Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)
The excision of the thickened, atheromatous tunica intima of a carotid artery.
Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery.
Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology.
Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.
The two principal arteries supplying the structures of the head and neck. They ascend in the neck, one on each side, and at the level of the upper border of the thyroid cartilage, each divides into two branches, the external (CAROTID ARTERY, EXTERNAL) and internal (CAROTID ARTERY, INTERNAL) carotid arteries.
A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
Ultrasonography applying the Doppler effect combined with real-time imaging. The real-time image is created by rapid movement of the ultrasound beam. A powerful advantage of this technique is the ability to estimate the velocity of flow from the Doppler shift frequency.
Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called ATHERECTOMY.
Brief reversible episodes of focal, nonconvulsive ischemic dysfunction of the brain having a duration of less than 24 hours, and usually less than one hour, caused by transient thrombotic or embolic blood vessel occlusion or stenosis. Events may be classified by arterial distribution, temporal pattern, or etiology (e.g., embolic vs. thrombotic). (From Adams et al., Principles of Neurology, 6th ed, pp814-6)
The condition of an anatomical structure's being constricted beyond normal dimensions.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.
Narrowing or constriction of a coronary artery.
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
A spectrum of pathological conditions of impaired blood flow in the brain. They can involve vessels (ARTERIES or VEINS) in the CEREBRUM, the CEREBELLUM, and the BRAIN STEM. Major categories include INTRACRANIAL ARTERIOVENOUS MALFORMATIONS; BRAIN ISCHEMIA; CEREBRAL HEMORRHAGE; and others.
A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control.
Branch of the common carotid artery which supplies the exterior of the head, the face, and the greater part of the neck.
Narrowing of the spinal canal.
The dilated portion of the common carotid artery at its bifurcation into external and internal carotids. It contains baroreceptors which, when stimulated, cause slowing of the heart, vasodilatation, and a fall in blood pressure.
A non-invasive technique using ultrasound for the measurement of cerebrovascular hemodynamics, particularly cerebral blood flow velocity and cerebral collateral flow. With a high-intensity, low-frequency pulse probe, the intracranial arteries may be studied transtemporally, transorbitally, or from below the foramen magnum.
Non-invasive method of vascular imaging and determination of internal anatomy without injection of contrast media or radiation exposure. The technique is used especially in CEREBRAL ANGIOGRAPHY as well as for studies of other vascular structures.
A method of delineating blood vessels by subtracting a tissue background image from an image of tissue plus intravascular contrast material that attenuates the X-ray photons. The background image is determined from a digitized image taken a few moments before injection of the contrast material. The resulting angiogram is a high-contrast image of the vessel. This subtraction technique allows extraction of a high-intensity signal from the superimposed background information. The image is thus the result of the differential absorption of X-rays by different tissues.
Transient complete or partial monocular blindness due to retinal ischemia. This may be caused by emboli from the CAROTID ARTERY (usually in association with CAROTID STENOSIS) and other locations that enter the central RETINAL ARTERY. (From Adams et al., Principles of Neurology, 6th ed, p245)
Radiography of the vascular system of the brain after injection of a contrast medium.
Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.
Blood clot formation in any part of the CAROTID ARTERIES. This may produce CAROTID STENOSIS or occlusion of the vessel, leading to TRANSIENT ISCHEMIC ATTACK; CEREBRAL INFARCTION; or AMAUROSIS FUGAX.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Radiography of blood vessels after injection of a contrast medium.
Narrowing of the pyloric canal with varied etiology. A common form is due to muscle hypertrophy (PYLORIC STENOSIS, HYPERTROPHIC) seen in infants.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
Blocking of a blood vessel in the SKULL by an EMBOLUS which can be a blood clot (THROMBUS) or other undissolved material in the blood stream. Most emboli are of cardiac origin and are associated with HEART DISEASES. Other non-cardiac sources of emboli are usually associated with VASCULAR DISEASES.
Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.
The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
The pathologic narrowing of the orifice of the PULMONARY VALVE. This lesion restricts blood outflow from the RIGHT VENTRICLE to the PULMONARY ARTERY. When the trileaflet valve is fused into an imperforate membrane, the blockage is complete.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.
Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.
Ultrasonography applying the Doppler effect, with the superposition of flow information as colors on a gray scale in a real-time image. This type of ultrasonography is well-suited to identifying the location of high-velocity flow (such as in a stenosis) or of mapping the extent of flow in a certain region.
Vascular diseases characterized by thickening and hardening of the walls of ARTERIES inside the SKULL. There are three subtypes: (1) atherosclerosis with fatty deposits in the ARTERIAL INTIMA; (2) Monckeberg's sclerosis with calcium deposits in the media and (3) arteriolosclerosis involving the small caliber arteries. Clinical signs include HEADACHE; CONFUSION; transient blindness (AMAUROSIS FUGAX); speech impairment; and HEMIPARESIS.
Act of listening for sounds within the body.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Ultrasonography applying the Doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. (Stedman, 25th ed)
Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION.
The circulation of blood through the BLOOD VESSELS of the BRAIN.
Diseases that do not exhibit symptoms.
The return of a sign, symptom, or disease after a remission.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
Damages to the CAROTID ARTERIES caused either by blunt force or penetrating trauma, such as CRANIOCEREBRAL TRAUMA; THORACIC INJURIES; and NECK INJURIES. Damaged carotid arteries can lead to CAROTID ARTERY THROMBOSIS; CAROTID-CAVERNOUS SINUS FISTULA; pseudoaneurysm formation; and INTERNAL CAROTID ARTERY DISSECTION. (From Am J Forensic Med Pathol 1997, 18:251; J Trauma 1994, 37:473)
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Thickening and loss of elasticity of the walls of ARTERIES of all sizes. There are many forms classified by the types of lesions and arteries involved, such as ATHEROSCLEROSIS with fatty lesions in the ARTERIAL INTIMA of medium and large muscular arteries.
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)
The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
Elements of limited time intervals, contributing to particular results or situations.
Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream.
The middle layer of blood vessel walls, composed principally of thin, cylindrical, smooth muscle cells and elastic tissue. It accounts for the bulk of the wall of most arteries. The smooth muscle cells are arranged in circular layers around the vessel, and the thickness of the coat varies with the size of the vessel.
A measurement of the thickness of the carotid artery walls. It is measured by B-mode ULTRASONOGRAPHY and is used as a surrogate marker for ATHEROSCLEROSIS.
The formation of an area of NECROSIS in the CEREBRUM caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., INFARCTION, ANTERIOR CEREBRAL ARTERY), and etiology (e.g., embolic infarction).
The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).
Sudden ISCHEMIA in the RETINA due to blocked blood flow through the CENTRAL RETINAL ARTERY or its branches leading to sudden complete or partial loss of vision, respectively, in the eye.
Changes in the observed frequency of waves (as sound, light, or radio waves) due to the relative motion of source and observer. The effect was named for the 19th century Austrian physicist Johann Christian Doppler.
The largest of the cerebral arteries. It trifurcates into temporal, frontal, and parietal branches supplying blood to most of the parenchyma of these lobes in the CEREBRAL CORTEX. These are the areas involved in motor, sensory, and speech activities.
Dysfunction of one or more cranial nerves causally related to a traumatic injury. Penetrating and nonpenetrating CRANIOCEREBRAL TRAUMA; NECK INJURIES; and trauma to the facial region are conditions associated with cranial nerve injuries.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.
Pathologic deposition of calcium salts in tissues.
Narrowing or occlusion of the RENAL ARTERY or arteries. It is due usually to ATHEROSCLEROSIS; FIBROMUSCULAR DYSPLASIA; THROMBOSIS; EMBOLISM, or external pressure. The reduced renal perfusion can lead to renovascular hypertension (HYPERTENSION, RENOVASCULAR).
Lesions formed within the walls of ARTERIES.
Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures.
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
A pathological constriction occurring in the region below the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
One of the CARBONIC ANHYDRASE INHIBITORS that is sometimes effective against absence seizures. It is sometimes useful also as an adjunct in the treatment of tonic-clonic, myoclonic, and atonic seizures, particularly in women whose seizures occur or are exacerbated at specific times in the menstrual cycle. However, its usefulness is transient often because of rapid development of tolerance. Its antiepileptic effect may be due to its inhibitory effect on brain carbonic anhydrase, which leads to an increased transneuronal chloride gradient, increased chloride current, and increased inhibition. (From Smith and Reynard, Textbook of Pharmacology, 1991, p337)
A thickening and loss of elasticity of the walls of ARTERIES that occurs with formation of ATHEROSCLEROTIC PLAQUES within the ARTERIAL INTIMA.
Summarizing techniques used to describe the pattern of mortality and survival in populations. These methods can be applied to the study not only of death, but also of any defined endpoint such as the onset of disease or the occurrence of disease complications.
A pathological constriction occurring in the region above the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.
Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the BRAIN STEM; CEREBELLUM; OCCIPITAL LOBE; medial TEMPORAL LOBE; and THALAMUS. Characteristic clinical features include SYNCOPE; lightheadedness; visual disturbances; and VERTIGO. BRAIN STEM INFARCTIONS or other BRAIN INFARCTION may be associated.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
The splitting of the vessel wall in one or both (left and right) internal carotid arteries (CAROTID ARTERY, INTERNAL). Interstitial hemorrhage into the media of the vessel wall can lead to occlusion of the internal carotid artery and aneurysm formation.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
Substances used to allow enhanced visualization of tissues.
The degree to which BLOOD VESSELS are not blocked or obstructed.
Benign paraganglioma at the bifurcation of the COMMON CAROTID ARTERIES. It can encroach on the parapharyngeal space and produce dysphagia, pain, and cranial nerve palsies.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.
Vascular filters or occlusive devices that provide mechanical protection of the distal end organ from blood clots or EMBOLISM-causing debri dislodged during ENDOVASCULAR PROCEDURES.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.
Developmental or acquired stricture or narrowing of the LARYNX. Symptoms of respiratory difficulty depend on the degree of laryngeal narrowing.
The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.
Subspecialty of radiology that combines organ system radiography, catheter techniques and sectional imaging.
Period of contraction of the HEART, especially of the HEART VENTRICLES.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
INFLAMMATION of any ARTERIES.
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
The pathologic narrowing of the orifice of the TRICUSPID VALVE. This hinders the emptying of RIGHT ATRIUM leading to elevated right atrial pressure and systemic venous congestion. Tricuspid valve stenosis is almost always due to RHEUMATIC FEVER.
A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.
Operative procedures for the treatment of vascular disorders.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Artery originating from the internal carotid artery and distributing to the eye, orbit and adjacent facial structures.
A technique of inputting two-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer.
The arterial blood vessels supplying the CEREBRUM.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
A type of constriction that is caused by the presence of a fibrous ring (discrete type) below the AORTIC VALVE, anywhere between the aortic valve and the MITRAL VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Pathological processes involving any one of the BLOOD VESSELS in the vasculature outside the HEART.
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force.
Narrowing of the pyloric canal due to HYPERTROPHY of the surrounding circular muscle. It is usually seen in infants or young children.
The process of generating three-dimensional images by electronic, photographic, or other methods. For example, three-dimensional images can be generated by assembling multiple tomographic images with the aid of a computer, while photographic 3-D images (HOLOGRAPHY) can be made by exposing film to the interference pattern created when two laser light sources shine on an object.
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
Obstruction of flow in biological or prosthetic vascular grafts.
The flow of BLOOD through or around an organ or region of the body.
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
The period following a surgical operation.
Iron (II,III) oxide (Fe3O4). It is a black ore of IRON that forms opaque crystals and exerts strong magnetism.
Rhythmic, intermittent propagation of a fluid through a BLOOD VESSEL or piping system, in contrast to constant, smooth propagation, which produces laminar flow.
Surgical insertion of synthetic material to repair injured or diseased heart valves.
A process of separating particulate matter from a fluid, such as air or a liquid, by passing the fluid carrier through a medium that will not pass the particulates. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)
A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.
The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.
A stricture of the ESOPHAGUS. Most are acquired but can be congenital.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
A subfield of acoustics dealing in the radio frequency range higher than acoustic SOUND waves (approximately above 20 kilohertz). Ultrasonic radiation is used therapeutically (DIATHERMY and ULTRASONIC THERAPY) to generate HEAT and to selectively destroy tissues. It is also used in diagnostics, for example, ULTRASONOGRAPHY; ECHOENCEPHALOGRAPHY; and ECHOCARDIOGRAPHY, to visually display echoes received from irradiated tissues.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
The veins and arteries of the HEART.
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
Cells specialized to detect chemical substances and relay that information centrally in the nervous system. Chemoreceptor cells may monitor external stimuli, as in TASTE and OLFACTION, or internal stimuli, such as the concentrations of OXYGEN and CARBON DIOXIDE in the blood.
The circulation of blood through the CORONARY VESSELS of the HEART.
Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.
The dimension of the physical universe which, at a given place, orders the sequence of events. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy.
Bleeding or escape of blood from a vessel.
A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.
A plasma protein that circulates in increased amounts during inflammation and after tissue damage.
The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM.
Compounds that inhibit HMG-CoA reductases. They have been shown to directly lower cholesterol synthesis.
The ratio of maximum blood flow to the MYOCARDIUM with CORONARY STENOSIS present, to the maximum equivalent blood flow without stenosis. The measurement is commonly used to verify borderline stenosis of CORONARY ARTERIES.
Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
7-carbon saturated monocarboxylic acids.
Improvement of the quality of a picture by various techniques, including computer processing, digital filtering, echocardiographic techniques, light and ultrastructural MICROSCOPY, fluorescence spectrometry and microscopy, scintigraphy, and in vitro image processing at the molecular level.
Surgical shunt allowing direct passage of blood from an artery to a vein. (From Dorland, 28th ed)
Pathological conditions involving ARTERIES in the skull, such as arteries supplying the CEREBRUM, the CEREBELLUM, the BRAIN STEM, and associated structures. They include atherosclerotic, congenital, traumatic, infectious, inflammatory, and other pathological processes.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material.
The main artery of the thigh, a continuation of the external iliac artery.
The neural systems which act on VASCULAR SMOOTH MUSCLE to control blood vessel diameter. The major neural control is through the sympathetic nervous system.
Tissue NECROSIS in any area of the brain, including the CEREBRAL HEMISPHERES, the CEREBELLUM, and the BRAIN STEM. Brain infarction is the result of a cascade of events initiated by inadequate blood flow through the brain that is followed by HYPOXIA and HYPOGLYCEMIA in brain tissue. Damage may be temporary, permanent, selective or pan-necrosis.
Methods developed to aid in the interpretation of ultrasound, radiographic images, etc., for diagnosis of disease.
A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters.
Diseases of the central and peripheral nervous system. This includes disorders of the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscle.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls.
Hypertension due to RENAL ARTERY OBSTRUCTION or compression.
Harmful effects of non-experimental exposure to ionizing or non-ionizing radiation in VERTEBRATES.
Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.
A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries.
Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins.

