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Carotid Stenosis

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https://www.readbyqxmd.com/read/28446654/optimal-management-of-patients-with-asymptomatic-carotid-stenosis
#1
EDITORIAL
Robert M Starke
No abstract text is available yet for this article.
April 26, 2017: Neurology
https://www.readbyqxmd.com/read/28446652/asymptomatic-carotid-stenosis-medicine-alone-or-combined-with-carotid-revascularization
#2
REVIEW
Donald V Heck, Gary S Roubin, Kenneth G Rosenfield, William A Gray, Christopher J White, Tudor G Jovin, Jon S Matsumura, Brajesh K Lal, Barry T Katzen, Guilherme Dabus, Brian T Jankowitz, Thomas G Brott
Two positive randomized trials established carotid endarterectomy (CEA) as a superior treatment to medical management alone for the treatment of asymptomatic carotid artery stenosis. However, advances in medical therapy have led to an active and spirited debate about the best treatment for asymptomatic carotid stenosis. The Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis (CREST 2) trial aims to better define the best treatment for the average patient with severe asymptomatic carotid stenosis...
April 26, 2017: Neurology
https://www.readbyqxmd.com/read/28446650/asymptomatic-carotid-stenosis-why-a-moratorium-is-needed-on-intervention-outside-clinical-trials
#3
EDITORIAL
J David Spence
No abstract text is available yet for this article.
April 26, 2017: Neurology
https://www.readbyqxmd.com/read/28446644/body-mass-index-and-outcome-after-revascularization-for-symptomatic-carotid-artery-stenosis
#4
Eline J Volkers, Jacoba P Greving, Jeroen Hendrikse, Ale Algra, L Jaap Kappelle, Jean-Pierre Becquemin, Leo H Bonati, Thomas G Brott, Richard Bulbulia, David Calvet, Hans-Henning Eckstein, Gustav Fraedrich, John Gregson, Alison Halliday, George Howard, Olav Jansen, Gary S Roubin, Martin M Brown, Jean-Louis Mas, Peter A Ringleb
OBJECTIVE: To determine whether the obesity paradox exists in patients who undergo carotid artery stenting (CAS) or carotid endarterectomy (CEA) for symptomatic carotid artery stenosis. METHODS: We combined individual patient data from 2 randomized trials (Endarterectomy vs Angioplasty in Patients with Symptomatic Severe Carotid Stenosis and Stent-Protected Angioplasty vs Carotid Endarterectomy) and 3 centers in a third trial (International Carotid Stenting Study)...
April 26, 2017: Neurology
https://www.readbyqxmd.com/read/28446026/medical-therapy-before-carotid-endarterectomy
#5
Daniele Bissacco, Michele Carmo, Iacopo Barbetta, Raffaello Dallatana, Piergiorgio G Settembrini
We evaluated the evolution of chronic medical therapy in patients admitted for carotid endarterectomy (CEA) over a 13-year period and to analyze the difference in medical treatment between symptomatic and asymptomatic patients. A retrospective study was conducted on patients treated between 2002 and 2015. The use of antiplatelets (acetylsalicylic acid [ASA], ticlopidine, and clopidogrel), oral anticoagulant therapy (OAT), statins and antihypertensives (angiotensin-converting enzyme inhibitors [ACE-I]/angiotensin receptor blockers [ARBs], β-blockers [BB]) administration was evaluated...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28442515/genetic-polymorphisms-rs699947-rs1570360-and-rs3025039-on-the-vegf-gene-are-correlated-with-extracranial-internal-carotid-artery-stenosis-and-ischemic-stroke
#6
Binod Kumar Yadav, Renu Yadav, Hyuk Chang, Kangho Choi, Joon-Tae Kim, Man Seok Park, Hyun Goo Kang, Insung Choo, Seong Hwan Ahn, Dong Seok Oh, Yeon Soo Ha, Ihngyu Kim, Man-Wook Seo, Byoung-Soo Shin
Extracranial internal carotid artery (ECICA) stenosis is a modifiable risk factor of ischemic stroke. VEGF plays a crucial role in the maintenance of endothelial integrity and physiological function. This study was designed to assess the correlations of VEGF polymorphisms with ECICA stenosis in ischemic stroke and to explore the relationships between these polymorphisms and different biochemical parameters. This study included a total of 650 ischemic stroke patients, 232 with ECICA stenosis while 418 had no ECICA stenosis as assessed by magnetic resonance angiography...
March 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28442330/symptomatic-carotid-artery-disease-revascularization
#7
REVIEW
Piero Montorsi, Stefano Galli, Paolo M Ravagnani, Marco Roffi
Patients with symptomatic carotid artery disease should be managed by a multidisciplinary team including neurologists, vascular surgeons and interventionalists. Duplex ultrasound is the most widely used diagnostic modality to assess carotid disease, followed by additional imaging tests (CT- or MR-angiography) to confirm the severity of the stenosis, detect brain lesions, and assess intracranial circulation as well as the supra-aortic anatomy. Although overall randomized trial results favored (CEA) over carotid artery stenting (CAS) in symptomatic patients, this was likely related to the insufficient expertise of the endovascular specialists in several of the trials...
