AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesDisciplines and OccupationsInformation ScienceHealth Care
Carotid StenosisEndarterectomy, CarotidStrokeCarotid ArteriesCarotid Artery DiseasesCarotid Artery, InternalIschemic Attack, TransientAngioplastyCerebrovascular DisordersUltrasonography, Doppler, DuplexStentsFollow-Up StudiesTreatment OutcomeRisk FactorsCarotid Artery, CommonProspective StudiesAortic Valve StenosisRecurrenceLife TablesEndarterectomyConstriction, PathologicPostoperative ComplicationsBrain IschemiaCoronary StenosisCarotid BodyCarotid Artery, ExternalSpinal StenosisRetrospective StudiesRisk AssessmentTime FactorsUltrasonography, Doppler, TranscranialMagnetic Resonance AngiographyCarotid SinusTracheal StenosisCerebral AngiographyAngiography, Digital SubtractionIntracranial EmbolismSeverity of Illness IndexAmaurosis FugaxCarotid Artery ThrombosisAngioplasty, BalloonAngiographyPyloric StenosisUltrasonographyMitral Valve StenosisIntracranial ArteriosclerosisPredictive Value of TestsCerebral InfarctionPulmonary Valve StenosisBlood Flow VelocityArterial Occlusive DiseasesUltrasonography, Doppler, ColorTomography, X-Ray ComputedCerebrovascular CirculationAuscultationUltrasonography, DopplerAsymptomatic DiseasesEmbolismSensitivity and SpecificityArteriosclerosisCarotid Artery InjuriesTunica IntimaTunica MediaCarotid Intima-Media ThicknessMiddle Cerebral ArteryObserver VariationIntracranial Embolism and ThrombosisHemodynamicsRetinal Artery OcclusionMagnetic Resonance ImagingPatient SelectionDoppler EffectReproducibility of ResultsCranial Nerve InjuriesBlood PressureCalcinosisCohort StudiesPlaque, AtheroscleroticAtherosclerosisVertebrobasilar InsufficiencyRenal Artery ObstructionIncidenceAge FactorsAcetazolamideAortic Stenosis, SubvalvularOdds RatioAortic Stenosis, SupravalvularCollateral CirculationCarotid Artery, Internal, DissectionFibrinolytic AgentsCoronary AngiographyCerebral ArteriesBrain InfarctionCoronary DiseaseComorbidityContrast MediaCerebral HemorrhageCoronary Artery BypassCatheterizationDisease Progression
ArteriesAtherosclerosisArtery diseaseBifurcationEuropean Carotid Surgery TrialOcclusionIschemic StrokesTransient ischemicMethodsHigh-grade carotid stenosisSevere symptomatic carotid stenosisInternalClinicalTrialistsModerate stenosisDegree of carotid stenosisTreatment of symptomatic carotidRevascularization Endarterectomy Versus Stenting TrialPatients with severeThrombosisAngioplastySymptomsPlaqueAlternative to carotid endarterectomyIschaemicAsymptomatic patientsContralateralMyocardialMiddle cerebrMajor ipsilateral strokeJournal of Vascular SurgeryRisk of periproceduralComparing carotid endarterectomyStent placementUnderwent carotid endarterectomyAcute ipsilateralTIAsDissectionAtherosclerotic stenosis
Arteries24
  • He found that most symptomatic lacunar strokes are due to the occlusion of penetrating arteries of 200-800 μm in diameter, whereas those with smaller-diameter penetrating artery infarcts tended to be asymptomatic. (medscape.com)
  • particularly in brain arteries with preexisting stenosis. (msdmanuals.com)
  • All carotid arteries were measured in millimeters at the narrowest diameter of the stenotic bulb, distal ICA well beyond the tapering bulb, and distal external carotid artery (ECA). (ajnr.org)
  • Atherosclerosis has a predilection for certain arteries, including the extracranial carotid artery. (medscape.com)
  • The carotid artery enlarges in the midneck, forming the carotid bulb, before bifurcating into the external and internal carotid arteries. (medscape.com)
  • Lacunar infarct is a type of stroke that occurs when one of the arteries supplying blood to the brain gets blocked. (belmarrahealth.com)
  • While most arteries in the body gradually become smaller, the arteries of the lacunar stroke branch off a large high-pressure artery. (belmarrahealth.com)
  • Like other types of strokes, a lacunar stroke is the result of insufficient blood flow to the brain through the lacunar arteries. (belmarrahealth.com)
  • The normal range of the ICA/CCA ratio was defined in 2966 symptomatic or contralateral carotid arteries with 0% to 49% stenosis. (ox.ac.uk)
  • Arteries with 70% to 99% symptomatic stenosis and an ICA/CCA ratio below this range were categorized as narrowed. (ox.ac.uk)
  • Carotid artery stenosis is a chronic atherosclerotic disease resulting in narrowing of the common and internal carotid arteries. (lecturio.com)
  • Carotid Artery Stenosis is a narrowing of the common and internal carotid arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. (lecturio.com)
  • Recommendations from the Australian and New Zealand Association of Neurologists on faints, headache disorders, low back pain, migraine & narrowed carotid arteries. (choosingwisely.org.au)
  • You have two carotid arteries one on each side of your neck. (diseasesdic.com)