Studies on structural changes of the carotid arteries and the heart in asymptomatic renal transplant recipients. (1/2863)

BACKGROUND: The present study was designed to characterize early structural changes of large arteries in renal transplant recipients with no clinical evidence of cardiovascular disease and normal blood pressure values, and to analyse the relationship between arterial alterations and those of the heart. METHODS: Intima media thickness and atherosclerotic plaques of the carotid arteries as well as left ventricular geometry and function were examined in 35 asymtomatic renal transplant recipients and 29 age- and sex-matched healthy controls by high resolution B-mode ultrasound and by echocardiography. RESULTS: Intima-media thickness of the carotid arteries was significantly higher in renal transplant recipients (1.21+/-0.08 mm) than in healthy controls (0.74+/-0.04 mm) (P<0.001). Atherosclerotic plaques were found in the majority of renal transplant recipients (71% vs 14% in healthy controls, P<0.001). Left ventricular mass index was significantly increased in the group of renal transplant recipients (264+/-13 g, 146+/-7 g/m2) when compared with healthy controls (155+/-8 g, 83+/-4 g/m2) (P<0.001). Multiple regression analysis in renal transplant recipients showed that intima media thickness of the carotid arteries was significantly related to left ventricular mass index (P<0.02), but not to age, blood pressure, body mass index, serum creatinine, cholesterol and lipoprotein (a) levels. In the group of healthy controls, intima-media thickness of the carotid artery was related to age (P<0.002), but not to left ventricular mass index or the other independent variables. CONCLUSIONS: The present study documents pronounced intima-media thickening in asymptomatic renal transplant recipients. Atherosclerotic lesions are present in most renal transplant recipients with no clinical evidence of cardiovascular disease. We observed a parallelism between arterial wall thickening and left ventricular hypertrophy, although blood pressure levels were normal during haemodialysis therapy and after renal transplantation.  (+info)

Combined carotid endarterectomy and coronary artery bypass graft. (2/2863)

Atherosclerosis is a generalized disease which afflicts a considerable number of patients in both the carotid and coronary arteries. Although the risk of stroke or death use to combined carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) is thought to be higher than that of each individual operation, the combined procedure is generally preferred over staged operations to treat such patients. We performed the combined procedure safely with the aid of intraoperative portable digital subtraction angiography (DSA). This report describes our experience with the operative strategy of simultaneous CEA and CABG. Ninety CEA and 404 CABG were carried out between January 1989 and December 1997. A total of six patients received the combined procedure with the aid of intraoperative DSA; they were studied retrospectively. Postoperative mortality and morbidity after the combined procedure was 0%. In the combined procedure, neurological complications are difficult to detect after CEA because the patient must be maintained under general anesthesia and extracorporeal circulation during the subsequent CABG. However, intraoperative DSA can confirm patency of the internal carotid artery and absence of flap formation after CEA, and the CABG can be performed safely. Intraoperative portable DSA between CEA and CABG is helpful in preventing perioperative stroke in the combined procedure.  (+info)

Brain-specific protein C activation during carotid artery occlusion in humans. (3/2863)

BACKGROUND AND PURPOSE: Activation of plasma protein C (PC) zymogen by thrombin-thrombomodulin at the endothelial surface is an important endogenous antithrombotic mechanism. It is unknown whether activated protein C (APC) is generated in vivo in the cerebrovasculature, because there is only limited thrombomodulin expression in human brain vascular endothelium. Therefore, we tested the hypothesis that carotid occlusion produces brain-specific PC activation. METHODS: Blood samples were simultaneously collected from the ipsilateral internal jugular vein and radial artery before and during carotid cross-clamping and on "de-occlusion" in 8 awake patients undergoing routine carotid endarterectomy. Plasma PC zymogen and circulating APC levels were measured using enzyme immunocapture assay and expressed as percent of pooled plasma controls. RESULTS: Internal jugular vein APC levels increased 28% exclusively during carotid occlusion and then decreased 32% with de-occlusion (F=8.1, P<0.005). PC zymogen increased only 5.9% with occlusion (F=6.3, P<0.02), consistent with hemoconcentration. There were no changes in radial artery PC or APC levels. CONCLUSIONS: These findings demonstrate brain-specific protein C activation in humans during carotid occlusion and suggest a protective role for endogenous APC generation during cerebrovascular occlusion.  (+info)

Outcome of carotid artery occlusion is predicted by cerebrovascular reactivity. (4/2863)

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the possibility of obtaining prognostic indications in patients with internal carotid occlusion on the basis of intracranial hemodynamic status, presence of previous symptoms of cerebrovascular failure, and baseline characteristics. METHODS: Cerebral hemodynamics were studied with transcranial Doppler ultrasonography. Cerebrovascular reactivity to apnea was calculated by means of the breath-holding index (BHI) in the middle cerebral arteries. Sixty-five patients with internal carotid artery occlusion were followed-up prospectively (median, 24 months), 23 patients were asymptomatic and 42 symptomatic (20 with transient ischemic attack and 22 with stroke). RESULTS: During the follow-up period, 11 symptomatic patients and 1 asymptomatic patient had another ischemic event ipsilateral to carotid occlusion. Among factors considered, only lower BHI values in the middle cerebral arteries ipsilateral to carotid occlusion and older age were significantly associated with the risk of developing symptoms (P=0.002 and P=0.003, respectively; Cox regression multivariate analysis). Based on our data, a cut point of the BHI value for distinguishing between pathological and normal cerebrovascular reactivity was determined to be 0.69. All patients except one, who developed TIA or stroke during the follow-up period, had BHI values ipsilateral to carotid occlusion of <0.69. CONCLUSIONS: These data suggest that impaired cerebrovascular reactivity is predictive for cerebral ischemic events in patients with carotid occlusion.  (+info)

Prevention of neointimal formation by a serine protease inhibitor, FUT-175, after carotid balloon injury in rats. (5/2863)

BACKGROUND AND PURPOSE: In vivo and vitro studies revealed the activation of thrombin and the complement system in vascular lesion formation during the process of atherosclerosis, along with pathological proliferation of smooth muscle cells. We examined the effect of the synthetic serine protease inhibitor FUT-175 (developed as a potent inhibitor of thrombin and the complement system) on vascular lesions using balloon dilatation-induced neointimal formation in the carotid artery of rats. METHODS: Sprague-Dawley (SD) rats underwent balloon dilatation injury of the left carotid artery to induce neointimal formation. Three groups of these rats (n=8, each) were treated with daily intraperitoneal injections of 1 of the following doses of FUT-175: 0.5, 1.0, or 2.0 mg/d in 1 mL of saline for 7 consecutive days. The control group (n=8) was similarly treated with 1 mL of saline for 7 days. The injections were started immediately after balloon injury. Two weeks after the injury, the left carotid arteries were perfusion-fixed, and the areas of the neointimal and medial layer were analyzed under a microscope. RESULTS: A morphometric analysis revealed that there were significant differences in the intima-media ratio between the 4 groups treated with vehicle (saline) or a low, medium, or high dose of FUT-175 (1.45+/-0.11, 1.08+/-0.06, 0.71+/-0.04, or 0.32+/-0.04, respectively). This suppression was achieved in a dose-dependent manner by the administration of FUT-175 after balloon injury. In the histological study, it was demonstrated that FUT-175 suppresses the production of platelet-derived growth factor (PDGF)-BB in the neointima and the medial smooth muscle cell layer. CONCLUSIONS: After balloon injury activated proteases that were inhibited by FUT-175 were demonstrated to have an essential role in the development of the pathological thickening of the arterial wall.  (+info)

Prostacyclin synthase gene transfer accelerates reendothelialization and inhibits neointimal formation in rat carotid arteries after balloon injury. (6/2863)

Prostacyclin (PGI2), a metabolite of arachidonic acid, has the vasoprotective effects of vasodilation, anti-platelet aggregation, and inhibition of smooth muscle cell proliferation. We hypothesized that an overexpression of endogenous PGI2 may accelerate the recovery from endothelial damage and inhibit neointimal formation in the injured artery. To test this hypothesis, we investigated in vivo transfer of the PGI2 synthase (PCS) gene into balloon-injured rat carotid arteries by a nonviral lipotransfection method. Seven days after transfection, a significant regeneration of endothelium was observed in the arteries transfected with a plasmid carrying the rat PCS gene (pCMV-PCS), but little regeneration was seen in those with the control plasmid carrying the lacZ gene (pCMV-lacZ) (percent luminal circumference lined by newly regenerated endothelium: 87. 1+/-6.9% in pCMV-PCS-transfected vessels and 6.9+/-0.2% in pCMV-lacZ vessels, P<0.001). BrdU staining of arterial segments demonstrated a significantly lower incorporation in pCMV-PCS-transfected vessels (7. 5+/-0.3% positive nuclei in vessel cells) than in pCMV-lacZ (50. 7+/-9.6%, P<0.01). Moreover, 2 weeks after transfection, the PCS gene transfer resulted in a significant inhibition of neointimal formation (88% reduction in ratio of intima/media areas), whereas medial area was similar among the groups. Arterial segments transfected with pCMV-PCS produced significantly higher levels of 6-keto-PGF1alpha, the main metabolite of PGI2, compared with the segments transfected with pCMV-lacZ (10.2+/-0.55 and 2.1+/-0.32 ng/mg tissue for pCMV-PCS and pCMV-placZ, P<0.001). In conclusion, this study demonstrated that an in vivo PCS gene transfer increased the production of PGI2 and markedly inhibited neointimal formation with accelerated reendothelialization in rat carotid arteries after balloon injury.  (+info)

Continuous perivascular L-arginine delivery increases total vessel area and reduces neointimal thickening after experimental balloon dilatation. (7/2863)

The aim of this study was to evaluate whether vascular remodeling and neointimal thickening occur after balloon dilatation of the nonatherosclerotic rabbit carotid artery, and whether both processes are influenced by continuous perivascular delivery of L-arginine or the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME). In the first experiment, histological and morphometric evaluation of arteries was performed at different time points after balloon dilatation: 10 minutes (n=7), and 1 (n=7), 2 (n=9), 3 (n=20), or 10 (n=5) weeks. Neointimal thickening progressively contributed to luminal narrowing for at least 10 weeks after angioplasty. During the first 2 weeks after dilatation, a significant decrease of the total vessel area was measured. Ten weeks after dilatation, both the neointimal and total vessel area were increased without further changing of the luminal area. In the second experiment, endothelial injured rabbits were randomly assigned to receive 2 weeks of continuous local perivascular physiological salt solution (n=6), L-arginine (n=8), or L-NAME (n=7), starting immediately after balloon dilatation (ie, local drug delivery during the first phase of the biphasic vascular remodeling process). Perivascular L-arginine delivery significantly reduced the neointimal area, despite an increased number of neointimal Ki-67-positive smooth muscle cells. Both the luminal area and total vessel area were significantly increased. Serum L-arginine levels remained unchanged. L-NAME administration had no effect on the neointimal area, nor on the luminal and total vessel area. Neointimal formation and biphasic vascular remodeling occur after experimental balloon dilatation of the nonatherosclerotic rabbit carotid artery, and can be influenced by continuous local perivascular delivery of L-arginine.  (+info)

Lumen reduction measurements of the internal carotid artery before and after Levovist enhancement: reproducibility and agreement with angiography. (8/2863)

Our aim was to assess reproducibility of three different lumen reduction measuring methods--North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial, and common carotid--using power Doppler and color Doppler sonography before and after Levovist enhancement. We included 20 symptomatic patients with mild or severe carotid disease. North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial, and common carotid measurements on longitudinal views and European Carotid Surgery Trial measurements on transverse views were performed. Examinations were repeated and the results compared to assess reproducibility of measurements. Correlation with angiography was obtained by calculating Pearson correlation coefficients. Reproducibility was significantly better (P < 0.05) for European Carotid Surgery Trial and common carotid measurements (95% limits of agreement between -10% to 10% and -19% to 17%) as compared to North American Symptomatic Carotid Endarterectomy Trial measurements (95% limits of agreement between -11% to 21% and -21% to 23%). Variability of measurements after enhancement increased slightly (not significant) for both power and color Doppler sonography. Additionally, European Carotid Surgery Trial measurements, using nonenhanced power Doppler or color Doppler sonography, did not correlate significantly with angiography, whereas North American Symptomatic Carotid Endarterectomy Trial and common carotid measurements correlated well with angiography, particularly in power Doppler mode after enhancement (r = 0.88 and r = 0.82, respectively). We conclude that for lumen reduction measurements of the internal carotid artery with power and color Doppler sonography, the common carotid method is the only method that is reproducible and has good correlation with angiography, which slightly improves after Levovist enhancement.  (+info)

