS). METHODS: In this multicenter, prospective cohort study, we enrolled patients with severe carotid artery stenosis (>70%) who were prepared for CAS. Plasma TMAO level was measured within 3 days before CAS, and MRI was performed 1 to 3 days after CAS...
March 14, 2018: Neurology
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Nupoor Narula, Daniella Kadian-Dodov, Jeffrey W Olin
Fibromuscular dyplasia (FMD) is an under-recognized non-atherosclerotic, non-inflammatory arteriopathy that occurs most commonly in middle-aged women, but may affect individuals of all age groups. FMD may result in stenosis, aneurysm, dissection, occlusion, or arterial tortuosity. Recently published data demonstrated a genetic association of FMD with a variant in the phosphatase and actin regulator 1 gene (PHACTR1), substantiating that the pathogenesis of this condition has genetic contribution. The renal and extracranial carotid and vertebral arteries are most often involved, although any arterial bed may be affected...
March 10, 2018: Progress in Cardiovascular Diseases
Zhu Zhang, Jun-Wei Gong, Ming Wen, Li-Qiang Zhang
Objective To assess the value of internal carotid artery stenosis in differentiating invasive pituitary adenoma (IPA) from invasive meningiomas (IM). Methods The clinical and imaging data of 28 IPA patients and 15 IM patients who were treated in our center from January 2012 to December 2016 were retrospectively analyzed. The magnetic resonance imaging (MRI) features were analyzed. The narrowest diameter (Dstenosis ) and area (Astenosis ) of internal carotid artery around the tumor were measured by computed tomography angiography (CTA),followed by the calculation of the stenosis score (%stenosis )...
February 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Dong Zhang, Pengcheng Xu, Hongyu Qiao, Xin Liu, Liangping Luo, Wenhua Huang, Heye Zhang, Changzheng Shi
BACKGROUND: Cerebrovascular events are frequently associated with hemodynamic disturbance caused by internal carotid artery (ICA) stenosis. It is challenging to determine the ischemia-related carotid stenosis during the intervention only using digital subtracted angiography (DSA). Inspired by the performance of well-established FFRct technique in hemodynamic assessment of significant coronary stenosis, we introduced a pressure-based carotid arterial functional assessment (CAFA) index generated from computational fluid dynamic (CFD) simulation in DSA data, and investigated its feasibility in the assessment of hemodynamic disturbance preliminarily using pressure-wired measurement and arterial spin labeling (ASL) MRI as references...
March 12, 2018: Biomedical Engineering Online
Yoko Kaneko, Takamoto Yanagawa, Yoshinori Taru, Sonoko Hayashi, Hong Zhang, Tomoki Tsukahara, Tsuneaki Matsunaga, Takashi Ishizu
INTRODUCTION: We describe a hemodialysis patient who developed subclavian steal syndrome via an arteriovenous fistula after percutaneous transluminal angioplasty. CASE DESCRIPTION: A 55-year-old female with end-stage renal failure due to polycystic kidney disease had been treated with hemodialysis for 10 years. Because of an autologous arteriovenous fistula stenosis, percutaneous transluminal angioplasty was performed. After successful treatment with percutaneous transluminal angioplasty, the patient developed dizziness...
March 1, 2018: Journal of Vascular Access
Kazumasa Tsuda, Norihiko Shiiya, Naoki Washiyama, Katsushi Yamashita, Kazuhiro Ohkura, Daisuke Takahashi, Yumi Kando, Kayoko Natsume, Ken Yamanaka, Yuki Takeuchi
OBJECTIVES: To prevent haemodynamic stroke during cardiovascular surgery in patients with carotid stenosis, we routinely evaluated magnetic resonance angiography and selectively evaluated brain perfusion single-photon emission computed tomography with acetazolamide challenge. Off-pump surgery was preferred when cerebral blood flow reserve was impaired. This strategy's usefulness was investigated. METHODS: Among the 1059 consecutive patients who underwent preoperative carotid screening by magnetic resonance angiography, 84 (7...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
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