  • You can develop carotid artery stenosis in either of the two arteries in your neck or in both. (diseasesdic.com)
  • Carotid artery disease, also known as carotid artery stenosis, refers to the narrowing or blockage of the carotid arteries, which are the major blood vessels that supply oxygen-rich blood to the brain. (diseasesdic.com)
  • This type occurs when the carotid arteries become narrowed due to the buildup of plaque on their walls. (diseasesdic.com)
  • In these cases, there might be a significant degree of stenosis or plaque buildup in the carotid arteries, but the patient does not experience any noticeable symptoms. (diseasesdic.com)
  • Carotid Artery Disease (CAD), characterized by the narrowing or blockage of the carotid arteries supplying blood to the brain, is a prevalent condition primarily affecting older adults, with prevalence rising notably beyond the age of 65. (diseasesdic.com)
  • In the present case, patient had the history of transient ischemic attack and in the magnetic resonance imaging, the right internal carotid artery was blocked while the left common and internal carotid arteries had significant stenosis. (journalajcr.com)
  • Successful balloon dilatation and stenting of the patient's ipsilateral common and internal carotid arteries were performed. (journalajcr.com)
  • Usachev DY, Lukshin V, Shmigel'skiy A, Akhmedov A. An anastomosis between the internal carotid and vertebral arteries in the treatment of a patient with bilateral carotid arteries occlusions. (journalajcr.com)
  • Abe T, Tokuda Y. Bilateral carotid arteries occlusion. (journalajcr.com)
  • This is almost invariably due to giant cell arteritis (GCA), which is a primary vasculitis that affects extracranial medium (especially external carotid artery-ECA-branches) and sometimes large arteries (aorta and its major branches)-large-vessel GCA [ 3 , 4 ]. (intechopen.com)
Atherosclerosis10
Artery disease12
  • Threshold values provide guidelines for CTA interpretation when assessing carotid artery disease and the presence of near-occlusion. (ajnr.org)
  • Identification of near-occlusion stenosis with associated decreased diameter of the distal internal carotid artery (ICA) is essential for proper diagnosis and management of atherosclerotic carotid artery disease. (ajnr.org)
  • Identification of near-occlusion affects management of atherosclerotic carotid artery disease. (ajnr.org)
  • With further prospective validation, CTA plaque measures could function as an easily implementable tool for risk stratification in carotid artery disease. (hofstra.edu)
  • Patients that are ideal for CAS include patients that have a high surgical risk, such as patients with prior neck irradiation, aberrant neck anatomy, contralateral recurrent laryngeal nerve injury, prior ipsilateral CEA, significant coronary artery disease, high cervical stenotic lesion location, and tracheostomy. (radiologykey.com)
  • Carotid Artery Disease or Carotid artery stenosis is a condition that happens when your carotid artery, the large artery on either side of your neck, becomes blocked. (diseasesdic.com)
  • Both symptomatic and asymptomatic carotid artery disease can be diagnosed through imaging tests like carotid ultrasound, Doppler ultrasound, magnetic resonance angiography (MRA), and computed tomography angiography (CTA). (diseasesdic.com)
  • Early risk of stroke after a transient ischemic attack in patients with internal carotid artery disease. (ox.ac.uk)
  • Our objective was to quantify the early risk of stroke after a TIA in patients with internal carotid artery disease. (ox.ac.uk)
  • Infarct on brain imaging (adjusted hazard ratio 2.1, 95% CI 1.5-3.0) and the presence of intracranial major-artery disease (adjusted hazard ratio 1.9, 95% CI 1.3-2.7) doubled the early risk of stroke in patients with a hemispheric TIA. (ox.ac.uk)
  • INTERPRETATION: Patients who had a hemispheric TIA related to internal carotid artery disease had a high risk of stroke in the first few days after the TIA. (ox.ac.uk)
  • We aim to describe the feasibility and initial safety of a robotic-assisted platform for treating carotid artery disease. (bmj.com)
Bifurcation5
  • The carotid sinus and carotid body are located at the bifurcation (see the image below). (medscape.com)
  • Less than 20% of these are caused by atheroma in the carotid bifurcation. (radiologykey.com)
  • Cardiogenic embolization to a normal carotid bifurcation or carotid dissection may also cause total occlusion of the internal carotid artery occlusion. (diseasesdic.com)
  • The therapy of patients with this disease pattern can be difficult since simultaneous lesions of the common carotid artery and the ipsilateral internal carotid bifurcation are uncommon. (journalajcr.com)
  • Primary closure was performed when the carotid artery had a diameter above 5 mm, when there was a high carotid bifurcation or when the contralateral carotid artery was occluded. (esmed.org)
