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Intravascular ultrasound and internal carotid artery

Namita Kumari, Abadan Khan Amitava, Sardar Mohammed Akram, Shivani Grover
We report a case of a 20-year-old female having systemic hypertension who presented with right-sided proptosis, chemosis, and diminished vision, preceded by an acute episode of unilateral throbbing headache. Imaging studies revealed a right-sided direct, spontaneous carotid-cavernous fistula (CCF), aneurysm of internal carotid artery, bleed in the parieto-frontal lobe, and swelling of extraocular muscles. Abdominal ultrasound revealed a small contracted right kidney measuring 64 mm × 27 mm. A direct spontaneous CCF can occur spontaneously following rupture of intracranial aneurysm without any history of trauma or connective tissue disorder...
April 2016: Indian Journal of Ophthalmology
Tobias Saam, Maximilian Habs, Martin Buchholz, Andreas Schindler, Anna Bayer-Karpinska, Clemens C Cyran, Chun Yuan, Maximilian Reiser, Andreas Helck
BACKGROUND: Based on intravascular ultrasound of the coronary arteries expansive arterial remodeling is supposed to be a feature of the vulnerable atheroslerotic plaque. However, till now little is known regarding the clinical impact of expansive remodeling of carotid lesions. Therefore, we sought to evaluate the correlation of expansive arterial remodeling of the carotid arteries with atherosclerotic plaque composition and vulnerability using in-vivo Cardiovascular Magnetic Resonance (CMR)...
March 3, 2016: Journal of Cardiovascular Magnetic Resonance
Cyril Štěchovský, Petr Hájek, Martin Horváth, Miloslav Špaček, Josef Veselka
Limited insights into the pathophysiology of the atherosclerotic carotid stenosis are available in vivo. We conducted a prospective study to assess safety and feasibility of intravascular ultrasound (IVUS) combined with near-infrared spectroscopy (NIRS) in carotid arteries. In addition, we described the size and the distribution of lipid rich plaques in significant atherosclerotic carotid stenoses. In a prospective single centre study 45 consecutive patients (mean age 66 ± 8 years) with symptomatic (≥50 %) or asymptomatic (≥70 %) stenosis of internal carotid artery (ICA) amendable to carotid stenting were enrolled...
January 2016: International Journal of Cardiovascular Imaging
Woong Choi, Yu Na Kim, Kyung-Hee Kim
INTRODUCTION: Moyamoya disease is characterized by progressive steno-occlusive changes of the distal internal carotid and developed collateral vasculature, so called 'moyamoya' vessels at the base of the brain. Variant angina is a rare occurrence in patients with moyamoya disease. CASE PRESENTATION: Here we report the case of a 41-year-old Korean woman who developed chest pain after indirect revascularization surgery of moyamoya disease. A treadmill test and an exercise stress echocardiograph showed positive results, but there was no significant major coronary arteries stenosis...
2015: Journal of Medical Case Reports
Simon Morr, Ning Lin, Adnan H Siddiqui
Carotid artery stenting technologies are rapidly evolving. Options for endovascular surgeons and interventionists who treat occlusive carotid disease continue to expand. We here present an update and overview of carotid stenting devices. Evidence supporting carotid stenting includes randomized controlled trials that compare endovascular stenting to open surgical endarterectomy. Carotid technologies addressed include the carotid stents themselves as well as adjunct neuroprotective devices. Aspects of stent technology include bare-metal versus covered stents, stent tapering, and free-cell area...
2014: Medical Devices: Evidence and Research
Hiromasa Katoh, Tsuyoshi Nozue, Hiroshi Nagamine, Yushi Kawase, Ichiro Michishita
A 71-year-old woman developed the dissection from right brachiocephalic trunk (BCT) to internal carotid artery 6 days after the operation of ascending aortic dissection. Since no improvement of symptoms was observed despite conservative therapy, we performed endovascular therapy (EVT). Although a balloon-expandable stent was implanted in the BCT to seal the entry point of the dissection, the true lumen of the carotid artery was still compressed. Thus, we covered the dissected lesion completely with multiple stents, and her neurological findings improved...
July 2014: Cardiovascular Intervention and Therapeutics
Giuseppe Sangiorgi, Francesco Bedogni, Paolo Sganzerla, Giorgio Binetti, Luigi Inglese, Piotr Musialek, Giovanni Esposito, Alberto Cremonesi, Giorgio Biasi, Jacek Jakala, Alessandro Mauriello, Giuseppe Biondi-Zoccai
BACKGROUND: Carotid occlusive disease is the most common determinant of thromboembolic stroke. However, limited insights in vivo into the pathophysiology and pathology of carotid plaques are available. We designed a prospective multicenter registry to appraise the safety and feasibility of intravascular ultrasound (IVUS) and IVUS-virtual histology (IVUS-VH) imaging before and immediately after carotid stenting. METHODS: Symptomatic and asymptomatic patients scheduled for carotid stenting were included...