April 22, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28439614/internal-carotid-artery-stenosis-and-collateral-recruitment-in-stroke-patients
#8
Jan W Dankbaar, Kelly G P Kerckhoffs, Alexander D Horsch, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
PURPOSE: Leptomeningeal collaterals improve outcome in stroke patients. There is great individual variability in their extent. Internal carotid artery (ICA) stenosis may lead to more extensive recruitment of leptomeningeal collaterals. The purpose of this study was to evaluate the association of pre-existing ICA stenosis with leptomeningeal collateral filling visualized with computed tomography perfusion (CTP). METHODS: From a prospective acute ischemic stroke cohort, patients were included with an M1 middle cerebral artery (MCA) occlusion and absent ipsilateral, extracranial ICA occlusion...
April 24, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28438895/the-casper-carotid-artery-stent-a-unique-all-metal-micromesh-stent-designed-to-prevent-embolic-release
#9
Orlando Diaz, Gloria Lopez, John O F Roehm, Ginna De la Rosa, Fernando Orozco, Rafael Almeida
BACKGROUND: Stroke due to the release of embolic debris during the placement of a stent to correct carotid artery stenosis is a constant procedural and peri-procedural threat. The new all metal Casper stent has been created with two layers of nitinol, the inner layer of which has pores diminutive enough to prevent embolic release. OBJECTIVE: To evaluate the safety, effectiveness, and utility of the double layer nitinol Casper carotid artery stent in the treatment of patients with severe carotid artery stenosis...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28436315/restenosis-after-carotid-artery-stenting
#10
Zhengze Dai, Gelin Xu
As a common etiology for ischemic stroke, atherosclerotic carotid stenosis has been targeted by vascular surgery since 1950s. Compared with carotid endarterectomy, carotid angioplasty and stenting (CAS) is almost similarly efficacious and less invasive. These advantages make CAS an alternative in treating carotid stenosis. However, accumulative evidences suggested that the long-term benefit-risk ratio of CAS may be decreased or even neutralized by the complications related to in-stent restenosis (ISR). Therefore, investigating the mechanisms and identifying the influential factors of ISR are of vital importance for improving the long-term outcomes of CAS...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28434816/co-existing-arterial-pathology-stenosis-and-aneurysm-in-carotid-territory-to-worry
#11
A B Crichton, S Rajagopalan
No abstract text is available yet for this article.
April 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28432519/carotid-plaque-with-expansive-arterial-remodeling-is-a-risk-factor-for-ischemic-complication-following-carotid-artery-stenting
#12
Daina Kashiwazaki, Naoya Kuwayama, Naoki Akioka, Kyo Noguchi, Satoshi Kuroda
BACKGROUND: Carotid artery stenting (CAS) is associated with a higher risk of periprocedural stroke than carotid endarterectomy. For better patient selection, more accurate risk factors should be identified. The aim of this study was to determine whether expansive arterial remodeling can predict ischemic complications in patients undergoing CAS. METHODS: This retrospective study included 82 patients with carotid stenosis treated by CAS. The plaque component was evaluated using MR plaque imaging before the procedure...
April 21, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28431773/atypical-moyamoya-syndrome-with-brain-calcification-and-stenosis-of-abdominal-aorta-and-renal-arteries
#13
Hideki Uchikawa, Katsunori Fujii, Mayuko Fujita, Tomoko Okunushi, Naoki Shimojo
Moyamoya syndrome is a progressive cerebrovascular disease that is characterized by stenosis of the terminal portion of the internal carotid artery and its main branches, in combination with an accompanying disease. We herein describe an 8-year-old boy exhibiting transient loss of consciousness, who had recurrent seizures in infancy with progressive brain calcification. On admission, he was alert but magnetic resonance angiography showed bilateral stenosis of the whole internal carotid artery and proliferation of vascular collaterals, and brain CT revealed calcification on bilateral putamen...