European Carotid Surgery Trial3
  • A recent review of catheter angiograms in patients with severe ICA stenosis (NASCET style ≥70%) from the NASCET and European Carotid Surgery Trial (ECST) was performed to estimate the accuracy of near-occlusion identification and to assess prognosis for patients with near-occlusion. (ajnr.org)
  • METHODS: We studied the carotid angiograms of 3007 patients in the European Carotid Surgery Trial. (ox.ac.uk)
  • Similarly, the European Carotid Surgery Trial (ECST) found that on average, the immediate risk of surgery was less than the long-term risk of stroke without surgery when the stenosis was greater than about 80% diameter. (medscape.com)
Occlusion14
  • however, microatheroma now is thought to be the most common mechanism of arterial occlusion (or stenosis). (medscape.com)
  • Ipsilateral internal or common carotid artery occlusion. (mayo.edu)
  • Identification of carotid near-occlusion is essential before calculation of percent stenosis because stroke risk is lower than other severe stenosis and the treatment benefit is less. (ajnr.org)
  • Receiver operating characteristic (ROC) curve analysis defined the threshold values that best predicted near-occlusion according to (1) ICA stenosis, (2) distal ICA, (3) distal ICA: contralateral distal ICA, and (4) distal ICA: ECA. (ajnr.org)
  • Ultimate identification of near-occlusion requires the interpreter's judgment, with attention to the following criteria: (1) notable stenosis of the ICA bulb and (2) distal ICA caliber reduction compared with (A) expected size, (B) contralateral ICA, and (C) ipsilateral ECA. (ajnr.org)
  • 1 - 3 The NASCET data showed that carotid endarterectomy is highly beneficial in symptomatic patients with ≥70% stenosis, 1 but only in cases without near-occlusion stenosis. (ajnr.org)
  • 5 Near-occlusion was defined as any decrease in the expected diameter of the distal ICA above a severe stenosis. (ajnr.org)
  • Despite their pooled data from the NASCET and the ECST studies, the relatively small sample size for near-occlusion, combined with low stroke event rates, 5 did not allow determination of any statistically significant conclusion supporting the use of endarterectomy for near-occlusion cases. (ajnr.org)
  • Total internal carotid artery occlusion results from thrombosis in the setting of chronic stenosis. (diseasesdic.com)
  • In patients with an acute stroke and an intracranial large vessel occlusion, we need to know if there is carotid pathology and if so what kind of pathology we are dealing with. (radiologyassistant.nl)
  • An isolated internal carotid artery is an unfavourable configuration of the circle of Willis which can lead to severe ischemia in case of a ICA occlusion. (radiologyassistant.nl)
  • In a high-grade atherosclerotic stenosis the flow through the internal carotid is severely decreased and results in a collapse and consequently a small caliber of the vessel distal to the occlusion. (radiologyassistant.nl)
  • This simulates an occlusion of the lower cervical part of the internal carotid, but is actually the result of a stop at the carotid T-top. (radiologyassistant.nl)
  • The primary effectiveness endpoint was angiographic evaluation that demonstrated complete aneurysm occlusion and absence of major stenosis at 180 days. (nih.gov)
Ischemic Strokes5
  • In the United States and other Western nations, lacunes account for 15-25% of all ischemic strokes. (medscape.com)
  • Currently, embolization is considered the most common mechanism causing ischemic strokes from atherosclerotic lesions in the carotid bulb. (medscape.com)
  • Ischemic strokes usually either are secondary to thrombosis or thromboembolism from the endarterectomy site or occur during intraoperative cross-clamping. (medscape.com)
  • Numerically less patients in the EPM arm had recurrent ischemic strokes (5.5% vs. 9.1%, P =0.18), transient ischemic attacks (3.0% vs. 4.5%, P =0.44) or died (4.5% vs. 6.6%, P =0.37). (j-stroke.org)
  • An estimated 88% of these are ischemic strokes, with 15% attributed to extracranial carotid occlusive disease. (radiologykey.com)
Transient ischemic15
  • Study limitations include the disease severity being assigned by imaging reports, and assessment of documented transient ischemic stroke in the Kaiser electronic health records is unreliable. (thecardiologyadvisor.com)
  • We, therefore, aimed to determine which transient ischemic attack and ischemic stroke subtypes using the TOAST classification occur most frequently in patients with CKD. (bvsalud.org)
  • We report here the results in the 659 patients in the latter stratum, who had had a hemispheric or retinal transient ischemic attack or a nondisabling stroke within the 120 days before entry and had stenosis of 70 to 99 percent in the symptomatic carotid artery. (duke.edu)