October 3, 2013: International Journal of Cardiology
Nobuhiko Ogata, Norihiko Shinozaki, Yuji Ikari
Carotid artery stenting (CAS) has been developed as an alternative therapeutic strategy of carotid endarterectomy (CEA) both for symptomatic and asymptomatic extra-cranial carotid artery stenosis. Some randomized clinical trial has been successfully proven the non-inferiority of CAS compared to CEA in terms of efficacy and safety regarding freedom from major adverse event (MAE). One of the remaining problems in CAS is a non-significant but relatively higher incidence of ipsi-lateral minor stroke related to the procedure, both during and soon after the procedure...
January 2014: Cardiovascular Intervention and Therapeutics
Alejandro González, Antonio López-Rueda, Isabel Gutiérrez, Francisco Moniche, Aurelio Cayuela, Alejandro Bustamante, Antonio Mayol, Jose Ramón Gonzalez-Marcos, Alberto Gil-Peralta
PURPOSE: To determine the incidence of vulnerable plaques characterized by virtual histology intravascular ultrasound (VH IVUS) in patients with severe internal carotid artery (ICA) stenosis and its relationship to the timing of protected carotid artery stenting (CAS). METHODS: The study included 141 patients (119 men; mean age 66.9 ± 9 years) with severe ICA stenosis undergoing CAS with cerebral protection. Patients were classified in 3 groups: 39 symptomatic early CAS (<14 days from clinical symptoms); 58 symptomatic delayed CAS (range 15-180 days), and 44 asymptomatic CAS...
December 2012: Journal of Endovascular Therapy
Piero Montorsi, Stefano Galli, Paolo M Ravagnani, Daniela Trabattoni, Franco Fabbiocchi, Alessandro Lualdi, Giovanni Teruzzi, Gianluca Riva, Sarah Troiano, Antonio L Bartorelli
PURPOSE: To evaluate the safety and efficacy of drug-eluting balloons (DEB) for the treatment of in-stent restenosis (ISR) after carotid artery stenting (CAS). METHODS: Among 830 consecutive patients undergoing CAS between November 2001 and June 2012, significant ISR (>80% stenosis) occurred in 10 (1.2%) asymptomatic patients. Angioplasty with DEB treatment was performed in 7 patients (6 internal and 1 common carotid arteries) at a mean of 20.9 ± 19.4 months (median 12...
December 2012: Journal of Endovascular Therapy
Tomohisa Dembo, Norio Tanahashi
A 24-year-old woman presented with headache and left-sided focal signs following multiple episodes of right monocular visual impairment. Magnetic resonance angiography revealed a decreased vascular image intensity due to a suspicious stenosis in the right internal carotid artery (ICA). The stenosis was not demonstrated on duplex sonography as it was beyond the field of view of the investigation. Intravascular ultrasound (IVUS) revealed that the outer vessel diameter was significantly reduced during stenosis, supporting the presence of vasospasm...
2012: Internal Medicine
Piotr Musialek, Piotr Pieniazek, Wieslawa Tracz, Lukasz Tekieli, Tadeusz Przewlocki, Anna Kablak-Ziembicka, Rafal Motyl, Zbigniew Moczulski, Jakub Stepniewski, Mariusz Trystula, Wojciech Zajdel, Agnieszka Roslawiecka, Krzysztof Zmudka, Piotr Podolec
BACKGROUND: Significant atherosclerotic stenosis of internal carotid artery (ICA) origin is common (5-10% at ≥ 60 years). Intravascular ultrasound (IVUS) enables high-resolution (120 µm) plaque imaging, and IVUS-elucidated features of the coronary plaque were recently shown to be associated with its symptomatic rupture/thrombosis risk. Safety of the significant carotid plaque IVUS imaging in a large unselected population is unknown. MATERIAL/METHODS: We prospectively evaluated the safety of embolic protection device (EPD)-assisted vs...
February 2012: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
S Yoshimura, M Kawasaki, K Yamada, Y Enomoto, Y Egashira, A Hattori, K Nishigaki, S Minatoguchi, T Iwama
BACKGROUND AND PURPOSE: OCT has been reported as a high-resolution imaging tool for characterizing plaque in the coronary arteries. The present study aimed to evaluate the ability of OCT to visualize carotid artery plaques compared with that of IVUS in asymptomatic and symptomatic patients. MATERIALS AND METHODS: OCT was performed for 34 plaques (17 symptomatic, 17 asymptomatic) in 30 patients during CAS under a proximal cerebral protection method. OCT was performed before balloon angioplasty and after stent placement...