TY - JOUR. T1 - Long-term results of medical and surgical therapy for Japanese patients with moderate carotid stenosis. AU - Ogata, Toshiyasu. AU - Yasaka, Masahiro. AU - Wakugawa, Yoshiyuki. AU - Inoue, Tooru. AU - Yasumori, Kotaro. AU - Kitazono, Takanari. AU - Iida, Mitsuo. AU - Okada, Yasushi. PY - 2012/1. Y1 - 2012/1. N2 - To clarify the efficacy of medication versus carotid endarterectomy (CEA), we investigated cardiovascular events and outcomes in Japanese patients with moderate carotid stenosis. We consecutively registered patients with significant carotid stenosis (50%-79%) measured by digital subtraction angiography (DSA) over 10 years and compared the incidences of stroke, myocardial infarction, and death between treatment groups (surgical group vs medical group). Of 406 registered patients, 163 (108 treated surgically and 55 treated medically) with moderate carotid stenosis were analyzed. Complete follow-up data (mean, 4.2 years) were available for 105 patients in the surgical group ...
Evidence-based recommendations on carotid artery stent placement for symptomatic extracranial carotid stenosis (narrowed carotid arteries in the neck)
TY - JOUR. T1 - Surgical advances for extracranial carotid stenosis. AU - Harbaugh, Robert E.. AU - Patel, Akshal. N1 - Copyright: Copyright 2014 Elsevier B.V., All rights reserved.. PY - 2014/2. Y1 - 2014/2. N2 - Carotid endarterectomy is a commonly performed operation to prevent stroke in patients who have asymptomatic or symptomatic internal carotid artery atherosclerotic stenosis. Carotid angioplasty and stenting has also been advocated for treatment of these patients. In this article, we address a number of questions for which a review of available data will advance our understanding of the role of carotid endarterectomy in stroke prevention. These include the following: Are carotid endarterectomy and carotid angioplasty and stenting equivalent procedures for the treatment of carotid artery disease? Which patients should be deemed at high risk for carotid endarterectomy? Should carotid endarterectomy be an urgent procedure in symptomatic patients with severe internal carotid artery ...
We systematically compared and appraised contemporary guidelines on management of asymptomatic and symptomatic carotid artery stenosis.We systematically searched for guideline recommendations on carotid endarterectomy (CEA) or carotid angioplasty/stenting (CAS) published in any language between January 1, 2008, and January 28, 2015. Only the latest guideline per writing group was selected. Each guideline was analyzed independently by 2 to 6 authors to determine clinical scenarios covered, recommendations given, and scientific evidence used.Thirty-four eligible guidelines were identified from 23 different regions/countries in 6 languages. Of 28 guidelines with asymptomatic carotid artery stenosis procedural recommendations, 24 (86%) endorsed CEA (recommended it should or may be provided) for ≈50% to 99% average-surgical-risk asymptomatic carotid artery stenosis, 17 (61%) endorsed CAS, 8 (29%) opposed CAS, and 1 (4%) endorsed medical treatment alone. For asymptomatic carotid artery stenosis ...
BACKGROUND AND PURPOSE: Blood supply through collateral pathways improves regional cerebral blood flow and may protect against ischemic events. The effect of collaterals on the risk of stroke and transient ischemic attack (TIA), in the presence of angiographic severe internal carotid artery (ICA) stenosis, was assessed. METHODS: Angiographic collateral filling through anterior communicating and posterior communicating arteries and retrograde filling through ophthalmic arteries were determined in all patients at entry into the North American Symptomatic Carotid Endarterectomy Trial. Kaplan-Meier event-free survival analyses were performed on 339 medically treated and 342 surgically treated patients. RESULTS: The presence of collaterals supplying the symptomatic ICA increased with severity of stenosis. Two-year risk of hemispheric stroke in medically treated patients with severe ICA stenosis was reduced in the presence of collaterals: 27.8% to 11.3% (P=0.005). Similar reductions were observed for
Background: Moderate to severe or bilateral carotid stenosis is associated with cerebral atrophy and cognitive decline. Prior studies have evaluated global atrophy and its correlation with the degree of stenosis. It is unclear whether carotid stenosis can lead to unilateral cerebral changes.. Objective: To evaluate for unilateral cerebral atrophy in asymptomatic patients with moderated to severe extracranial unilateral carotid stenosis.. Methods: Subjects were selected from patients who had undergone carotid vascular imaging and MRI of the brain, from January 2007 to January 2013 at our institution. Patients with history of TIA or ischemic stroke were excluded. Carotid stenosis (CS) group consisted of patients with unilateral moderate to severe carotid stenosis (n=9). Patients without any stenosis (n=5) were used as controls. T1-weighted brain images (FOV 256 x 256 x128, resolution 1.5 x 1.5 x 5 mm) were registered to Talairach space using FSL software. Non-brain tissue was removed using the BET ...
TY - JOUR. T1 - Usefulness of Early Stenting for Symptomatic Extracranial Carotid Stenosis. AU - Yang, Na Rae. AU - Jeon, Pyoung. AU - Kim, Byungjun. AU - Kim, Keon Ha. AU - Jo, Kyung Il. PY - 2016/12/1. Y1 - 2016/12/1. N2 - Background While carotid angioplasty and stenting (CAS) have become an established procedure, outcomes of early CAS for symptomatic extracranial carotid stenosis (SECS) remain poorly understood. The present study aimed at determining the effectiveness of early CAS in SECS. Methods Herein, 224 SECS patients underwent elective CAS between January 2008 and June 2015. The study population was stratified based on the time from symptom onset to the procedure (early CAS group: within 14 days; delayed CAS group: later than 14 days). Subgroup analysis (chi-square test, Mantel-Haenszel chi-square test, and analysis of covariance) evaluated the demographics, incidence of periprocedural thromboembolic complications, cerebral hyperperfusion syndrome (CHS), intracranial bleeding, and ...
TY - JOUR. T1 - Carotid stenting in a nonagenarian patient with symptomatic carotid stenosis. AU - Ranjan Shetty, K.. AU - Vivek, G.. AU - Gupta, Manoj K.. AU - Nayak, Krishananda. AU - Pai, Umesh. AU - Dias, Lorraine. AU - Naha, Kushal. AU - Acharya, Raviraj. PY - 2012/11/8. Y1 - 2012/11/8. N2 - Carotid artery stenosis is a disabling disease in all age groups. Elderly people are more prone to recurrent strokes due to advancing age and multiple co-morbidities. Treatment options for symptomatic carotid stenosis in the very elderly are the same as in younger patients although with a higher operative risk. We describe a successful case of carotid artery stenting in a nonagenarian with symptomatic carotid artery stenosis, a subgroup for whom treatment options are rarely discussed in guidelines.. AB - Carotid artery stenosis is a disabling disease in all age groups. Elderly people are more prone to recurrent strokes due to advancing age and multiple co-morbidities. Treatment options for symptomatic ...
1. European Carotid Surgery Trialists Collaborative Group: Randomised trial of endarterectomy for recently symptomatic carotid stenosis: Final results of the MRC European Carotid Surgery Trial (ECST). Lancet 1998;351:1379-1387. [Abstract] [PDF] 2. Rothwell PM, Gutnikov SA, Warlow CP for the ECST: Re-analysis of the final results of the European Carotid Surgery Trial. Stroke 2003;34:514-523. [Abstract] [PDF] 3. Rothwell PM, Warlow CP on behalf of the ECST Collaborators: Prediction of benefit from carotid endarterectomy in individual patients: A risk-modelling study. Lancet 1999;353:2105--2110. [Abstract] [PDF] 4. Rothwell PM, Mehta Z, Howard SC, Gutnikov SA, CP Warlow. From subgroups to individuals: general principles and the example of carotid endartectomy. Lancet 2005; 365: 256-65. [Abstract] [PDF] 5. Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJM for the Carotid Endarterectomy Trialists Collaboration. Endarterectomy for symptomatic carotid stenosis in relation to clinical ...
TY - JOUR. T1 - Asymptomatic carotid stenosis and cognitive improvement using transcervical stenting with protective flow reversal technique. AU - Ortega, G.. AU - Álvarez, B.. AU - Quintana, M.. AU - Yugueros, X.. AU - Álvarez-Sabin, J.. AU - Matas, M.. PY - 2014/1/1. Y1 - 2014/1/1. N2 - Objectives The relationship between carotid artery stenosis and cognitive function in individuals without a history of stroke is not clear. The possible pathomechanisms of cognitive impairment include silent embolization and hypoperfusion. In this study the aim was to assess cognitive changes after transcervical carotid artery stenting with proximal cerebral protection by flow reversal in patients with asymptomatic carotid stenosis, a novel technique that has been proved to decrease the number intraoperative emboli. Methods 25 consecutive patients were assessed, of which 22 were men (88%) mean age of 74 years with severe asymptomatic carotid stenosis who underwent revascularization by carotid artery stenting ...
The investigators of the Asymptomatic Carotid Atherosclerosis Study (ACAS) are reporting the interim results of a randomized controlled clinical trial of carotid endarterectomy in patients who have asymptomatic carotid stenosis of greater than 60% reduction in diameter. In addition to aspirin and aggressive management of modifiable risk factors, one half of the patients were randomly assigned to receive surgery after angiographic confirmation of the lesion. Carotid endarterectomy is beneficial with a statistically significant absolute reduction of 5.8% in the risk of the primary end point of stroke within 5 years and a relative risk reduction of 55%. As a consequence of the trial reaching statistical significance in favor of endarterectomy, and on the recommendation of the studys data monitoring committee, physicians participating in the study were immediately notified and advised to reevaluate patients who did not receive surgery. It is important to note that the success of the operation is ...
TY - JOUR. T1 - Cerebral blood flow and cerebrovascular reactivity capacity in patients with bilateral high-grade carotid artery stenosis. AU - Liu, Hon Man. AU - Tu, Yong Kwang. AU - Yip, Ping Keung. AU - Su, Cheng Tau. PY - 1996/12/1. Y1 - 1996/12/1. UR - http://www.scopus.com/inward/record.url?scp=0029689112&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0029689112&partnerID=8YFLogxK. U2 - 10.1111/j.1600-0404.1996.tb00559.x. DO - 10.1111/j.1600-0404.1996.tb00559.x. M3 - Article. C2 - 8686451. AN - SCOPUS:0029689112. VL - 93. SP - 90. EP - 92. JO - Acta Neurologica Scandinavica. JF - Acta Neurologica Scandinavica. SN - 0001-6314. IS - SUPPL166. ER - ...
TY - JOUR. T1 - Comparative Outcomes of Carotid Artery Stent Placement and Carotid Endarterectomy in Patients with Chronic Kidney Disease and End-Stage Renal Disease. AU - Adil, Malik M.. AU - Saeed, Fahad. AU - Chaudhary, Saqib A.. AU - Malik, Ahmed. AU - Qureshi, Adnan I.. PY - 2016/7/1. Y1 - 2016/7/1. N2 - Background Patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) have a high prevalence of carotid artery stenosis but are excluded from clinical trials. We sought to determine the clinical characteristics and outcomes related to carotid endarterectomy (CEA) and carotid artery stenting (CAS) in ESRD and CKD patients. Methods We determined the frequency of CAS and CEA performed in patients with ESRD and CKD and associated in-hospital outcomes using data from the nationwide inpatient sample data files from 2005 to 2011. All the in-hospital outcomes were analyzed after adjusting for potential confounders using multivariate analysis. Results Of the 43,875 CKD patients ...
BACKGROUND AND PURPOSE: The use of three methods of measuring carotid stenosis, which produce different values on the same angiograms, has caused confusion and reduced the generalizability of the results of research. If the results of future studies are to be properly applied to clinical practice, and if noninvasive methods of imaging are to be properly validated against angiography, a single, standard method of measurement of stenosis on angiograms must be adopted. This standard method should be selected on the bases of its ability to predict risk of ipsilateral carotid distribution ischemic stroke and its reproducibility. METHODS: The method of measurement of carotid stenosis used in the European Carotid Surgery Trial (ECST), that used in the North American Symptomatic Carotid Endarterectomy Trial (NASCET), and a method based on the measurement of the common carotid (CC) lumen diameter were studied. Their use in the prediction of ipsilateral carotid distribution ischemic stroke was assessed in 1001
BACKGROUND AND PURPOSE: Contrast-enhanced MR angiography and extracranial color-coded duplex sonography are noninvasive, preoperative imaging modalities for evaluation of carotid artery stenosis. Innovative techniques and improvements in image quality require frequent reassessment of accuracy, reliability, and diagnostic value compared with those of digital subtraction angiography (DSA). We evaluated contrast-enhanced MR angiography and duplex sonography compared with DSA for detection of high-grade carotid artery stenoses. METHODS: Four readers, blinded to clinical symptoms and the outcome of other studies, independently evaluated stenoses on contrast-enhanced MR angiograms in 71 vessels of 39 symptomatic patients. Duplex sonography was also performed in all vessels. The severity of stenosis was defined according to North American Symptomatic Carotid Endarterectomy Trial criteria (0-29%, 30-69%, 70-99%, 100%). Results of both modalities were compared with the corresponding DSA finding
© 2018, The Author(s). Purpose of Review: Provide a current overview regarding the optimal strategy for managing patients with asymptomatic carotid artery stenosis. Recent Findings: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce long-term stroke risk in asymptomatic patients. However, CAS is associated with a higher risk of peri-procedural stroke. Improvements in best medical therapy (BMT) have renewed uncertainty regarding the extent to which results from older randomised controlled trials (RCTs) comparing outcomes following carotid intervention can be generalised to modern medical practise. Summary: Average surgical risk patients with an asymptomatic carotid artery stenosis of 60-99% and increased risk of late stroke should be considered for either CEA or CAS. In patients deemed high risk for surgery, CAS is indicated. Use of an anti-platelet, anti-hypertensive and statin, with strict glycaemic control, is recommended. Results from ongoing large, multicentre RCTs comparing
Carotid endarterectomy (CEA) has been shown effective in both asymptomatic and symptomatic patients with carotid stenosis. However, the clinical trials upon which we have relied for this information may not reflect the advances made in primary stroke prevention. For this reason, revascularization may not be the preferred method of intervention among patients with carotid stenosis. This comparative effectiveness study used databases of the U.S. Veterans Affairs to investigate the differences between initial medical therapy and CEA in preventing strokes among patients with asymptomatic carotid stenosis. Patients without a carotid imaging report, those with a history of stroke within six months of index imaging, and those with carotid stenosis of less than 50% or hemodynamically insignificant stenosis were excluded from subsequent analyses. Of the 5,221 patients included, 51.9% received CEA (M [SD] age = 73.6 [6.0] years, 1.2% female) and 48.1% received initial medical therapy (M [SD] age = 73.6 [ ...
We aim to determine whether cognitive impairment attributable to cerebral hemodynamic impairment in patients with high-grade asymptomatic carotid artery stenosis is reversible with restoration of flow. To accomplish this aim CREST-H will add on to the NINDS-sponsored CREST-2 trial (parallel, outcome-blinded Phase 3 clinical trials for patients with asymptomatic high-grade carotid artery stenosis which will compare carotid endarterectomy plus intensive medical management (IMM) versus IMM alone (n=1,240), and carotid artery stenting plus IMM versus IMM alone (n=1,240) to prevent stroke and death). CREST-H addresses the intriguing question of whether cognitive impairment can be reversed when it arises from abnormal cerebral hemodynamic perfusion in a hemodynamically impaired subset of the CREST-2 -randomized patients. We will enroll 500 patients from CREST-2, all of whom receive cognitive assessments at baseline and yearly thereafter. We anticipate identifying 100 patients with hemodynamic ...
Severe carotid stenosis patients in the North American Symptomatic Carotid Endarterectomy Trial (NASCET) were shown to have a high risk of stroke and significant benefit from carotid endarterectomy. More than 20 years after the 1991 NASCET results for severe stenosis, there is a common claim to use the NASCET method to determine % carotid stenosis, but without following the details necessary to properly identify the group most benefitting from carotid endarterectomy. NASCET interpreted for loss of diameter of the cervical ICA, near occlusion, and didnt calculate % stenosis if present as it is fallacious. NASCET measured the distal ICA for well beyond the tapering ICA bulb where the ICA walls are parallel. The pitfalls of stenosis quantification and differences between methods are problems of the ratios denominator, and may potentially be resolved by the use of absolute measurements for stenosis on CTA or MRA. Furthermore, trials evaluating vessel wall components including intraplaque hemorrhage such