  • CONCLUSIONS: Carotid endarterectomy is highly beneficial to patients with recent hemispheric and retinal transient ischemic attacks or nondisabling strokes and ipsilateral high-grade stenosis (70 to 99 percent) of the internal carotid artery. (duke.edu)
  • Since acute stroke and transient ischemic attack (TIA) are disruptions of brain hemodynamics, perfusion neuroimaging might be of clinical utility. (radiologykey.com)
  • Is There an Optimal Management Regimen for Transient Ischemic Attack Patients to Best Prevent Stroke? (touchneurology.com)
  • Transient ischemic attacks (TIAs) are associated with a high risk of subsequent stroke and often pose a diagnostic and treatment challenge. (touchneurology.com)
  • Carotid artery stenosis in patients is usually discovered after an ischemic event (either a transient ischemic attack [TIA] or a permanent stroke). (radiologykey.com)
  • The aim of this doctoral thesis was to investigate and analyze changes in carotid hemodynamics in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and symptomatic carotid stenosis in the preoperative and three-month postoperative period as well as the assessment of revascularisation effect of carotid endarterectomy (CEA). (gov.rs)
  • This can lead to a stroke or transient ischemic attack (TIA), also known as a mini-stroke. (diseasesdic.com)
  • This refers to cases where the narrowing or blockage of the carotid artery leads to symptoms such as transient ischemic attacks (TIAs) or strokes. (diseasesdic.com)
  • Early detection and prevention through lifestyle modifications are vital in mitigating the disease's impact, particularly its association with strokes and transient ischemic attacks. (diseasesdic.com)
  • BACKGROUND: Transient ischemic attacks (TIAs) often herald a stroke, but little is known about the acute natural history of TIAs. (ox.ac.uk)
  • SOCRATES [ 3 ] was a large trial with more than 13,000 patients who had a high-risk transient ischemic attack (TIA) or minor stroke. (medscape.com)
  • 70% and symptomatic if there was any history of stroke or transient ischemic attack (TIA) within last 6 months involving same side. (ejcvsmed.org)
Methods11
  • Ratio calculations to determine percent degree of carotid bulb stenosis, as in North American Symptomatic Carotid Endarterectomy Trial (NASCET) and other study methods, 1 - 4 rely upon proper measurement of the distal ICA diameter for the denominator data. (ajnr.org)
  • NASCET methods required that no ratio calculation be done in cases of collapsed or partly collapsed distal ICAs above a severe ICA bulb stenosis, 1 - 5 because the use of this denominator data would provide a fallacious stenosis calculation that underestimates the true stenosis. (ajnr.org)
  • METHODS: We used data from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands). (bvsalud.org)
  • METHODS: Data from the Carotid Stenosis Trialists' Collaboration included outcomes from symptomatic patients in EVA-3S (Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis), SPACE (Stent-Protected Angioplasty Versus Carotid Endarterectomy in Symptomatic Patients), ICSS (International Carotid Stenting Study), and CREST. (ox.ac.uk)
  • METHODS: We conducted a randomized trial at 50 clinical centers throughout the United States and Canada, in patients in two predetermined strata based on the severity of carotid stenosis--30 to 69 percent and 70 to 99 percent. (duke.edu)
  • MATERIALS AND METHODS: We measured soft-plaque and hard-plaque thickness on CIA axial source images in each carotid artery plaque in subjects with NASCET 50%-69% ICA stenosis. (hofstra.edu)
  • Objective:To investigate the risk factors of restenosis after dilation of anastomotic stenosis in patients with esophageal cancer surgery.Methods:Clinical data of 997 patients who underwent endoscopic dilation due to anastomotic stenosis after esophageal cancer radical surgery in the Affiliated Huai′an First Hospital of Nanjing Medical University from June 2015 to July 2021, were retrospectively analyzed. (bvsalud.org)
  • METHODS: Using patient data from the medical arm of the North American Symptomatic Carotid Endarterectomy Trial, we calculated the risk of ipsilateral stroke in the territory of the symptomatic internal carotid artery within 2 and 90 days after a first-recorded hemispheric TIA. (ox.ac.uk)
  • METHODS: The Vascular Quality Initiative database was reviewed for patients who had undergone TfCAS and TCAR for restenosis after prior ipsilateral CEA between January 2016 and August 2020. (touro.edu)
  • METHODS: We did a pooled analysis of individual patient-level data, acquired from the four largest randomised controlled trials assessing the relative efficacy of CAS and CEA for treatment of symptomatic carotid stenosis (Endarterectomy versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis trial, Stent-Protected Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy trial, International Carotid Stenting Study, and Carotid Revascularization Endarterectomy versus Stenting Trial). (lshtm.ac.uk)