February 2012: AJNR. American Journal of Neuroradiology
Peter Kan, Mandy J Binning, Adnan H Siddiqui
Intravascular ultrasound (IVUS) has provided invaluable real-time information during carotid artery stenting (CAS). We present a case of IVUS-guided thrombus extraction during CAS. A 46-year-old man underwent an urgent right CAS under proximal flow reversal for embolic protection for a hemodynamically significant symptomatic near-occlusion of the internal carotid artery. IVUS was used to evaluate immediate poststenting results and identify potential thromboembolic material extruding through the tines of the stent...
October 2012: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Victoria Stager, Rajesh Gandhi, David Stroman, Carlos Timaran, Harshal Broker
We report a case of traumatic internal carotid artery pseudoaneurysm near the skull base that was successfully treated with anticoagulation and antiplatelet therapy and two overlapping bare stents placed under intravascular ultrasound guidance. Although incomplete exclusion of the pseudoaneurysm was seen on completion angiography, follow-up computed tomography angiography revealed complete resolution of the treated lesion. The patient remains asymptomatic at the 18-month clinical follow-up. This case report illustrates a successful endovascular treatment of a complex traumatic pseudoaneurysm with bare metal stenting using intravascular ultrasound guidance...
February 2011: Journal of Vascular Surgery
Joe J Barfett, Jorn Fierstra, David J Mikulis, Timo Krings
OBJECTIVE: Though functional intravascular parameters such as blood velocity and direction of blood flow are available via imaging modalities such as Doppler ultrasound and phase contrast magnetic resonance imaging, such quantitative information is not yet supported by computed tomography (CT). In this study, we examined a method to calculate intra-arterial blood velocity from contrast-enhanced dynamic CT angiography (4D CTA) using the unique advantages of a volumetric 320 detector row scanner...
December 2010: Investigative Radiology
Bryan P Yan, David J Clark, Michael R Jaff, Thomas J Kiernan, Robert M Schainfeld, Sara Lessio, Kenneth Rosenfield
BACKGROUND: Duplex ultrasonography criteria for assessing the severity of carotid artery (CA) in-stent restenosis are not well established. METHODS AND RESULTS: We analyzed 39 patients (40 CAs) who underwent CA stenting with baseline and 6-month follow-up carotid duplex ultrasonography and intravascular ultrasound. Intravascular ultrasound measurements included minimum luminal diameter, percent diameter, and lumen area stenosis. Duplex ultrasonography measurements included peak systolic velocity (PSV), percentage change in PSV, end-diastolic velocity (EDV), and internal-to-common CA PSV ratio (ICA/CCA)...
October 2009: Circulation. Cardiovascular Interventions
D F Bandyk, P A Armstrong
Intravascular ultrasound (IVUS) provides high-resolution vessel imaging and has been shown to improve clinical outcomes when used to assess the technical result of peripheral angioplasty procedures. Our vascular group compared anatomic and clinical outcomes of carotid artery stent-angioplasty (CAS) performed with angiogram monitoring alone, or in combination with IVUS imaging to select stent/balloon diameter and interrogate stent deployment region for residual stenosis. A retrospective review of our carotid stent registry (N=306) identified 220 CAS procedures performed with either a digital C-arm fluoroscopy alone (N=110) or in conjunction with IVUS (N=110) with at least 6-month of clinical follow-up...
December 2009: Journal of Cardiovascular Surgery
M Mellado Joan, B Gómez Moya, F Pañella Agustí, R García Vidal, Y Abril Arjona, M P Fariñas Alija, V Martín Paredero
BACKGROUND: Intravascular ultrasound (IVUS) examination may provide useful information during endovascular procedures. However, its actual clinical utility for carotid stenting remains unclear. We evaluated the usefulness of IVUS as a complementary tool during endovascular procedures in the carotid arteries and its impact on the modification of the therapeutic strategy. METHODS: Between April 2006 and April 2007, 18 symptomatic patients (nine with transient ischemic attack, nine with stroke) underwent angioplasty and stenting of >70% stenosis of the internal carotid artery (ICA)...
September 2009: Annals of Vascular Surgery
Philip M Meyers, H Christian Schumacher, William A Gray, Johanna Fifi, John G Gaudet, Eric J Heyer, Ji Y Chong
BACKGROUND: Intracranial artery stenosis is assumed to represent atherosclerotic plaque. Catheter cerebral arteriography shows that intracranial stenosis may progress, regress, or remain unchanged. It is counterintuitive that atherosclerotic plaque should spontaneously regress, raising questions about the composition of intracranial stenoses. Little is known about this disease entity in vivo. We provide the first demonstration of in vivo atherosclerotic plaque with intraplaque hemorrhage using intravascular ultrasound (IVUS)...
July 2009: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
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