Severe carotid stenosis patients in the North American Symptomatic Carotid Endarterectomy Trial (NASCET) were shown to have a high risk of stroke and significant benefit from carotid endarterectomy. More than 20 years after the 1991 NASCET results for severe stenosis, there is a common claim to use the NASCET method to determine % carotid stenosis, but without following the details necessary to properly identify the group most benefitting from carotid endarterectomy. NASCET interpreted for loss of diameter of the cervical ICA, near occlusion, and didnt calculate % stenosis if present as it is fallacious. NASCET measured the distal ICA for well beyond the tapering ICA bulb where the ICA walls are parallel. The pitfalls of stenosis quantification and differences between methods are problems of the ratios denominator, and may potentially be resolved by the use of absolute measurements for stenosis on CTA or MRA. Furthermore, trials evaluating vessel wall components including intraplaque hemorrhage such
The Asymptomatic Carotid Atherosclerosis Study (ACAS) results suggest that carotid endarterectomy combined with aspirin and risk factor reduction is superior to aspirin and risk factor reduction alone in preventing ipsilateral stroke in asymptomatic patients with diameter stenosis of the carotid artery of 60% or more. The absolute risk reduction over 5 years conferred by surgical therapy is modest (5.9%) compared with the risk reduction conferred by surgical therapy for symptomatic carotid disease but compares favorably with the degree of stroke prevention shown for antihy-pertensive therapy in the elderly. For prevention of stroke in women and for prevention of major stroke, the ACAS results favoring surgery did not reach statistical significance. The combined arteriographic and perioperative surgery-related mortality and stroke rates achieved by the carefully selected surgical teams was low (2.3%). Accordingly, carotid endarterectomy can be recommended for preventing stroke in the setting of ...
The current trend to often err on the side of using endarterectomy or stenting when significant carotid disease is found - regardless of whether there are symptoms - appears based primarily on two large trials in the 1990s. The Asymptomatic Carotid Artery Study and the Asymptomatic Carotid Surgery Trial basically showed the approaches were more effective than medical therapy. For example, the Asymptomatic Carotid Atherosclerosis study showed surgery reduced the five-year stroke risk by more than half in symptom-free patients with significant blockage of 60-99 percent. The original CREST, which started in 2000 and also followed about 2,500 patients, was the first to compare endarterectomy to stenting in patients with and without symptoms of carotid artery disease, and found they were essentially the same in both risks and stroke prevention. But a more current study, the SAMMPRIS trial, comparing stenting and current medical therapy in patients who have had recent transient ischemic attacks or a ...
OBJECTIVES: several ancillary surgical techniques, such as shunting and patching, are used in association with carotid endarterectomy. However, the balance of risks and benefits of these techniques is uncertain because of the lack of large randomised controlled trials (RCTs). To assess the potential for further trials, we studied the variation in use of these techniques by surgeon and by country in the European Carotid Surgery Trial (ECST). METHODS: use of each ancillary technique was assessed by surgeon and by country. For each technique, the relationships between the use of the technique and baseline patient characteristics, use of other techniques, and the 30-day operative risk of stroke and death were determined. RESULTS: there was considerable variation between surgeons in the use of ancillary operative techniques both within (p|0.001 for shunting and patching), and between countries (p|0.001 for shunting and patching). Some surgeons used techniques selectively, and so the characteristics of
It is well known that risk of fatal and non-fatal stroke is increased in patients with significant carotid atherosclerosis. For asymptomatic patients, AHA guidelines recommend carotid endarterectomy (CEA) for stenosis 60% to 99%, if the risk of perioperative stroke or death is less than 3%.. Although clinical trial data support CEA in asymptomatic patients with carotid stenosis 60% to 79%, the AHA guidelines indicate that some physicians delay revascularization until there is greater than 80% stenosis in asymptomatic patients.. Our study is designed to determine whether optimal medical therapy alone reduces the risk of death and nonfatal stroke in patients with carotid artery stenosis as compared with CEA coupled with optimal medical therapy. ...
Recent randomised controlled trials comparing carotid artery stenting (CAS) with endarterectomy (CEA) for the treatment of symptomatic carotid stenosis were not powered to investigate differences in risks in specific patient subgroups. We therefore performed a pooled analysis of individual patient data from the Symptomatic Severe Carotid Stenosis trial (EVA-3S), the Stent-Protected Angioplasty versus Carotid Endarterectomy trial (SPACE), and the International Carotid Stenting Study (ICSS ...
Choi et al attempt to shine additional light on an already hotly debated topic. The investigators used multivariable logistic regression, propensity score matching and a grouped-treatment approach (with adjustments for baseline characteristics) to compare in-hospital death and postoperative stroke after either carotid artery stenting (CAS) or carotid endarterectomy (CEA). A cohort of 17,716 patients with asymptomatic carotid stenosis treated with CEA and 3,962 patients treated with CAS at 186 different academic medical centers which participate in the University Health System Consortium were reviewed. The patients were identified using ICD 9 codes between the years 2010-2012. Patient information, such as demographics, was obtained from the medical record. They examined the annual volume of both CAS and CEA at each hospital as well as the volume and outcomes of patients undergoing each procedure per physician. The primary outcome was defined as a composite of postoperative stroke or in-hospital ...
With the publication of randomized controlled trials on carotid endarterectomy, the appropriate indications for this surgery (when to operate) are becoming better defined. From a public health perspective, however, the benefits of carotid surgery are convincing only when surgical morbidity and mortality rates are very low. Thus, an equally important question needs to be considered: Who should operate in carotid disease?. In this issue of American Family Physician, Biller and Thies1 review evidence showing that carotid endarterectomy can be highly effective in preventing stroke. Patients with high-grade internal carotid artery stenosis (greater than 70 percent) that is ipsilateral to the side of previous symptoms or nondisabling stroke benefit dramatically from the combined use of surgery and medical therapy compared with the use of medical therapy alone. In patients with severe carotid artery stenosis, fewer than eight carotid endarterectomies are required to prevent one stroke. The benefits ...
Background: We sought to study the association between carotid stenosis and white-matter hyperintensity (WMH) among patients without intracranial large-vessel stenosis. Methods: This was a prospective study of patients with acute lacunar infarcts without concomitant intracranial large-vessel stenosis having undergone carotid ultrasonography. WMH was quantified using the modified Fazekas scale. Patients were grouped into quartiles based on the degree of carotid stenosis. The association among carotid stenosis, vascular risk factors, and WMH were modeled using logistic regression analysis. Results: In all, 100 patients with a mean age of 56.2 ± 11.7 years were studied. The quartile with the greatest carotid stenosis had a mean internal/common carotid artery peak systolic velocity ratio of 2.36. Total WMH was 4.64 in the highest quartile and 2.52 in the lowest quartile of carotid stenosis. Periventricular (pv)-WMH was significantly greater between the highest and lowest quartiles (2.80 versus ...
TY - JOUR. T1 - High cardiovascular event rates in patients with asymptomatic carotid stenosis. T2 - The REACH registry. AU - Aichner, F. T.. AU - Topakian, R.. AU - Alberts, M. J.. AU - Bhatt, D. L.. AU - Haring, H. P.. AU - Hill, M. D.. AU - Montalescot, G.. AU - Goto, S.. AU - Touzé, E.. AU - Mas, J. L.. AU - Steg, P. G.. AU - Röther, J.. PY - 2009/8. Y1 - 2009/8. N2 - Background and purpose: Data on current cardiovascular event rates in patients with asymptomatic carotid artery stenosis (ACAS) are sparse. We compared the 1-year outcomes of patients with ACAS ≥70% versus patients without ACAS in an international, prospective cohort of outpatients with or at risk of atherothrombosis. Methods: The Reduction of Atherothrombosis for Continued Health Registry enrolled patients with either ≥3 atherothrombotic risk factors or established atherothrombotic disease. We investigated the 1-year follow-up data of patients for whom physicians reported presence/absence of ACAS at the time of ...
Objective: Radiotherapy to the head and neck often results in carotid stenosis, but the course of disease is unknown. We investigated the natural history and progression of asymptomatic carotid stenosis induced by external irradiation. Patients and Methods: The study included 130 carotid arteries in 95 patients who had received external radiation therapy to the head and neck area and who had asymptomatic, mild internal carotid artery or common carotid artery stenosis. Stenosis of 15% to 49% on duplex ultrasound (US) scans defined mild (< 50%) disease. Another 95 arteries in 74 patients with matched degree of carotid artery stenosis but who had not received radiation therapy were used as control. Both groups were followed up prospectively with serial duplex US scanning, and degree of carotid artery stenosis was categorized as 15% to 49%, 50% to 69%, 70% to 99%, and occlusion. Progression of carotid artery stenosis was defined as increase in stenosis from less than 50% to 50% or greater at ...
After searching the scientific literature, USPSTF investigators found no recent eligible studies that directly investigated the benefits or harms of asymptomatic carotid artery stenosis screening. The two studies that were conducted on the topic in the past six years were both prematurely terminated and produced mixed results.. When looking at the benefits and harms of CEA or CAS, the authors found an additional two national datasets and three surgical registries that met their inclusion criteria. Rates of 30-day postoperative stroke or death after CEA ranged from 1.4% to 3.5% depending on the registry or database. Similarly, 30-day stroke or death after CAS ranged from 2.6% to 5.1%.. Based on the evidence -- or lack thereof -- the investigators concluded there wasnt enough new information to change the D rating for asymptomatic carotid artery stenosis screening. However, they pointed out that two clinical trials are currently underway, which may shed light on the topic in the future.. There ...
BACKGROUND AND PURPOSE: Carotid endarterectomy reduces the risk of carotid territory ischemic stroke ipsilateral to a recently symptomatic severe carotid stenosis. However, the benefit is limited by the risks of stroke and death associated with the operation. Although reported surgical risks vary enormously, there has been no systematic review of the published literature. METHODS: We performed a systematic review of mortality and the risk of stroke and/or death due to endarterectomy for symptomatic carotid stenosis in studies published since 1980. RESULTS: Fifty-one studies fulfilled our criteria. Overall mortality was 1.62% (95% confidence interval [CI], 1.3 to 1.9), and the risk of stroke and/or death was 5.64% (95% CI, 4.4 to 6.9). However, there was significant heterogeneity of risk of stroke and/or death (P | .001). The risk varied systematically with the methods and the authorship of the study. The risk of stroke and/or death was highest in studies in which patients were assessed by a neurologist
BACKGROUND: The anatomy of carotid stenosis may influence the outcome of endovascular treatment or carotid endarterectomy. Whether anatomy favors one treatment over the other in terms of safety or efficacy has not been investigated in randomized trials. METHODS: In 414 patients with mostly symptomatic carotid stenosis randomized to endovascular treatment (angioplasty or stenting; n = 213) or carotid endarterectomy (n = 211) in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), the degree and length of stenosis and plaque surface irregularity were assessed on baseline intraarterial angiography. Outcome measures were stroke or death occurring between randomization and 30 days after treatment, and ipsilateral stroke and restenosis ≥50% during follow-up. RESULTS: Carotid stenosis longer than 0.65 times the common carotid artery diameter was associated with increased risk of peri-procedural stroke or death after both endovascular treatment [odds ratio 2.79 (1.17-6.65), P = 0.02] and
Stroke is the third-leading cause of death in America, and carotid artery stenosis-also known as carotid artery disease-is one of the leading risk factors for stroke, accounting for about 20 percent of strokes. To mark National Stroke Month in May, we asked University of Minnesota Health Neurosurgeon and Neurointerventionist Ramachandra Tummala, MD, to tell us five things we should know about carotid artery stenosis and its link to stroke risk.. Carotid stenosis occurs when buildup begins blocking blood flow.. Stenosis is a medical term for narrowing of blood vessels in the body due to a buildup of inflammatory substances and cholesterol deposits-called plaque. Two carotid arteries in the neck carry most of the blood flow from the heart to the brain. When stenosis occurs in these arteries it is known as carotid artery stenosis. Carotid artery stenosis can lead to a stroke.. Patients with carotid artery stenosis are at increased risk for a stroke, which can lead to disability or death. Sometimes, ...
A randomized treatment study comparing carotid stent and endarterectomy versus medical management.. 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. One trial will randomize patients in a 1:1 ratio to endarterectomy versus no endarterectomy and another will randomize patients in a 1:1 ratio to carotid stenting with embolic protection versus no stenting. Medical management will be uniform for all randomized treatment groups and will be centrally directed.. ...
TY - JOUR. T1 - Transcranial doppler assessment of the functional effects of symptomatic carotid stenosis. AU - Silvestrini, Mauro. AU - Troisi, E.. AU - Cupini, L. M.. AU - Matteis, M.. AU - Pistolese, G. R.. AU - Bernardi, G.. PY - 1994. Y1 - 1994. N2 - Mean flow velocity changes in the middle cerebral arteries (MCAs) during a 2-minute thumb-to-fin-ger opposition task were measured by means of transcranial Doppler ultrasonography in patients with severe unilateral carotid stenosis and ipsilateral transient ischemic attacks and in control subjects. The increase of flow velocity in the MCA contralateral to the hand performing the task was significantly different (p ,0.001, one-way ANOVA) in controls (+5.52 ± 2.4 cm/sec) and in patients (+ 1.76 ± 1.6 cm/sec, side of stenosis; +3.83 ± 2.1 cm/sec, normal side). A post hoc least significant difference test revealed a significant difference between controls and patients on the side of stenosis (p ,0.001) and between the normal side and the ...
Backgorund: Chronic cerebral hypoperfusion may lead to impairment in neurocognitive performance in patients with severe carotid artery stenosis (CAS) or occlusion (CAO), and the effects of carotid artery stenting on neurocognitive function were unclear.. Methods and Results: We prospectively enrolled 18 patients (7 CAS, 11 CAO) with objective ipsilateral hemisphere ischemia, in whom carotid artery stenting was attempted. A battery of 5 neuropsychological tests were applied prior to and 3 months after intervention. Procedural success was achieved in 6 of 11 CAOs and all CASs. The demographics and baseline cognitive performances were similar between the successful (group 1, n=13) and failed (group 2, n=5) patients. Significant improvement in Alzheimer Disease Assessment Scale (ADAS) (pre 9.2±8.4 vs post 6.8±6.8, p=0.011) and Mini-Mental State Examination score (pre 24.1±4.1 vs post 26.1±4.0, p=0.012), and a trend towards improvement in Color Trail test A (pre 115.0±64.0 vs post 95.1±47.2, ...
Description of disease Carotid stenosis. Treatment Carotid stenosis. Symptoms and causes Carotid stenosis Prophylaxis Carotid stenosis
Carotid artery stenting is associated with a higher microembolic burden than carotid endarterectomy. The rate and procedural stage of highest risk depends on the embolic protection device used, said Sumaira Macdonald, consultant vascular radiologist and honorary clinical senior lecturer, Newcastle, UK, at the annual iCON meeting in Phoenix, USA, in February.. She presented the results of a recent non-randomised comparison of carotid endarterectomy, filter-protected carotid artery stenting and carotid artery stenting with flow reversal utilising microembolic signals on transcranial Doppler as primary outcome event.. Results from the study (Gupta N, Corriere MA, Dodson TF et al. JVS Dec 1st 2010 [Epub]) showed that carotid endarterectomy had the fewest microembolic signals (largely in the post-protection phase). This was followed by flow reversal carotid artery stenting; in this case, signals detected were mostly in the pre-protection phase. Of the three procedures, filter-protected carotid ...
Asymptomatic carotid artery stenosis confers mobility impairment and cognitive dysfunction and increases the risk for falls, according to data presented at the Society for Vascular Surgery Vascular Annual Meeting. The researchers analyzed 80 older adults (mean age, 74 years; 47 men) without outward symptoms of carotid stenosis and after carotid ultrasonography stratified them into three groups:
TY - JOUR. T1 - What should we do with asymptomatic carotid stenosis?. AU - Abbott, Anne. AU - Bladin, Christopher. AU - Levi, Christopher R. AU - Chambers, Brian. PY - 2007. Y1 - 2007. N2 - Abstract The benefit of prophylactic carotid endarterectomy (CEA) for patients with asymptomatic severe carotid stenosis in the major randomised surgical studies was small, expensive and may now be absorbed by improvements in best practice medical intervention. Strategies to identify patients with high stroke risk are needed. If surgical intervention is to be considered the complication rates of individual surgeons should be available. Clinicians will differ in their interpretation of the same published data. Maintaining professional relationships with clinicians from different disciplines often involves compromise. As such, the management of a patient will, in part, depend on what kind of specialist the patient is referred to. The clinician s discussion with patients about this complex issue must be ...
TY - JOUR. T1 - MR perfusion studies of brain for patients with unilateral carotid stenosis or occlusion. T2 - Evaluation of maps of time to peak and percentage of baseline at peak. AU - Teng, Michael Mu Huo. AU - Cheng, Hui Cheng. AU - Kao, Yi Hsuan. AU - Hsu, Li Chi. AU - Yeh, Tzu Chen. AU - Hung, Chung Shiou. AU - Wong, Wen Jang. AU - Hu, Han Hwa. AU - Chiang, Jen Huey. AU - Chang, Cheng Yen. PY - 2001/2/6. Y1 - 2001/2/6. N2 - Maps of time to peak (TTP) and percentage of baseline at peak (PBP) were compared with maps of conventional brain perfusion parameters, namely, mean transit time (MTT) and relative cerebral blood volume (rCBV). We performed MR perfusion studies in 11 patients. All of them had occlusion or high-grade stenosis of the unilateral carotid artery. Three areas of old infarct, 4 areas of new infarct, and 10 areas of brain without infarct were evaluated specifically. In all these cases, the TTP maps appeared similar to the MTT maps. They showed increases, normal values, ...
Carotid intervention (either endarterectomy or stenting) is the current standard of care for the majority of patients with symptomatic high-grade carotid stenosis.1 The benefits of surgical intervention appear to be highly time dependent, declining rapidly after the symptomatic event.2 However, the management of carotid stenosis in women remains a topic of some controversy due to apparent differences in the likelihoods of benefit for men and women.3-5 It is not clear whether the observed difference between men and women is a true phenomenon or an artefact of study sampling, in that women were consistently under-represented in early randomised controlled trials (RCT).6 7 If there is indeed a difference, it may reflect biological, psychological or sociological factors. For example, it is recognised that women take longer to get to hospital after onset of stroke, but they are also less likely to receive diagnostic tests and to receive secondary prevention drugs.8 9 As a consequence, women have ...
Randomised controlled trials (RCT) have demonstrated a net benefit of carotid endarterectomy (CEA) in stroke prevention for patients with severe carotid artery stenosis as compared to best medical treatment. Results in routine clinical practice must not be inferior to those in the RCTs. The carotid arteries are clamped during CEA which may impair the cerebral perfusion. The aim of this thesis was to assess population-based outcomes from CEA, investigate risk factors for perioperative complications/late mortality and to evaluate effects of carotid clamping during CEA. In the Swedish vascular registry 6182 CEAs were registered during 1994-2003. Data on all CEAs were retrieved, analysed and validated. In the validation process no death or disabling stroke was unreported. The perioperative stroke or death rate was 4.3% for those with symptomatic and 2.1% for asymptomatic stenosis (the latter decreasing over time). Risk factors for perioperative complications were age, indication, diabetes, cardiac ...
OBJECTIVE Carotid stenoses ≥50% are associated with increased risk for stroke that can be reduced by prophylactic carotid endarterectomy (CEA). Calcifications in arteries can be detected in panoramic radiographs (PRs). In a cross-sectional study, we analyzed (1) extirpated plaques for calcification, (2) how often PRs disclosed calcified plaques, (3) how often patients with stenoses ≥50% presented calcifications in PRs, and (4) the additional value of frontal radiographs (FRs). STUDY DESIGN Patients (n = 100) with carotid stenosis ≥50% were examined with PRs and FRs before CEA. Extirpated carotid plaques were radiographically examined (n = 101). RESULTS It was found that 100 of 101 (99%) extirpated plaques were calcified, of which 75 of 100 (75%) were detected in PRs; 84 of 100 (84%) patients presented carotid calcifications in the PRs, in 9.5% contralateral to the stenosis ≥50%. CONCLUSIONS Carotid calcifications are seen in PRs in 84% of patients with carotid stenosis ≥50%, independent
TY - JOUR. T1 - Endarterectomy for asymptomatic high-grade internal carotid artery stenosis-Does age alone really matter?. AU - Assadian, Afshin. AU - Taher, Fadi. AU - Assadian, Ojan. PY - 2016/9/20. Y1 - 2016/9/20. N2 - Background The aim of this retrospective observational study was to assess whether patients ≥ 75 years of age had a significantly inferior 5-year stroke free survival rate compared to patients ,75 years of age after carotid endarterectomy under regional anesthesia. Methods All consecutive patients with asymptomatic high-grade internal carotid artery (ICA) stenosis operated on from January 1997 to December 1999. Of 273 consecutive patients with asymptomatic carotid artery stenosis, follow up was complete for 253 patients. Results Of 253 patients, 152 were younger and 102 older than 75 years at surgery (65 ± 8 years (range 43-74) and 79 ± 4 years (range 75-90); P , 0.001), respectively. Perioperatively, 4 patient developed stoke (1.6%), 2 in each group (1.3% and 1.6%, ...
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The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) completed randomization on July 18, 2008. Sponsored by the National Institute of Neurological Disorders and Stroke (NINDS), the trial has enrolled 2,522 participants across North America and is the largest randomized clinical trial (RCT) comparing the efficacy of carotid artery stenting (CAS) to carotid endarterectomy (CEA). It is also the largest RCT to assess carotid revascularization in both symptomatic and asymptomatic patients with carotid artery stenosis. Conventional-risk patients with symptomatic carotid stenosis (> or =50% by angiography, > or =70% by ultrasound) or asymptomatic carotid stenosis (> or =60% by angiography, > or =70% by ultrasound) were randomized to both treatment arms in a 1:1 ratio. Eligibility criteria for CREST were similar to those of the previous NINDS-sponsored CEA RCTs. The investigational devices used in the CAS arm of the study are the RX Acculink stent and the RX Accunet embolic protection ...
TY - JOUR. T1 - Risk of early carotid endarterectomy for symptomatic carotid stenosis. AU - Brinjikji, Waleed. AU - Rabinstein, Alejandro A.. AU - Meyer, Fredric B.. AU - Piepgras, David G.. AU - Lanzino, Giuseppe. PY - 2010/10/1. Y1 - 2010/10/1. N2 - Background And Purpose-: The purpose of this study was to determine and compare the rate of stroke, myocardial infarction, and death in patients undergoing early and late carotid endarterectomy (CEA) after a symptomatic event and in asymptomatic patients. Methods-: We conducted a retrospective analysis of all CEAs performed in the Department of Neurosurgery between January 2004 and May 2009. Patients were divided into 3 groups: Group 1, asymptomatic patients; Group 2, symptomatic patients operated on ,2 weeks after their transient ischemic attack or stroke; and Group 3, symptomatic patients operated on ≤2 weeks of their transient ischemic attack or stroke. Primary outcomes were any myocardial infarction, stroke, or death occurring within 30 days ...
TY - JOUR. T1 - The use of covered stents for the endovascular treatment of extracranial internal carotid artery stenosis. T2 - A prospective study with a 5-year follow-up. AU - Szólics, Alex. AU - Sztriha, László K.. AU - Szikra, Péter. AU - Sźlics, Mikĺs. AU - Palḱ, András. AU - Vörös, Erika. PY - 2010/7/1. Y1 - 2010/7/1. N2 - Objectives: To evaluate the safety and feasibility of the use of covered stents for the treatment of extracranial carotid artery stenosis caused by highly embologenic plaques, and to study the long-term outcome of patients receiving such covered stents. Methods: Between 2002 and 2007, 46 patients (63% symptomatic, 78.3% male, 67± 8.6 years old) with internal carotid artery stenosis caused by embologenic plaques or restenosis were treated with self-expanding covered stents (Symbiot, Boston Scientific). Pre-dilatation or protecting devices were not used. Post-dilatation was applied in every patient. Each patient was followed long-term. The outcome measures were ...
TY - JOUR. T1 - Evaluation and Management of Atherosclerotic Carotid Stenosis. AU - Meschia, James F.. AU - Klaas, James P.. AU - Brown, Robert D.. AU - Brott, Thomas G.. N1 - Publisher Copyright: © 2017 Mayo Foundation for Medical Education and Research Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 2017/7. Y1 - 2017/7. N2 - Medical therapies for the prevention of stroke have advanced considerably in the past several years. There can also be a role for mechanical restoration of the lumen by endarterectomy or stenting in selected patients with high-grade atherosclerotic stenosis of the extracranial carotid artery. Endarterectomy is generally recommended for patients with high-grade symptomatic carotid stenosis. Stenting is considered an option for patients at high risk of complications with endarterectomy. Whether revascularization is better than contemporary medical therapy for asymptomatic extracranial carotid stenosis is a subject of several ongoing randomized clinical ...
Asymptomatic Carotid Surgery Trial 2 (ACST-2) is a large international randomised trial comparing carotid endarterectomy (CEA) versus carotid artery stenting (CAS) in patients with asymptomatic carotid stenosis where there is substantial uncertainty as to which treatment is more appropriate. ACST-2 seeks to compare these procedures and their benefit in stroke prevention.
Common carotid artery stenosis is often diagnosed when actually looking for internal carotid artery stenosis. The methods for diagnosis include duplex ultrasound and computed tomography. The criteria for the diagnosis of common carotid artery stenosis are unclear. The convention is that a doubling of the flow velocity between adjacent artery segments denotes significant stenosis. A retrospective analysis compared duplex ultrasound of 62 patients with common carotid artery stenosis to CT. A peak systolic velocity >182 cm/sec and an end-diastolic velocity >30 cm/sec were the most accurate as assessed by receiver-operating curves. While sensitivity was not very high, specificity was better. In this analysis duplex ultrasonography was also accurate in detection of common carotid artery occlusion, albeit in a small number of patients.. ...
[Endarterectomy for cervical internal carotid artery stenosis accompanied with severe aortic valve stenosis--case report].: A 75-year-old man, who had undergone
INTRODUCTION: Understanding the pathophysiological mechanism of procedural stroke during carotid intervention may help reduce the risk of stroke in those undergoing surgery. We therefore studied the features of procedural strokes within the first Asymptomatic Carotid Surgery Trial-1 (ACST-1) to identify the underlying pathophysiological mechanism. METHODS: In ACST-1, 3,120 patients with severe asymptomatic carotid stenosis thought suitable for surgery were randomized to CEA or indefinite deferral of surgery. Information on procedural (within 30 days) stroke type, laterality, severity and timing was collected. Eight possible mechanisms were defined: embolism from the carotid artery, haemodynamic, thrombosis or occlusion of the carotid artery, hyperperfusion syndrome, cardioembolic, either carotid embolic or haemodynamic, either carotid embolic or thrombotic occlusion, or undetermined. RESULTS: Procedural strokes occurred in 53 patients (2.7%). Strokes were predominantly ischaemic (n = 43; 81%),
Il nostro Team vanta ventanni di esperienza nella cura del piede diabetico ed è stato parte importante nella evoluzione della cura di questa patologia, in. Background Previous studies have shown that carotid endarterectomy in patients with symptomatic severe carotid stenosis (defined as stenosis of 70 to 99 percent of. Background Previous studies chirurgia vascolare carotids shown that carotid endarterectomy in patients with symptomatic severe carotid stenosis (defined as stenosis of 70 to 99 percent of. Il nostro Team vanta ventanni di esperienza nella cura del piede diabetico ed è stato parte importante nella evoluzione della cura di questa patologia, in. Background Carotid-artery stenting and carotid endarterectomy are both options for treating carotid-artery stenosis, an important cause of stroke. Methods We randomly. ...
I wish to congratulate Eric Russell for his conscientious and thought-provoking commentary on the status of carotid stenting. The technique of carotid stenting is about to begin a new phase of additional rigorous scrutiny and investigation. The National Institute of Neurologic Disorders and Stroke (NINDS) recently has approved and funded a large multicenter, multinational, randomized, controlled trial comparing carotid stenting with carotid endarterectomy. The Carotid Revascularization Endarterectomy vs. Stent Trial (CREST) plans to begin training and credentialing interventionalists this summer, and recruitment is expected to begin late this year or in early 2000. The trial will address the relevant efficacy of carotid stenting and carotid endarterectomy in a North American Symptomatic Carotid Endarterectomy Trial (NASCET)-like population of patients with symptomatic high-grade stenoses. We anticipate that 2500 patients will need to be recruited to satisfy the statistical requirements of the ...
Background and Purpose- This analysis was performed to assess the association between perioperative and clinical variables and the 30-day risk of stroke or death after carotid endarterectomy for symptomatic carotid stenosis. Methods- Individual patient-level data from the 5 largest randomized controlled carotid trials were pooled in the Carotid Stenosis Trialists Collaboration database. A total of 4181 patients who received carotid endarterectomy for symptomatic stenosis per protocol were included. Determinants of outcome included carotid endarterectomy technique, type of anesthesia, intraoperative neurophysiological monitoring, shunting, antiplatelet medication, and clinical variables. Stroke or death within 30 days after carotid endarterectomy was the primary outcome. Adjusted risk ratios (aRRs) were estimated in multilevel multivariable analyses using a Poisson regression model. Results- Mean age was 69.5±9.2 years (70.7% men). The 30-day stroke or death rate was 4.3%. In the multivariable
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OBJECTIVE To decrease the procedural risk of carotid revascularisation it is crucial to understand the mechanisms of procedural stroke. This study analysed the features of procedural strokes associated with carotid artery stenting (CAS) and carotid endarterectomy (CEA) within the International Carotid Stenting Study (ICSS) to identify the underlying pathophysiological mechanism. MATERIALS AND METHODS Patients with recently symptomatic carotid stenosis (1,713) were randomly allocated to CAS or CEA. Procedural strokes were classified by type (ischaemic or haemorrhagic), time of onset (intraprocedural or after the procedure), side (ipsilateral or contralateral), severity (disabling or non-disabling), and patency of the treated artery. Only patients in whom the allocated treatment was initiated were included. The most likely pathophysiological mechanism was determined using the following classification system: (1) carotid-embolic, (2) haemodynamic, (3) thrombosis or occlusion of the revascularised carotid
臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。. To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of NTU Repository with Academic Hub to form NTU Scholars.. ...
Severe internal carotid artery (ICA) stenosis is a common cause of cerebrovascular accident (CVA) in middle-aged patients. Contralateral carotid occlusion (CCO) in patients with severe ICA stenosis is associated with high risk of CVA. Carotid endarterectomy (CEA) is associated with more complications in patients with CCO than those without CCO. In this study, we present the case of a 61-year-old patient who presented with multiple transient ischemic attack and severe ICA stenosis associated with CCO and occlusion of vertebral arteries. The patient was treated successfully with carotid angioplasty and stenting.
The primary objective of this cadaveric study was to review the morphological variations of the anatomy of the human carotid artery bifurcation relevant to carotid endarterectomy (CEA) and carotid artery stent-supported angioplasty (CSSA). We quantify carotid bifurcation plaque morphology. Results showed that the angle of deviation at the origin of the internal carotid artery (ICA), in relation to the common carotid artery (CCA), measured a mean of 21.8 degrees with a range from seven to 45 degrees. This anatomical finding is important for the interventionalist concerned with insertion of a carotid stent. The angle of the ICA origin may be an independent risk factor for early atherosclerotic changes at the ICA bulb. Carotid bifurcation plaque was observed in a small, random cohort of seven out of 13 cadavers, and contributed to a mean stenosis of 15.2% (range 5.0-34.8%). Plaque morphology (n = 7) showed haemorrhage (29%), superficial thrombosis (57%), calcification (71%), areas of focal necrosis ...