  • Methods Single-center technical report of the first four consecutive cases of carotid artery stenting for the treatment of severe symptomatic carotid stenosis utilizing the CorPath GRX Robotic System (Corindus Inc, Waltham, MA). (bmj.com)
High-grade carotid stenosis2
  • Carotid revascularization for primary prevention of stroke (CREST-2) is two independent multicenter, randomized controlled trials of carotid revascularization and intensive medical management versus medical management alone in patients with asymptomatic high-grade carotid stenosis. (mayo.edu)
  • Scholars@Duke publication: Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. (duke.edu)
Severe symptomatic carotid stenosis1
  • Low risk of ischemic stroke in patients with reduced internal carotid artery lumen diameter distal to severe symptomatic carotid stenosis: cerebral protection due to low poststenotic flow? (ox.ac.uk)
Internal17
  • CT angiography (CTA) is convenient and accurately quantifies internal carotid artery (ICA) stenosis. (ajnr.org)
  • This type of stroke occurs due to a blockage of blood flow to one of the following areas: the internal capsule, corona radiata, or the pons. (belmarrahealth.com)
  • This condition results in trouble speaking and a clumsy hand as a result of a stroke that affects the anterior portion of the internal capsule. (belmarrahealth.com)
  • The most direct angiographic correlate of poststenotic perfusion pressure is the degree of narrowing of the distal internal carotid artery (ICA) lumen. (ox.ac.uk)
  • Unilateral infarction in the watershed regions, and particularly the internal border zone region, raises the possibility of ipsilateral carotid or middle cerebral artery stenosis ( figure 2 ). (bmj.com)
  • In patients with confirmed high-grade (70-99%) stenosis of the internal carotid artery , surgical carotid endarterectomy (CEA) is highly beneficial and has become the standard surgical treatment. (medscape.com)
  • 70% stenosis of the internal carotid artery. (choosingwisely.org.au)
  • Early risk of stroke was not affected by the degree of internal carotid artery stenosis. (ox.ac.uk)
  • The efficacy of CEA is well validated with a significant stroke risk reduction in patients with symptomatic internal carotid artery (ICA) stenosis [2,3]. (irispublishers.com)
  • Objectives: The aim was to determine the diagnostic value of a juxtaluminal black (hypoechoic) area without a visible echogenic cap (JBA) in ultrasonic images of internal carotid artery plaques. (ucy.ac.cy)
  • Bilateral or unilateral internal carotid artery stenosis might present. (journalajcr.com)
  • Other pathology that we will discuss is the floating thrombus, the carotid web and the isolated internal carotid artery. (radiologyassistant.nl)
  • Contrast that tries to enter the internal carotid will give a waterpaint appearance due to this outflow obstruction. (radiologyassistant.nl)
  • This is a thin shelf-like luminal protrusion of the intimal fibrous tissue that extends from the posterior aspect of the proximal internal carotid artery bulb into the lumen. (radiologyassistant.nl)
  • In patients with symptomatic or asymptomatic severe internal carotid artery stenosis, carotid endarterectomy (CEA) has been shown to reduce risk for stroke. (esmed.org)
  • The Pipeline for Uncoilable or Failed Aneurysms is a multicenter, prospective, interventional, single-arm trial of PED for the treatment of uncoilable or failed aneurysms of the internal carotid artery. (nih.gov)
  • [1] Approximately 8-10% of patients scheduled for coronary artery bypass graft (CABG) surgery, have significant but asymptomatic internal carotid artery (ICA) stenosis. (ejcvsmed.org)
Clinical11
  • We hypothesize that 3D MRI is superior to 2D MRI in characterizing major plaque constituents that contribute to severe clinical events such as myocardial infarction or stroke. (nih.gov)
  • In this retrospective study utilizing techniques to mimic a clinical trial, carotid endarterectomy was found to be protective of stroke in patients with asymptomatic stenosis compared with medical therapy alone," the investigators wrote. (thecardiologyadvisor.com)
  • This article provides practical tips to diagnose the underlying subtype of stroke, and in particular discusses non-lacunar pathologies that can present with a clinical lacunar syndrome. (bmj.com)
  • 3 Classification systems that record clinical syndromes rather than underlying pathophysiological mechanisms, such as in the Oxfordshire Community Stroke Project, are less useful. (bmj.com)
  • Acute management of TIA and minor stroke Patients who present with symptoms suggestive of minor stroke or TIA must undergo a comprehensive evaluation to confirm the diagnosis and begin treatment to reduce the risk of major stroke as soon as it is appropriate to the clinical situation. (slideserve.com)