April 18, 2017: Brain & Development
https://www.readbyqxmd.com/read/28431600/assessment-of-on-treatment-platelet-reactivity-and-relationship-with-cerebral-micro-embolic-signals-in-asymptomatic-and-symptomatic-carotid-stenosis
#14
Justin A Kinsella, W Oliver Tobin, Sean Tierney, Timothy M Feeley, Bridget Egan, Tara Coughlan, D Ronan Collins, Desmond O'Neill, Joseph A Harbison, Colin P Doherty, Prakash Madhavan, Dermot J Moore, Sean M O'Neill, Mary-Paula Colgan, Maher Saqqur, Raymond P Murphy, Niamh Moran, George Hamilton, Dominick J H McCabe
INTRODUCTION: The relationship between on-treatment platelet reactivity and cerebral micro-embolic signals (MES) is unknown, and has not been previously simultaneously assessed in asymptomatic and symptomatic carotid stenosis patients. METHODS: Consecutive eligible patients with ≥50% asymptomatic or recently symptomatic carotid stenosis (≤4weeks following TIA/ischaemic stroke) were recruited to this pilot study. Symptomatic patients were followed up to the 'late' phase (≥3months) following symptom onset or carotid intervention; longitudinal data were analysed from symptomatic patients with data available at both time-points...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28429599/lipoprotein-associated-phospholipase-a2-and-risk-of-carotid-atherosclerosis-and-cardiovascular-events-in-community-based-older-adults-in-china
#15
Chunxiu Wang, Xianghua Fang, Yang Hua, Yutong Liu, Zhongying Zhang, Xiang Gu, Xiaoguang Wu, Zhe Tang, Shaochen Guan, Hongjun Liu, Beibei Liu, Xiuhai Guo, Xunming Ji
We explored the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and carotid atherosclerosis with all phenotypes and cardiovascular disease (CVD) events in Chinese older adults. A total of 1257 adults aged ≥55 years who were free of CVD were enrolled in this cohort study. Lipoprotein-associated phospholipase A2 level was evaluated in 3 categories: Lp-PLA2 < 175, 175≤ Lp-PLA2 < 223, and Lp-PLA2 ≥ 223 ng/mL. The highest level of Lp-PLA2 was independently associated with common carotid artery intima-media thickening (≥1...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28427600/carotid-artery-stenting-investigation-of-plaque-protrusion-incidence-and-prognosis
#16
Masashi Kotsugi, Katsutoshi Takayama, Kaoru Myouchin, Takeshi Wada, Ichiro Nakagawa, Hiroyuki Nakagawa, Toshiaki Taoka, Shinichiro Kurokawa, Hiroyuki Nakase, Kimihiko Kichikawa
OBJECTIVES: This study sought to clarify the incidence and prognosis of PP in carotid artery stenting (CAS). BACKGROUND: Projections thought to be plaque may be observed inside the stent on angiography or intravascular ultrasound (IVUS) during CAS. Known as plaque protrusion (PP), the incidence and prognosis of this complication are unclear. METHODS: A total of 354 consecutive carotid atherosclerotic stenoses in 328 patients (285 men, 43 women; age range 51 to 97 years [mean age 73...
April 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28424133/carotid-duplex-ultrasonography-additional-imaging-is-rarely-necessary-for-appropriate-treatment-planning-for-carotid-artery-disease
#17
Chad P Ammar, Stephen D Helmer, Alex D Ammar
This study was conducted to determine the utility of multiple imaging studies (CT angiography, magnetic resonance angiography, and/or conventional angiography), in addition to duplex ultrasonography (DU), in evaluating patients with carotid stenosis. A retrospective case series was conducted of patients with carotid stenosis who underwent DU alone or DU plus additional imaging. Concordance between DU and additional imaging and the effect on treatment plan was evaluated. Two hundred patients with carotid stenosis were evaluated...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28420337/right-aortic-arch-analysis-anatomical-variant-or-serious-vascular-defect
#18
Agata Arazińska, Michał Polguj, Konrad Szymczyk, Magdalena Kaczmarska, Łukasz Trębiński, Ludomir Stefańczyk
BACKGROUND: The right-sided aortic arch (RAA) is a rare congenital defect of the aorta. The aim of the study was to assess the occurrence of RAA in diagnoses performed by the University Radiology Department and analyze the frequency of concomitant vascular abnormalities. METHODS: The database of the Radiology Department was retrospectively analyzed between January 2008 and May 2016 with the keyword "right aortic arch". Twenty patients with this diagnosis were identified from a total of 11,690 CT examinations of the chest area, 19,623 CT examinations of brain-supplying vessels, and 1863 MRI examinations of the heart and aortic arch or brain-supplying arteries...
April 19, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28417663/is-neck-dissection-associated-with-an-increased-risk-of-postoperative-stroke
#19
John D Cramer, Urjeet A Patel, Matthew B Maas, Sandeep Samant, Stephanie Shintani Smith
Objective Prior studies have reported widely disparate rates of postoperative stroke, with conflicting analyses of whether neck dissection is an independent risk factor. Study Design Cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2013. Subjects and Methods We compared the 30-day rate of postoperative stroke between patients undergoing complete or modified radical neck dissection and a control cohort composed of those undergoing resections in the oral cavity, oropharynx, larynx, or hypopharynx without neck dissection...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416412/successful-treatment-of-symptomatic-intracranial-carotid-artery-stenosis-using-a-24-mm-long-bare-metal-coronary-stent
#20
Azeem A Rehman, Ryan C Turner, Brandon P Lucke-Wold, SoHyun Boo
BACKGROUND: Intracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis. CASE DESCRIPTION: We present a case of a 42-year-old male with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management...
April 14, 2017: World Neurosurgery
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