Carotid endarterectomy reduced death and strokes in patients with ipsilateral high-grade stenosis and recent hemispheric transient ischemic attacks or nondisabling strokes. The ECST and the NASCET are landmark studies. Many clinicians believed that persons with cerebral ischemic symptoms associated with high-grade carotid stenosis benefited from carotid endarterectomy. However, considerable doubt arose about a net benefit to society, given the high risk of surgery reported from some communities and the reported high frequency of inappropriate indications for carotid endarterectomy. These studies do not completely allay the doubt. In both studies the surgeons were carefully chosen and demonstrated lower perioperative morbidity and mortality than shown in community surveys. The major surprise in these studies is the high risk for stroke in the patients who did not have surgery; 22% in 3 years in ECST and 28% in 2 years in NASCET. The apparently higher risk in NASCET may be at least partly an ...
As reported in EJVES, K I Paraskevas, St Georges Vascular Institute, St Georges Healthcare NHS Trust, London, UK and colleagues EL Kalmykov and AR Naylor from the Department of Vascular Surgery, Leicester Royal Infirmary, Leicester, UK, write that randomised trials have reported higher stroke/death rates after carotid artery stenting vs. carotid endarterectomy.. Despite this, the 2011 American Heart Association (AHA) guidelines expanded carotid artery stenting indications, partly because of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), but also because of improving outcomes in industry sponsored carotid artery stenting registries, the authors write.. This systematic review set out to compare stroke/death rates after carotid stenting or endarterectomy in contemporary dataset registries. The investigators also sought to examine whether published stroke/death rates after stenting fall within AHA thresholds, and to see if there had been a decline, over time, in ...
TY - JOUR. T1 - Letter to the Editor re. T2 - carotid stenting through the right brachial approach for left internal carotid artery stenosis and bovine aortic arch configuration. AU - Berko, Netanel S.. AU - Haramati, Linda B.. PY - 2010/1/1. Y1 - 2010/1/1. UR - http://www.scopus.com/inward/record.url?scp=77952094584&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=77952094584&partnerID=8YFLogxK. U2 - 10.1007/s00330-009-1609-x. DO - 10.1007/s00330-009-1609-x. M3 - Letter. C2 - 19816691. AN - SCOPUS:77952094584. VL - 20. SP - 816. EP - 817. JO - European Radiology. JF - European Radiology. SN - 0938-7994. IS - 4. ER - ...
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TY - JOUR. T1 - Correlation of continuous-wave Doppler spectral flow analysis with gross pathology in carotid stenosis. AU - Call, G. K.. AU - Abbott, W. M.. AU - Macdonald, N. R.. AU - Megerman, J.. AU - Davis, K. R.. AU - Heros, Roberto. AU - Kistler, J. P.. PY - 1988/1/1. Y1 - 1988/1/1. N2 - Preoperative continuous-wave Doppler spectral analysis was used to generate two parameters, peak frequency in the internal carotid artery (f(max)) and the ratio of peak frequencies in the internal and common carotid arteries (carotid index). These were compared with direct measurement of residual lumen diameter in pathologic specimens obtained from carotid endarterectomy in 37 patients. Doppler shift frequency parameters were well correlated with residual lumen diameter when the latter was at least 1 mm. Residual lumens of ≤2 mm were found to have an f(max) of ,7.5 kHz and a carotid index of ,3.8. If f(max) was ,14 kHz or the carotid index was ,7, the residual lumen diameter was nearly always ≤1 mm. ...
BACKGROUND: Age was reported to be an effect-modifier in four randomised controlled trials comparing carotid artery stenting (CAS) and carotid endarterectomy (CEA), with better CEA outcomes than CAS outcomes noted in the more elderly patients. We aimed to describe the association of age with treatment differences in symptomatic patients and provide age-specific estimates of the risk of stroke and death within narrow (5 year) age groups. METHODS: In this meta-analysis, we analysed individual patient-level data from four randomised controlled trials within the Carotid Stenosis Trialists Collaboration (CSTC) involving patients with symptomatic carotid stenosis. We included only trials that randomly assigned patients to CAS or CEA and only patients with symptomatic stenosis. We assessed rates of stroke or death in 5-year age groups in the periprocedural period (between randomisation and 120 days) and ipsilateral stroke during long-term follow-up for patients assigned to CAS or CEA. We also assessed
Carotid artery disease is a major cause of stroke. Carotid endarterectomy when performed with a low complication rate in patients with severe lesions has been shown to reduce the subsequent risk of stroke in a series of randomised controlled trials in both symptomatic and asymptomatic populations. The CAVATAS trial demonstrated that simple balloon angioplasty of carotid stenoses was as good as endarterectomy in terms of stroke prevention and was associated with a lower complication rate. Carotid stenting performed with the use of distal protection devices has been shown to be superior to endarterectomy in patients considered to be at increased perioperative risk as assessed by a variety of clinical and angiographic parameters. Comparisons of carotid stenting and endarterectomy in patients considered to be of normal perioperative risk are ongoing. Optimal medical therapy is mandatory for all patients with carotid artery disease. ...
EVIDENCE ACQUISITION: The studies included in the analysis were: Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA3S), Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy (SPACE), International Carotid Stenting Study (ICSS) and Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST). The trials characteristics and bias were considered. The outcomes analyzed were the death stroke and myocardial infarction (MI) at 30-day. The meta-analysis was performed by random effect model, results reported by odds ratio (OR) and confidence intervals (CI) according the preoperative symptomatic status ...
TY - JOUR. T1 - Results of endovascular treatment of internal carotid artery stenoses with a newly developed balloon protection catheter. AU - Terada, Tomoaki. AU - Tsuura, Mitsuharu. AU - Matsumoto, Hiroyuki. AU - Masuo, Osamu. AU - Yamaga, Hiroo. AU - Tsumoto, Tomoyuki. AU - Itakura, Toru. AU - Sadato, Akiyo. AU - Hashimoto, Nobuo. AU - Cullen, Sean. AU - Higashida, Randall T.. AU - Harrigan, Mark R.. AU - Hopkins, L. Nelson. AU - Rosenwasser, Robert H.. AU - Marks, Michael P.. PY - 2003/9/1. Y1 - 2003/9/1. N2 - OBJECTIVE: A new balloon protection catheter to prevent distal emboli during internal carotid artery percutaneous transluminal angioplasty and stenting was developed, and its efficacy was evaluated in both an experimental model and clinical cases. METHODS: The balloon protection catheter was navigated over a steerable 0.014-inch guidewire to negotiate tight stenoses and sharp bends, which would cause difficulties for the passage of a flow-directed balloon catheter. Percutaneous ...
EVIDENCE BASED MEDICINE (MIMS April 2003) Stroke prevention Comparative effectiveness of various interventions. PRIOR TO STROKE OR TRANSIENT ISCHAEMIC ACCIDENT (TIA) Beneficial. 1. Antiplatelet treatment. 2. Cholestrerol reduction (for those patients who also have coronary heart disease). 3. Carotid endarterectomy (in patients with severe symptomatic carotid artery stenosis). Unknown effectiveness. 1. Cholesterol reduction (for patients without CHD). 2. Blood pressure reduction. 3. Carotid endarterectomy (in patients with severe symptomatic carotid artery stenosis). 4. Catotid angioplasty Likely to ineffective or even harmful. Oral anticoagulation ATRIAL FIBRILLATION AND A PRIOR STROKE OR TIA Beneficial 1. Oral anticoagulation. 2. Aspirin for patients with contraindications to an anticoagulant. ATRIAL FIBRILLATION BUT NO OTHER MAJOR RISK FACTORS FOR STROKE Likely to be beneficial.. KEY POINTS. In patients with a prior stroke or TIA. 1. Insufficient evidence to support routine blood presure ...
Carotid endarterectomy (CEA) is the most frequently performed noncardiac vascular procedure. CEA is preventative surgery aimed at reducing the rate of stroke in patients at high risk of such an event. Performing a CEA itself has considerable risk. The inherent risk of carotid surgery is perioperative stroke occurring at rates from 5 % to 7.5 % [1]. The causes of perioperative stroke are hypoperfusion, hyperperfusion or embolization during cross-clamping of the internal carotid artery. The co-morbidity associated with carotid disease is considerable. Many of these patients have existed ischaemic heart disease, chronic obstructive pulmonary disease or diabetes. In addition, they may be smokers and elderly. A significant number of patients undergoing coronary artery surgery have severe carotid artery disease. It is also true that up to half of the patients undergoing CEA have severe treatable coronary lesions. Stroke is the most serious postoperative risk. Other major complications that can occur ...
The carotid stenosis was one of the higher risk of the ischemia stroke in China.In the mean time ,more and more people accept revascularization because of carotid stenosis.NASCAT indicated that CEA is the golden standard of the therapy of the carotid stenosis.But in china , case the opposite,only little patient receive CEA,on the other hand , most patients received angioplasty.. Expected no less than 2100 cases within 2 years for the whole study. We choose 39 hospitals whose experienced in CAS or/and CEA spread all over the country as multiple centers for this clinic registration study. All cases inclusion must be continuously registration.. The subject choice:All registered patients must be signed informed consent to register for non intrusive research this study ,the researchers during the study period should be continuous registration in patients undergoing surgical treatment of carotid stenosis, to ensure that the selected participants reflect the target patient population.. Medical Center ...
As for the current trials assessing the surgery vs. stenting debate, the panel hoped the Carotid Revascularization Endarterectomy versus Stent Trial (CREST) and the Carotid Angioplasty and Stenting vs. Endarterectomy in Asymptomatic Patients with Significant Extracranial Carotid Occlusive Disease Trial (ACT I) would provide some much needed answers. CREST is a NIH/NINDS sponsored trial contrasting the relative efficacy of carotid endarterectomy and carotid stenting in preventing primary outcomes of stroke, myocardial infarction, or death during a 30-day periprocedural period, or ipsilateral stroke over the follow-up period extending up to four years. Stroke events will be verified by an Adjudication Committee masked to the assigned treatment. The primary eligibility criterion is a significant (>50%) stenosis of the carotid artery in patients with transient ischemic attack or ipsilateral non-disabling stroke within the prior 180 days.. The trial is aiming to 2,500 patients (1,100 asymptomatic, ...
The results of this study suggest that carotid stenting is as effective as carotid endarterectomy for middle-term prevention of ipsilateral stroke, but the safety of carotid stenting needs to be improved before it can be used as an alternative to carotid endarterectomy in patients with symptomatic c …
Introduction: In appropriately selected patients with severe carotid stenosis, carotid revascularization reduces risk of ischemic stroke. Prior clinical research has focused on the efficacy and safety of carotid revascularization, but few investigators have considered readmission as a clinically important outcome. We examined frequency and timing of 30-day readmission following carotid revascularization and assessed differences in 30-day readmission rates between patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS). We also examined whether hospital variation in procedural choice (CEA vs CAS) was associated with differences in hospitals risk standardized readmission rates (RSRR).. Methods: Medicare administrative claims data were used to identify acute care hospitalizations of CEA and CAS from 2009 to 2011. The outcome of interest was time to first hospital readmission within 30-days of carotid revascularization. Hospitals performing more than 25 carotid ...
Strokes arising from carotid stenosis are most often due to atheroembolisms.4-6 During carotid endarterectomy the plaque is completely removed; however, with carotid stenting, the plaque remains contained between the stent and the vessel wall. Stroke occurring after CAS is probably caused by the release of fractured plaque deposits through the struts of the stent. In the Carotid Revascularization Endarterectomy versus Stenting Trial,7 the periprocedural stroke rate was significantly higher in the stenting group than in the endarterectomy group (4.1% vs 2.3%, p=0.01).. Transcranial Doppler studies have demonstrated the generation of emboli with each passage across a stenosis with a guidewire, EPD, balloon or stent,8 ,9 with the highest potential for embolization occurring during post-dilatation when the balloon crushes friable plaque against the metal stent struts.8 ,9 Although the clinical significance of microemboli is unclear, Ackerstaff et al10 demonstrated in a study of 550 patients that ...
TY - JOUR. T1 - Advantages of Staged Angioplasty in a Patient with Internal Carotid Artery Pseudo-Occlusion Besides Prevention of Cerebral Hyperperfusion Syndrome. AU - Takahashi, Satoshi. AU - Akiyama, Takenori. AU - Nakahara, Jin. AU - Yoshizaki, Takahito. AU - Suzuki, Norihiro. AU - Yoshida, Kazunari. PY - 2018/1/1. Y1 - 2018/1/1. N2 - Background Staged angioplasty for carotid artery stenosis has been reported to be effective in preventing postoperative cerebral hyperperfusion syndrome (CHS) in patients with severe carotid stenosis; thus, it is also recommended for patients with internal carotid artery (ICA) pseudo-occlusion, the treatment strategy for which is controversial. Case Description This study reports the case of an Asian man in his 50s who had motor aphasia and right-side weakness caused by pseudo-occlusion of the left ICA. After medical treatment, he underwent a staged angioplasty. After the first stage of percutaneous transluminal angioplasty, anterograde blood flow to the left ...
TY - JOUR. T1 - Outcomes after carotid artery stenting and endarterectomy in the medicare population. AU - Wang, Fen Wei. AU - Esterbrooks, Dennis J.. AU - Kuo, Yong Fang. AU - Mooss, Aryan N.. AU - Mohiuddin, Syed M.. AU - Uretsky, Barry F.. PY - 2011/7. Y1 - 2011/7. N2 - Background and Purpose- Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for stroke prevention. The value of this therapy relative to CEA remains uncertain. Methods- In 10 958 Medicare patients aged 66 years or older between 2004 and 2006, we analyzed in-hospital, 1-year stroke, myocardial infarction, and death rate outcomes and the effects of potential confounding variables. Results- CAS patients (87% were asymptomatic) had a higher baseline risk profile, including having a higher percentage of coronary and peripheral arterial disease, heart failure, and renal failure. In-hospital stroke rate (1.9% CAS versus 1.4% CEA; P=0.14) and mortality (CAS 0.9% versus 0.6% CEA; P=0.20) were similar. By 1 ...
The duplex scan is the main tool used to diagnose carotid artery stenosis, and there is agreement that it might be the single preoperative diagnostic test. All limitations of carotid duplex scanning should be taken into consideration during qualification to surgical or endovascular treatment. Awareness of these limitations is especially important when neurological symptoms are typical and duplex examination is negative. The authors describe the pitfalls of the duplex scan examination in a symptomatic patient with bilateral severe distal internal carotid artery stenosis ...
TY - JOUR. T1 - Does carotid stenting measure up to endarterectomy? A vascular surgeons experience. AU - Eskandari, Mark K.. AU - Longo, G. Matthew. AU - Vijungco, Joseph D.. AU - Morasch, Mark D.. AU - Pearce, William H.. PY - 2004/7/1. Y1 - 2004/7/1. N2 - Hypothesis: Carotid angioplasty and stenting seems to have equal or better outcomes in high-risk patients than carotid endarterectomy. Design: Single-center case-control study. Setting: University hospital tertiary referral center. Patients: Individuals (n=53) undergoing elective carotid angioplasty and stenting for cervical carotid stenosis (n= 57) between April 2001 and October 2003. All patients were referred to and treated by the primary author (M.K.E.). Results: Mean±SD age was 68.8±1.2 years (64% men [34] and 36% women [19]), and overall mean±SD rate of stenosis was 79%±10%. Preprocedural neurologic symptoms were present in 42% of the group. Indications for treatment included prior neck surgery with irradiation (4), recurrent ...
INTRODUCTION. Carotid artery stenosis leads to stroke and long-lasting disabilities. Atherosclerosis, which settles inside the bifurcation of common carotid artery, is one of the major causes of recurrent ischemic stroke[1]. Current medical approaches aim to slow down the progression of the disease and prevent stroke[2]. Since the first successful carotid endarterectomy (CEA) performed in the 1950s, surgical treatment has become the gold standard in the treatment of carotid stenosis[3]. Its superiority over medical therapy in cases with symptomatic and serious carotid stenosis has definitively been revealed in many studies[4-6]. CEA is a widely performed procedure in many medical centers, with low complication rates. Within the first 30 postoperative days, local neurological damage, hematoma and bleeding, cardiovascular complications, permanent or transient stroke, and death are the most frequently encountered complications[7]. CEA techniques differ among surgeons; however, no difference ...