  • 2013). Asymptomatic Carotid Artery Stenosis and the Risk of Ischemic Stroke According to Subtype in Patients With Clinical Manifest Arterial Disease. (uran.ua)
  • 4 Predictors such as the ABCD2 score 5 or fluctuations of symptoms 6 characterizing the individual risk for stroke are clinical or imaging-related (CT, MRI). (touchneurology.com)
  • The original TIA definition as "a cerebral dysfunction of ischemic nature lasting no longer than 24 hours with a tendency to recur" was based on pure clinical findings and was formulated in a time period in which neuroimaging was rudimental and acute stroke treatment missing. (touchneurology.com)
  • Today, the rate of complications from CEA versus CAS are nearly equivocal, making the choice of therapy based more on clinical presentation, medical comorbidities, and carotid artery anatomy. (radiologykey.com)
  • Considering clinical manifestations of stroke, the patients were divided into three groups: patients with TIA and amaurosis fugax, with partial infarction in area ACA or ACM and with lacunar infarct. (gov.rs)
  • Identifying vulnerable atherosclerotic plaques in symptomatic patients with moderate (30-69%) carotid artery stenosis can contribute to clinical decision making. (myesr.org)
Trialists2
Moderate stenosis2
  • Conversely, the 5-year stroke risk was low for patients with moderate stenosis on contemporary medical treatment, calling into question any benefit from revascularisation. (ox.ac.uk)
  • Fifty-eight patients with transient ischaemic attack (TIA) or minor stroke in the carotid territory and ipsilateral carotid plaque causing a moderate stenosis were included. (myesr.org)
Degree of carotid stenosis1
  • The degree of carotid stenosis by ultrasound should be reported based on the Society of Radiologists in Ultrasound's consensus conference in 2003. (radiologykey.com)
Treatment of symptomatic carotid2
  • BACKGROUND: The risk of periprocedural stroke or death is higher after carotid artery stenting (CAS) than carotid endarterectomy (CEA) for the treatment of symptomatic carotid stenosis. (lshtm.ac.uk)
  • We sought to combine individual patient-level data from the four major randomised controlled trials of CAS versus CEA for the treatment of symptomatic carotid stenosis to assess long-term outcomes. (lshtm.ac.uk)
Revascularization Endarterectomy Versus Stenting Trial1
Patients with severe4
  • Investigators aimed to compare CEA plus standard medical therapy versus medical therapy alone for prevention of ipsilateral stroke in adult patients with severe carotid stenosis. (thecardiologyadvisor.com)
  • INTERPRETATION: Contrary to the assumptions of current guidelines and the findings of subgroup analyses of previous randomised controlled trials, the stroke risk reported in cohort studies was highly dependent on the degree of asymptomatic carotid stenosis, suggesting that the benefit of endarterectomy might be underestimated in patients with severe stenosis. (ox.ac.uk)
  • Simultaneous carotid and off-pump coronary artery bypass surgery is safe and effective method of treatment patients with severe concomitant carotid artery stenosis and ischemic heart disease with relatively low mortality rate. (ejcvsmed.org)
  • In this study we performed a retrospective analysis of safety and efficacy of CEA combined with CABG in patients with severe carotid stenosis requiring CABG surgery. (ejcvsmed.org)
Thrombosis6
  • These plaques can cause stenosis (see the image below), embolization, and thrombosis. (medscape.com)
  • Stroke secondary to cardioembolism also has a thromboembolic basis, although from thrombosis occurring in the heart. (bmj.com)
  • The exact mechanisms underlying lacunar stroke are uncertain, and there is debate about the role of thrombosis as a final mediating mechanism causing ischaemia. (bmj.com)
  • None developed any neurological event and post-operative scan did not show any ICA thrombosis or stenosis from an ICA kinking after a median follow-up of 6 months (range: 5 to 17). (irispublishers.com)
  • The risk of developing thrombosis at the site of PTP remains unknown, and little is known about the efficacy and effectiveness of the above techniques to prevent an arterial kinking stenosis during CEA in the presence of significantly tortuous ICA. (irispublishers.com)
  • In five cases a patient had an ipsilateral cerebrovascular thrombosis in the group after patch angioplasty compared to zero in the primary closure group (P-value= .02). (esmed.org)
Angioplasty5
  • We have decided to make no changes in coverage of patient groups for percutaneous transluminal angioplasty (PTA) of the carotid artery concurrent with stenting (Medicare NCD Manual 20.7B3 and B). We have decided to retain our existing coverage policy with a slight revision to the language regarding embolic protection devices. (cms.gov)
  • however, carotid artery balloon angioplasty and stent placement has enjoyed significant technological advances over the last decade and can now offer a comparable treatment alternative to CEA. (radiologykey.com)
  • Carotid artery balloon angioplasty and stent placement (CAS) during its infancy was associated with higher rates of perioperative ischemic complications when compared with CEA. (radiologykey.com)
  • Purpose of Review: We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues. (elsevierpure.com)
  • One was caused by cerebral hyperperfusion syndrome within one month postoperative after patch angioplasty and none were caused by an ipsilateral ischemic stroke. (esmed.org)
Symptoms7
  • These plaques can result in symptoms by causing stenosis, by embolizing, or by thrombosing. (medscape.com)
  • They conducted a retrospective observational, data-only (causal inference) cohort study that included 3824 patients aged at least 18 years (mean age, 73.7 years ) who had severe (70% to 99%) carotid stenosis (no neurological symptoms within 6 months) with no prior ipsilateral carotid artery intervention. (thecardiologyadvisor.com)
  • Treatment is with statins, anti-hypertensive and antiplatelet agents, and, in some cases (depending on the degree of stenosis and associated symptoms) , surgical revascularization. (lecturio.com)
  • RESULTS: Twenty of 72 vessels studied (27.7%) had ischemic symptoms ipsilateral to the side of moderate-grade carotid stenosis. (hofstra.edu)
  • 50% stenosis) that has not caused symptoms. (choosingwisely.org.au)
  • Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. (choosingwisely.org.au)
  • Carotid plaques have been associated with ipsilateral neurological symptoms. (ucy.ac.cy)
Plaque13
  • Nicolaides has undertaken research on venous thromboembolism, noninvasive vascular investigations with particular emphasis on venous disease, the cardiac assessment of the arteriopath and more recently carotid plaque (atheroma) characterisation, identification of patients at increased risk for stroke and stroke prevention. (wikipedia.org)
  • On the basis of this study and the work on plaque characterisation it has become possible to identify a high risk group of patients with asymptomatic carotid stenosis (5.5% stroke rate per year), but most important has been the identification of a low risk group with an annual stroke risk of less than 1%, that can be spared from unnecessary intervention. (wikipedia.org)
  • The multidisciplinary approach combining angiography, high-resolution ultrasound, thrombolytic therapy, plaque pathology, histochemistry, coagulation studies, and more recently molecular biology has led to the realisation that carotid plaque rupture is a key mechanism underlying the development of cerebrovascular events. (wikipedia.org)
  • The goal of this observational study is to learn more about plaque biology in asymptomatic carotid artery stenosis (ACAS) patients through imaging. (nih.gov)
  • Carotid plaque. (medscape.com)
  • Atherosclerotic plaque removed at time of carotid endarterectomy (areas of ulceration with thrombus and intraplaque hemorrhage are present). (medscape.com)
  • The main mechanism of stroke appears to be plaque surface thrombus formation and distal embolism. (ox.ac.uk)
  • We studied the association between soft and hard (calcified) plaque thickness measurements on CTA and symptomatic disease status (ipsilateral stroke or TIA) in patients with moderate-grade carotid artery stenosis. (hofstra.edu)
  • Each 1-mm increase in soft plaque resulted in a 3.7 times greater odds of a prior ipsilateral ischemic event (95% CI,1.9-7.2). (hofstra.edu)
  • CONCLUSIONS: Simple CTA plaque-thickness measurements might differentiate symptomatic and asymptomatic moderate-grade carotid artery plaque. (hofstra.edu)
  • Search for Reliable Circulating Biomarkers to Predict Carotid Plaque Vulnerability. (uran.ua)
  • When plaque blocks the normal flow of blood through your carotid artery, you're at a higher risk of stroke. (diseasesdic.com)
  • In this type, the carotid artery becomes completely blocked, usually by a blood clot or a piece of plaque that breaks off from the artery wall and lodges farther downstream, blocking blood flow to a portion of the brain. (diseasesdic.com)
Alternative to carotid endarterectomy2
  • Takayama said: "Carotid artery stenting is becoming an alternative to carotid endarterectomy. (neuronewsinternational.com)
  • Endovascular therapy for the treatment of carotid atherosclerotic disease has advanced over the last decade and is now considered to be a viable alternative to carotid endarterectomy (CEA) in appropriately selected patients. (radiologykey.com)
Ischaemic10
  • The risk of recurrent stroke is increased following ischaemic stroke and transient ischaemic attack (TIA), particularly in the first few weeks. (bmj.com)
  • Ischaemic stroke represents a syndrome caused by several diverse pathologies that all result in disruption of blood supply and secondary ischaemic damage. (bmj.com)