Background and Purpose Early carotid surgery or stenting after thrombolytic treatment for stroke has become more common during recent years. It is unclear whether this carries an increased risk of postoperative complications and death. The aim of this nationwide population-based study was, therefore, to investigate the safety of urgently performed carotid procedures in patients treated with thrombolysis for stroke. Methods Using the national Vascular and Stroke registries, we identified 3998 patients who had undergone carotid endarterectomy or carotid artery stenting for symptomatic carotid stenosis between May 2008 and December 2012. Among these, 2% (79 of 3998) had undergone previous thrombolysis for stroke. We conducted a retrospective review of registry data and individual case records with regard to postoperative complications, including surgical-site bleeding, stroke, and death. The outcome was compared with the results for the remaining patient cohort (3919 of 3998) undergoing carotid ...
Results We received 668 responses from 71 countries. The majority favored CT angiography (70.2%) to evaluate carotid stenosis, CEA (69.1%) over CAS, an aspirin-containing regimen (88.5%), and a clopidogrel-containing regimen (64.4%) if already on aspirin. Whereas diverse antithrombotic regimens were chosen, monotherapy was favored by 54.4%-70.6% of respondents across 3 scenarios. The preferred dual therapy was low-dose aspirin (75-100 mg) plus clopidogrel (22.2%) or high-dose aspirin (160-325 mg) plus clopidogrel if already on aspirin (12.2%). Respondents favoring CAS more often chose ≥2 agents (adjusted odds ratio [aOR] vs CEA: 2.00, 95% confidence interval 1.36-2.95, p = 0.001) or clopidogrel-containing regimens (aOR: 1.77, 1.16-2.70, p = 0.008). Regional differences included respondents from Europe less commonly choosing multiple agents if already on aspirin (aOR vs United States/Canada: 0.57, 0.35-0.93, p = 0.023), those from Asia more often favoring multiple agents (aOR: 1.95, 1.11-3.43, ...
Purpose: There is a lack of consensus regarding the significance of calcification in the atherosclerotic carotid plaque. While some studies suggest calcification is a stabilizing factor, others have associated it with intraplaque hemorrhage (IPH) - an indicator of plaque vulnerability. Since magnetic resonance imaging (MRI) has been proven to accurately identify the lipid-rich necrotic core (LRNC) and IPH of the carotid lesion, we sought to determine if carotid MRI can accurately detect and quantify calcification. We then tested the hypothesis that the location of calcification relative to the LRNC is an important determinant for the presence of IPH.. Methods: 24 subjects scheduled for carotid endarterectomy were imaged with high-resolution, multi-contrast carotid MRI (T1-weighted, proton density, T2-weighted, and 3D time of flight) at 1.5T. The LRNC, IPH and calcification were identified with previously established MRI criteria. Types of calcification were defined based on location as Type I: ...
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Aims: Carotid artery stenting (CAS) has become an alternative to carotid endarterectomy in the treatment of carotid artery disease. The use of an embolic protection device (EPD) can reduce the frequency of embolic events during CAS. Difficult vascula
Ferri M, Faggioli GL, Ferri GG, Pirodda A (June 2004). "Is carotid stenosis correlated with tympanosclerosis". International ...
Carotid artery stenosis (CAS) screening through skin thermal maps. Active Dynamic Thermography (ADT) for medical applications. ... Saxena, A; Ng, EYK; Lim, ST (May 2020). "Active dynamic thermography to detect the presence of stenosis in the carotid artery ... thermography as a potential screening modality for carotid artery stenosis". Computers in Biology and Medicine. 113: 103419. ...
... where carotid ultrasound is used for assessing blood flow and stenoses in the carotid arteries, and transcranial Doppler is ... ISBN 978-2-225-63679-0. Saxena, A; Ng, EYK; Lim, ST (28 May 2019). "Imaging modalities to diagnose carotid artery stenosis: ... Echocardiography is an essential tool in cardiology, assisting in evaluation of heart valve function, such as stenosis or ... stenosis, vasospasm from a subarachnoid hemorrhage (bleeding from a ruptured aneurysm), and other problems. Doppler fetal ...
"Randomized Trial of Stent versus Surgery for Asymptomatic Carotid Stenosis". New England Journal of Medicine. 374 (11): 1011- ...
Disrecommend for asymptomatic carotid stenosis unless the complication rate is low (. ... Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Don't use opioid or ...
"Antioxidant effects of tocotrienols in patients with hyperlipidemia and carotid stenosis". Lipids. 30 (12): 1179-83. doi: ...
Almog, DM; Illig, KA; Khin, M; Green, RM (2000). "Unrecognized carotid artery stenosis discovered by calcifications on a ... Carotid artery calcifications on panoramic radiographs identify patients at risk for stroke". The New York State Dental Journal ... Friedlander, AH; Yueh, R; Littner, MR (1998). "The prevalence of calcified carotid artery atheromas in patients with ... Friedlander, AH; Friedlander, IK; Yueh, R; Littner, MR (1999). "The prevalence of carotid atheromas seen on panoramic ...
He was the organiser and coordinator of the multicentre Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) prospective ... Nicolaides, A: "The Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study. Aims and results of quality control.", ... results from the asymptomatic carotid stenosis and risk of stroke study.", Vascular, Vol. 13, Issue 4, Pages 211-21. ... "Carotid plaque characterization using digital image processing and its potential in future studies of carotid endarterectomy ...
Stenosis, for example, of the carotid arteries may be a warning sign for an impending stroke. A clot, embedded deep in one of ... images of carotid, cerebral, coronary or other arteries. The introduction of computed tomography in the early 1970s ... renal artery stenosis, inferior vena cava filter placement, gastrostomy tube placements, biliary stents and hepatic ...
The most frequent etiology of mixed transcortical aphasia is stenosis (narrowing) of the internal carotid artery. Mixed ...
Chambers BR, Donnan GA «Carotid endarterectomy for asymptomatic carotid stenosis». Cochrane Database Syst Rev, 4, 2005, pàg. ... 18,0 18,1 18,2 18,3 Ederle J, Brown MM «The evidence for medicine versus surgery for carotid stenosis». European Journal of ... Ringleb PA, Chatellier G, Hacke W, et al. «Safety of endovascular treatment of carotid artery stenosis compared with surgical ... Ederle J, Featherstone RL, Brown MM «Percutaneous transluminal angioplasty and stenting for carotid artery stenosis». Cochrane ...
... including carotid artery stenosis, pulmonary embolisms, and acute limb ischaemia; arterial stenosis, which is particularly ... and digital subtraction angiography in severe carotid stenoses" (PDF). European Journal of Neurology. 11: 774-5. doi:10.1111/j. ... It also helps detect and diagnose lesions in the carotid arteries, a potential cause of strokes. IV-DSA has also been useful in ... However, IV-DSA has been used successfully to study the vessels of the brain and heart and has helped detect carotid artery ...
Severe ipsilateral or bilateral carotid artery stenosis or occlusion is the most common cause of ocular ischemic syndrome. The ... internal carotid artery, and less frequently the external carotid artery. Other causes include: Takayasu's arteritis Giant cell ... If carotid occlusive disease results in ophthalmic artery occlusion, general ocular ischemia may result in retinal ... Those caused by a carotid artery embolism or occlusion have the potential for further stroke by detachment of embolus and ...
Unilateral AS can be associated with contralateral carotid artery stenosis or decreased intraocular pressure in the affected ...
"Survival from accidental strangulation from a scarf resulting in laryngeal rupture and carotid artery stenosis: the "Isadora ...
The authors also found that men with carotid stenosis or ischemic heart disease were at greater risk for the progression of ... 2000) the authors examined the relationship between standing at work and the progression of carotid atherosclerosis in men. ... This study provides evidence that hemodynamic changes from standing can influence the progressions of carotid atherosclerosis. ... Krause, N (2000). "Standing at work and progression of carotid atherosclerosis". Scandinavian Journal of Work, Environment & ...
Carotid artery stenosis is a narrowing of the carotid artery in the neck and which supplies blood to the brain. Peripheral ...
Carotid artery stenosis can be treated with angioplasty and carotid stenting for patients at high risk for undergoing carotid ... "Revascularization of Radiation-Induced Carotid Artery Stenosis With Carotid Endarterectomy vs. Carotid Artery Stenting: A ... Also, PTCA is not recommended if there is less than 70% stenosis of the coronary arteries, as the stenosis it is not deemed to ... stenting is indicated in select patients with radiation-induced stenosis or a carotid lesion not suitable for surgery. ...
Carotid ultrasonography is often used to screen for carotid artery stenosis, as it is more readily available, is noninvasive, ... Confirming a diagnosis of carotid artery stenosis is important because the treatment for this condition, carotid endarterectomy ... Also, carotid stenosis secondary to atherosclerosis narrowing the diameter of the lumen and thus limiting blood flow is another ... Individuals with carotid stenosis may present with TIA symptoms, thus labeled symptomatic, while others may not experience ...
... carotid stenosis, strokes, and spinal malformations, and vasospasms. Techniques such as angioplasty, stenting, clot retrieval, ... Microvascular techniques are used in EC-IC bypass surgery and in restoration carotid endarterectomy. The clipping of an ... Some of these divisions of neurosurgery are: Vascular neurosurgery includes clipping of aneurysms and performing carotid ... nervous system infections including abscesses Spinal disc herniation Cervical spinal stenosis and Lumbar spinal stenosis ...
Microemboli can be common in some high-risk patients, such as those with carotid stenosis. However, in healthier patients ... During carotid angioplasty, an angiography cather with a small deflated balloon attached on the tip is advanced to a carotid ... which can lead to deformed red blood cells clogging blood vessels and impeding blood flow Carotid artery stenosis, or narrowing ... stenosis. The ballon is then inflated slowly, forcing the narrowed portion of the vessel to expand. Carotid stenting follows a ...
He also showed the relationship between stroke and carotid artery stenosis, which made preventive surgery possible and greatly ... Estol CJ (March 1996). "Dr C. Miller Fisher and the history of carotid artery disease". Stroke. 27 (3): 559-66. doi:10.1161/01. ... He contributed greatly to the understanding of stroke, more specifically carotid artery disease and lacunar infarcts and their ... He made a number of contributions to the understanding of cervical artery dissection (carotid artery dissection and vertebral ...
... renal artery stenosis and for carotid interventions. Due to rapid ambulation post procedure the radial interventions became ... Radial access has also been used successfully to treat peripheral artery disease including bilateral iliac artery stenosis, ... contralateral transradial approach for carotid artery stenting: A feasibility study. Tejas Patel, Sanjay Shat et al. ...
Endovascular neurosurgery utilizes endovascular image-guided procedures for the treatment of aneurysms, AVMs, carotid stenosis ... Microvascular techniques are used in EC-IC bypass surgery and in restoration carotid endarterectomy. The clipping of an ...
... and a carotid endarterectomy considered based on the location and grade of the stenosis. Generally, if the carotid artery is ... "Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American ... Most episodes of amaurosis fugax are the result of stenosis of the ipsilateral carotid artery. With that being the case, ... However, a severely atherosclerotic carotid artery may also cause amaurosis fugax due to its stenosis of blood flow, leading to ...
Another finding displayed the prevalence of PAD, carotid artery stenosis (CAS) and AAA was higher not only with overall ... Common diseases that may be detected by such screenings include Carotid artery stenosis, osteoporosis, abdominal aortic ...
Stroke (mainly the ischemic type) Carotid artery stenosis does not occur more often in diabetes, and there appears to be a ...
... and bilateral stenosis. The first symptom is usually severe headache, and a headache in the setting of recent carotid ... usually following treatment of carotid artery stenosis. Risk factors include hypertension, particularly high blood pressures in ... "Pathophysiology and management of reperfusion injury and hyperperfusion syndrome after carotid endarterectomy and carotid ... Kirchoff-Torres, KF; Bakradze, E (19 March 2018). "Cerebral Hyperperfusion Syndrome After Carotid Revascularization and Acute ...
... or occlusion or stenosis of the external carotid artery. The term is derived by analogy from claudication of the leg, where ...
... that with intensive medical therapy most patients with asymptomatic carotid stenosis cannot benefit from endarterectomy or ... Carotid Plaque Area: A Tool for Targeting and Evaluating Vascular Preventive Therapy Stroke. 2002;33:2916-2922 Stroke 1986; 17( ... Carotid Plaque Area: A Tool for Targeting and Evaluating Vascular Preventive Therapy Stroke. 2002;33:2916-2922 Stroke 1999;30: ... The effect of drug therapies on carotid plaque volume can now be evaluated in a very cost-effective way. Development of ...
... which is associated with lumbar spinal stenosis. It is strongly associated with smoking, hypertension, and diabetes.[2] ... Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
The left and right internal carotid arteries arise from the left and right common carotid arteries. ... Subclavian steal syndrome results from a proximal stenosis (narrowing) of the subclavian artery, an artery supplied by the ... The posterior communicating artery is given off as a branch of the internal carotid artery just before it divides into its ... In another variation the anterior communicating artery is a large vessel, such that a single internal carotid supplies both ...
Bilateral renal artery stenosis should always be considered as a differential diagnosis for the presentation of HN. Kidney ... This leads to a build-up of plaques and they can be deposited in the renal arteries causing stenosis and ischemic kidney ... Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
The word tachycardia came to English from New Latin as a neoclassical compound built from the combining forms tachy- + -cardia, which are from the Greek ταχύς tachys, "quick, rapid" and καρδία, kardia, "heart". As a matter both of usage choices in the medical literature and of idiom in natural language, the words tachycardia and tachyarrhythmia are usually used interchangeably, or loosely enough that precise differentiation is not explicit. Some careful writers have tried to maintain a logical differentiation between them, which is reflected in major medical dictionaries[7][8][9] and major general dictionaries.[10][11][12] The distinction is that tachycardia be reserved for the rapid heart rate itself, regardless of cause, physiologic or pathologic (that is, from healthy response to exercise or from cardiac arrhythmia), and that tachyarrhythmia be reserved for the pathologic form (that is, an arrhythmia of the rapid rate type). This is why five of the previously referenced ...
Stenosis merupakan efek vasodilasi endotelium yang umumnya disebabkan oleh turunnya sekresi NO oleh sel endotelial, dapat ... Beberapa ahli lain mempertimbangan klasifikasi berdasarkan fenotipe seperti keberadaan internal carotid artery plaque, intima- ... Dalam pronosis LVD, leukoaraiosis memiliki kecenderungan ke arah grup stenosis intrakranial dengan 40,3% untuk grup ... Intra-cranial stenting yang diterapkan pada gejala penyumbatan intracranial arterial stenosis, boleh dikatakan sukses ...
Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
In humans, hypoxia is detected by the peripheral chemoreceptors in the carotid body and aortic body, with the carotid body ... Therefore, in patients with chronic mitral stenosis, pulmonary capillary pressures of 40 to 45 mm Hg have been measured without ...
This is known as renovascular hypertension; it is thought that decreased perfusion of renal tissue due to stenosis of a main or ... Voiculescu A, Rump LC (January 2009). "[Hypertension in patients with renal artery stenosis]". Der Internist (in German). 50 (1 ... Kidney disease / renal artery stenosis - the normal physiological response to low blood pressure in the renal arteries is to ... Kendrick J, Chonchol M (October 2008). "Renal artery stenosis and chronic ischemic nephropathy: epidemiology and diagnosis". ...
Left common carotid artery. Left subclavian artery. Descending aorta, thoracic part: Left bronchial arteries. esophageal ... Aortic stenosis. *Aortitis, inflammation of the aorta that can be seen in trauma, infections, and autoimmune disease ... For example, the left vertebral artery may arise from the aorta, instead of the left common carotid artery.[9]:188 ... The aortic arch has three major branches: from proximal to distal, they are the brachiocephalic trunk, the left common carotid ...
The other type, carotid artery dissection, involves the carotid arteries. Vertebral artery dissection is further classified as ... It is therefore possible for the symptoms to occur on both sides, or for symptoms of carotid artery dissection to occur at the ... Prior to this, there had been isolated case reports about carotid dissection. In 1971, C. Miller Fisher, a Canadian neurologist ... While dissection of the carotid and vertebral arteries accounts for only 2% of strokes (which are usually caused by high blood ...