  • All patients in OxVasc with a recent suspected transient ischaemic attack or stroke, between April 1, 2002, and April 1, 2017, who had asymptomatic carotid stenosis were included in these analyses. (ox.ac.uk)
  • Data presented at CIRSE (14-18 September, Barcelona, Spain) by a team of investigators from Japan showed that pre-treatment with pitavastatin significantly reduced the frequency of periprocedural ischaemic complications associated with carotid artery stenting. (neuronewsinternational.com)
  • Katsutoshi Takayama, from the Department of Radiology and Interventional Neuroradiology, Ishinkai Yao General Hospital, Yao city, Japan, reported on the Effect of Pitavastatin on preventing ischaemic complications with carotid artery stenting (EPOCH-CAS) and told delegates that it was a multicentre prospective study carried out at 11 centres in Japan. (neuronewsinternational.com)
  • We aimed to assess whether preoperative statin therapy reduces the risk of periprocedural ischaemic complications with carotid artery stenting. (neuronewsinternational.com)
  • Frequencies of new ipsilateral ischaemic lesions on diffusion-weighted imaging (DWI) within 72h after carotid artery stenosis and major adverse events (defined as transient ischaemic attack, stroke, myocardial infarction or death) within 30 days were assessed. (neuronewsinternational.com)
  • New ipsilateral ischaemic lesions were identified in eight of 31 patients (25.8%) in group 1 and 16 of 30 patients (55.3%) in group II (p=0.027). (neuronewsinternational.com)
  • Forty-five strokes (52 per cent) were ischaemic, nine (10 per cent) haemorrhagic, and stroke subtype was not determined in 32 patients (37 per cent). (ox.ac.uk)
  • CONCLUSION: At least half of the procedural strokes in this study were ischaemic and ipsilateral to the treated artery. (ox.ac.uk)
Asymptomatic patients3
  • Generally, symptomatic patients with greater than 50% stenosis and healthy, asymptomatic patients with greater than 60% stenosis warrant consideration for CEA. (medscape.com)
  • Timing of procedural stroke and death in asymptomatic patients undergoing carotid endarterectomy: individual patient analysis from four RCTs. (ox.ac.uk)
  • In asymptomatic patients, CAS is as safe as CEA, although modern medical therapy may be as effective as any carotid intervention. (elsevierpure.com)
Contralateral1
  • Of the 86 strokes, 67 (78 per cent) were ipsilateral, 17 (20 per cent) were contralateral and two (2 per cent) were vertebrobasilar. (ox.ac.uk)
Myocardial4
  • [ 9 , 4 ] In addition to perioperative stroke, serious complications that may develop after CEA include myocardial ischemia and infarction , hemodynamic instability, cranial nerve (CN) injuries, and bleeding resulting in neck hematomas and airway compromise. (medscape.com)
  • Rates of stroke, death and myocardial infarction post-TCAR do not differ. (neuronewsinternational.com)
  • As in the main study, the endpoint was stroke, myocardial infarction, or death after 90 days. (medscape.com)
  • A total of 103 patients (2·l8 per cent) had serious procedural complications (18 fatal strokes, 68 non-fatal strokes, 11 fatal myocardial infarctions and 6 deaths from other causes). (ox.ac.uk)
Middle cerebr1
Major ipsilateral stroke2
  • Prior major ipsilateral stroke in the past with substantial residual disability (mRS ≥ 2) that is likely to confound study outcomes. (mayo.edu)
  • The primary safety endpoint was occurrence of major ipsilateral stroke or neurologic death at 180 days. (nih.gov)
Journal of Vascular Surgery1
Risk of periprocedural1
  • Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. (elsevierpure.com)
Comparing carotid endarterectomy1
Stent placement2
  • The primary management choices include a medical management approach (lifestyle, exercise, pharmaceuticals, etc) versus a revascularization approach (endarterectomy, carotid stent placement). (ajnr.org)
  • Although revascularization via carotid stent placement is increasingly common, the large randomized outcome studies of carotid artery stenotic disease systematically evaluated the risks and benefits of carotid endarterectomy. (ajnr.org)
Underwent carotid endarterectomy1
  • Those assigned to surgical treatment underwent carotid endarterectomy performed by neurosurgeons or vascular surgeons. (duke.edu)
Acute ipsilateral2
TIAs3
Dissection3
  • Much of our current knowledge of lacunar strokes is due to Fisher's prior cadaveric dissection of postmortem stroke patients. (medscape.com)
  • Non-atherosclerotic carotid stenosis (dissection, fibromuscular dysplasia, or stenosis following radiation therapy). (mayo.edu)
  • There is a problem diagnosing carotid dissection versus pseudo-obstruction. (radiologyassistant.nl)
Atherosclerotic stenosis1
  • Increasing plasma level lipoprotein-associated phospholipase A2 and E-selectin in patients with the carotid atherosclerotic stenosis were observe. (uran.ua)