They are used to diagnose and monitor esophageal reflux, dysphagia, hiatus hernia, strictures, diverticula, pyloric stenosis, ... and stenosis in Barium X-rays.[26] Anisakiasis is demonstrated by Barium X-rays as bowel wall oedema, thickening, ulceration, ... Carotid ultrasonography. *Contrast-enhanced. *3D ultrasound. *Endoscopic ultrasound. *Emergency ultrasound *FAST. *Pre-hospital ...
Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
precerebral: Carotid artery stenosis. *cerebral: MCA. *ACA. *Amaurosis fugax. *Moyamoya disease. POCI. *precerebral: Anterior ...
To the front left lie the large blood vessels the aortic arch and its branches the left common carotid artery and the ... These O rings are smaller than the normal C-shaped rings and can cause narrowing (stenosis) of the trachea, resulting in ... Xue, B; Liang, B; Wang, S; Zhu, L; Lu, Z; Xu, Z (January 2015). "One-stage surgical correction of congenital tracheal stenosis ... tracheal stenosis).[10] Obstruction invariably causes a harsh breathing sound known as stridor.[10] A camera inserted via the ...
Q42.0) Congenital absence, atresia and stenosis of rectum with fistula. *(Q42.2) Congenital absence, atresia and stenosis of ... H05.81) Carotid cavernous fistula. *(H70.1) Mastoid fistula *Craniosinus fistula: between the intracranial space and a ...
The most important arterial baroreceptors are located in the left and right carotid sinuses and in the aortic arch.[70] ... The presence of an arterial stenosis increases resistance to flow, however this increase in resistance rarely increases ...
"Aortic Stenosis: Overview - eMedicine Emergency Medicine". Retrieved 2009-02-28.. *^ Redington AN, Gray HH, Hodson ME, Rigby ML ... "Prediction of left ventricular pressure in infants with aortic stenosis". British Heart Journal. 44 (4): 406-10. doi:10.1136/ ... elevated pressure difference between the aortic pressure and the left ventricular pressure may be indicative of aortic stenosis ...
... where ultrasound is used for assessing blood flow and stenoses in the carotid arteries (Carotid Ultrasonography) and ... Echocardiography is an essential tool in cardiology, assisting in evaluation of heart valve function, such as stenosis or ... stenosis, vasospasm from a subarachnoid hemorrhage (bleeding from a ruptured aneurysm), and other problems. ...
... grafts are also used to treat stenoses in vascular grafts and fistulas used for hemodialysis. ... Common sites treated with peripheral artery stents include the carotid, iliac, and femoral arteries. Because of the external ...
Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
Aortic stenosis, hypertrophic cardiomyopathy, left bundle branch block (LBBB), and a ventricular pacemaker could all cause a ... Wide splitting: seen in conditions that delay RV emptying (pulmonic stenosis, RBBB). Delay in RV emptying causes delayed ... It is seen in conditions that delay left ventricular emptying (e.g., aortic stenosis, left bundle branch block). ...
The cavernous sinus also contains the carotid artery, which supplies blood to the brain; occasionally, compression of the ... Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
This separates the carotid artery from the vertebral artery and the carotid artery can be massaged against this tubercle to ... Cervical degenerative changes arise from conditions such as spondylosis, stenosis of intervertebral discs, and the formation of ... The carotid tubercle is also used as a landmark for anaesthesia of the brachial plexus and cervical plexus. ... The anterior tubercle of the sixth cervical vertebra is known as the carotid tubercle or Chassaignac tubercle. ...
Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
... by the aortic and carotid bodies, as well as by the blood gas and pH sensor on the anterior surface of the medulla oblongata in ... Laryngotracheal stenosis. Lower RT/lung disease. (including LRTIs). Bronchial/. obstructive. acute. Acute bronchitis. chronic. ... The aortic and carotid bodies, are the peripheral blood gas chemoreceptors which are particularly sensitive to the arterial ...
Stenosis of the carotid arteries can presage cerebral infarcts (strokes). DVT in the legs can be found via ultrasound before it ... Interventional radiologists diagnose and treat several disorders including peripheral vascular disease, renal artery stenosis, ... rapid administration of IV contrast during the CT scan these fine detail images can be reconstructed into 3D images of carotid ...
The former affects vessels such as the internal carotids, vertebral and the circle of Willis. The latter can affect smaller ... Stenosis. *Carotid artery stenosis. *Renal artery stenosis. Other. *Aortoiliac occlusive disease. *Degos disease ...
The internal carotid artery supplies the brain. Plaque often builds up at that division, and causes a narrowing (stenosis). ... Plaque can also build up at the origin of the carotid artery at the aorta.] ... of the carotid artery, usually caused by atherosclerosis. ... Carotid stenosis is a narrowing or constriction of the inner ... Carotid stenosis is a narrowing or constriction of the inner surface (lumen) of the carotid artery, usually caused by ...
arotid artery stenosis refers to a narrowing of the carotid arteries, the major arteries in the neck that supply the brain with ... Carotid artery stenosis refers to a narrowing of the carotid arteries, the major arteries in the neck that supply the brain ... Carotid Artery Stenosis Diagnosis. News-Medical. 29 May 2020. ,https://www.news-medical.net/health/Carotid-Artery-Stenosis- ... Carotid Artery Stenosis Diagnosis. News-Medical. https://www.news-medical.net/health/Carotid-Artery-Stenosis-Diagnosis.aspx. ( ...
In carotid artery disease, a waxy substance (plaque) clogs the arteries that bring blood to your brain and head. Find out how ... Carotid artery disease (Medical Encyclopedia) Also in Spanish * Carotid artery stenosis -- self-care (Medical Encyclopedia) ... ClinicalTrials.gov: Carotid Artery Diseases (National Institutes of Health) * ClinicalTrials.gov: Carotid Stenosis (National ... Carotid Artery Disease (Texas Heart Institute) Also in Spanish * What Is Carotid Artery Disease? (National Heart, Lung, and ...
Fatigue Carotid stenosis Chris511 History of progressive fatigue for past 5 years, now so bad that I returned to my physician. ... Fatigue Carotid stenosis History of progressive fatigue for past 5 years, now so bad that I returned to my physician. I was ... CT angiography show stenosis. So, heres the question. Can the level of fatigue I am experiencing be due to the carotid ... CT angiography show stenosis. So, heres the question. Can the level of fatigue I am experiencing be due to the carotid ...
A red eye from carotid stenosis. BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i364 (Published 29 January 2016) Cite this as: ...
Carotid endarterectomy for asymptomatic carotid stenosis: a meta-analysis. Published: 28 November 1998; BMJ 317 doi:10.1136/bmj ... Carotid endarterectomy for asymptomatic carotid stenosis Better data, but the case is still not convincing ... Carotid endarterectomy for asymptomatic carotid stenosis. BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7171.1468 ( ... Variations in rates of appropriate and inappropriate carotid endarterectomy for stroke prevention in 4 Canadian provinces ...
The carotid arteries provide the main blood supply to the brain. They are located on each side of your neck. You can feel their ... Carotid artery stenosis occurs when the carotid arteries become narrowed or blocked. This can lead to stroke. ... Management of recurrent carotid stenosis. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA ... The carotid arteries provide the main blood supply to the brain. They are located on each side of your neck. You can feel their ...
Drs John Mandrola and Richard Bulbulia discuss the results of the ACST-2 trial comparing carotid artery stenting and carotid ... Possibly a contralateral carotid stenosis in a patient who previously had a symptomatic carotid intervention. Possibly patients ... What Are the Implications of ACST-2 for Patients With Asymptomatic Carotid Stenosis?. An Interview With Richard Bulbulia, MD. ... Mandrola: Where do these patients with asymptomatic carotid stenosis come from? Are these from screening facilities, screening ...
Learn about this procedure and about carotid stenosis with this neurosurgeon-edited guide. ... What is carotid endarterectomy, and how can it help prevent stroke? ... Severe blockage is called carotid stenosis. Carotid stenosis may cause the patient to experience a TIA. Common temporary ... Carotid stenosis is frequently asymptomatic. A doctor may detect it through an abnormal sound called a bruit (BROOe) when ...
Carotid Stenosis. Cerebrovascular Disorders. Pathological Conditions, Anatomical. Carotid Artery Diseases. Brain Diseases. ... Recurrent Carotid Stenosis. The safety and scientific validity of this study is the responsibility of the study sponsor and ... Cardiovascular Diseases Carotid Stenosis Cerebrovascular Disorders Heart Diseases Vascular Diseases Drug: aspirin Drug: ... The Recurrent Carotid Stenosis Study established whether antiplatelet therapy was beneficial in the prevention of recurrent ...
... carotid stenosis.. 2. Pathophysiology of Carotid Stenosis. In most cases, carotid stenosis is the result of atherosclerotic ... carotid stenosis and decisions on the degree of carotid stenosis alone could therefore be misleading. Carotid disease should be ... Hence, 93 patients (58.9%) had an "asymptomatic" carotid stenosis despite suggested acute stroke from carotid stenosis. ... for high-grade stenosis (,70% distal degree of stenosis) and about 7% for moderate stenosis. Carotid occlusions were found to ...
... carotid stenting was as effective as endarterectomy, the randomized, controlled CREST trial showed. ... Stenting Equals Surgery for Carotid Stenosis. For patients with carotid stenosis, carotid stenting was as effective as ... For patients with carotid stenosis, carotid stenting was as effective as endarterectomy, the randomized, controlled CREST trial ... Source Reference: Brott T, et al "Stenting versus endarterectomy for treatment of carotid-artery stenosis" N Engl J Med 2010; ...
encoded search term (Carotid Artery Stenosis Imaging) and Carotid Artery Stenosis Imaging What to Read Next on Medscape. ... CEMRA detected stenosis in 24 (52%) of 46 carotid arteries, while TOF detected stenosis in 27 (59%) of 46 carotid arteries. ... both the carotid stenosis (arrows) and the carotid ulcerations (arrowheads) are demonstrated. ICA = internal carotid artery. ... for carotid artery stenosis evaluation at 3T. Twenty-three patients with internal carotid artery stenosis detected with ...
Carotid artery stenosis is a condition in which the carotid arteries become abnormally narrow, making it hard for the brain to ... the patient will likely undergo a Doppler ultrasound of the carotid artery to confirm stenosis. When carotid artery stenosis is ... The carotid arteries, located in the neck, are the major source of oxygen-rich blood flow to the brain. Carotid artery stenosis ... When carotid artery stenosis is greater than 50%, several strategies may be employed to treat it. Carotid endarterectomy is a ...
Carotid artery stenosis occurs when the carotid arteries narrow. The carotid arteries are major arteries found on each side of ... Carotid artery stenosis occurs when the carotid arteries narrow. The carotid arteries are major arteries found on each side of ... Carotid artery stenosis is caused by the build-up of plaque along the lining of the arteries. This build-up is known as ... Carotid artery stenosis is caused by the build-up of plaque along the lining of the arteries. This build-up is known as ...
The available methods of preventing carotid-associated stroke are optimal medical therapy, carotid endarterectomy (CEA), and... ... Arteriosclerotic lesions of the extracranial portion of the carotid artery are the cause of 10 20% of all ischemic strokes. ... asymptomatic stenosis, 50 69% stenosis, and contralateral carotid occlusion (for CEA only). ... Carotid Stenosis Trialist Collaboration [Table 2], only for symptomatic stenosis) (26, 27) has shown that CEA is associated ...
... as a viable therapy to treat carotid disease and stroke prevention is growing. One of the limitations of carotid stenting is ... Gore Medical Products Related to Carotid Artery Stenosis. GORE® ACUSEAL Cardiovascular Patch. The GORE® ACUSEAL Cardiovascular ... Carotid artery stenting (CAS) as a viable therapy to treat carotid disease and stroke prevention is growing. One of the ... The GORE® Embolic Filter features a unique diamond frame that expands the safety of neuro protection during carotid ...
What are the risk numbers for a stroke with a 50% and 69% carotid blockage, if one follows a protocol of aspirin, statins ( ...
... a disease known as carotid stenosis. If these interfere with blood flow, a stroke can occur. ... A less-invasive option, called carotid stenting, involves inserting a catheter into an artery in the groin, advancing it to the ... The same process that causes obstructions in the hearts arteries can block the carotid arteries in the neck, ... carotid artery, opening the blockage with a balloon, and leaving behind a wire cage (or stent) to hold the artery open. ...
DETROIT-Carotid endarterectomy is effective for preventing stroke in symptomatic patients with moderate to severe stenosis, but ... 26-Symptomatic patients with severe to moderate carotid-artery stenosis may benefit from carotid endarterectomy, but ... In a pooled analysis of the NASCET, ECST, and VA trials, the authors found that among patients with moderate to severe stenosis ... They also found that among asymptomatic patients between the ages of 40 and 75 years with 60% to 99% stenosis, CE is a ...
Investigate the current situation of carotid stenosis therapy in China. Establish the data bank of carotid stenosis ... CAS:the patient who accepted carotid angioplasty due to catotid artery stenosis CEA:the patient who accepted carotid ... Carotid Stenosis. Carotid Artery Diseases. Constriction, Pathologic. Pathological Conditions, Anatomical. Cerebrovascular ... The carotid stenosis was one of the higher risk of the ischemia stroke in China.In the mean time ,more and more people accept ...
... issued a draft recommendation statement and draft evidence review on screening asymptomatic adults for carotid artery stenosis ... Dont Screen for Carotid Artery Stenosis, Says Task Force USPSTF Draft Recommendation. Dont Screen for Carotid Artery Stenosis ... The task force wants to help prevent people from having a stroke, but screening for carotid artery stenosis in those without ... 17, 2020, 08:00 am News Staff - Asymptomatic carotid artery stenosis is one of several factors for increased stroke risk. ...
... without outward symptoms of carotid stenosis and after carotid ultrasonography stratified them into three groups: ... Asymptomatic carotid artery stenosis confers mobility impairment and cognitive dysfunction and increases the risk for falls, ... no carotid stenosis (n = 54), moderate carotid stenosis (n = 17) and high-grade carotid stenosis (n = 9). ... no carotid stenosis (n = 54), moderate carotid stenosis (n = 17) and high-grade carotid stenosis (n = 9). ...
High impact information on Carotid Stenosis. *CONCLUSION: Severe carotid stenosis is associated with a higher risk for ... Chemical compound and disease context of Carotid Stenosis. *Carotid stenosis was not usefully predictive of stroke in patients ... Gene context of Carotid Stenosis. *In asymptomatic patients and in patients with a contralateral carotid stenosis of ,50%, ... Biological context of Carotid Stenosis. *METHODS: Eight patients with severe unilateral carotid stenosis (, 70%) were evaluated ...
To evaluate the feasibility and safety of elective carotid stent implantation in patients with carotid stenoses and concomitant ... Elective stenting of carotid artery stenosis in patients with severe coronary artery disease.. Waigand J1, Gross CM, Uhlich F, ... In three patients the opposite carotid artery was occluded; nine patients had bilateral stenoses of which two received stents ... We treated 50 patients with ,70%, stenoses in 53 carotid arteries with balloon angioplasty followed by elective stent ...
Evidence-based recommendations on carotid artery stent placement for asymptomatic extracranial carotid stenosis (narrowed ... Carotid artery stent placement for asymptomatic extracranial carotid stenosis. Interventional procedures guidance [IPG388]. ... In addition the ICD-10 codes I65.2 Occlusion and stenosis of carotid artery or I65.3 Occlusion and stenosis of multiple and ... NICE has also produced guidance on carotid artery stent placement for symptomatic extracranial carotid stenosis (NICE ...
Evidence-based recommendations on carotid artery stent placement for symptomatic extracranial carotid stenosis (narrowed ... Carotid artery stent placement for symptomatic extracranial carotid stenosis. Interventional procedures guidance [IPG389]. ... NICE has also published guidance on carotid artery stent placement for asymptomatic extracranial carotid stenosis (NICE ... It replaces the previous guidance on carotid artery stent placement for carotid stenosis (NICE interventional procedures ...
... stenosis of the left internal carotid artery. This carotid stenosis was asymptomatic because the patient did not have any ... Proportion of carotid revascularization (mainly using surgery) performed in patients with asymptomatic carotid stenosis in ... Echo-Doppler showed an atherosclerotic stenosis at the site of the left carotid bifurcation. On grayscale, this stenosis was ... Most patients in early trials of carotid surgery for asymptomatic carotid stenosis did not receive medical treatment that is ...
Carotid Velocities Determine Cerebral Blood Flow Deficits in Elderly Men with Carotid Stenosis ,50%. Arkadiusz Siennicki-Lantz, ... R. W. Hobson II, D. G. Weiss, W. S. Fields et al., "Efficacy of carotid endarterectomy for asymptomatic carotid stenosis," The ... Out of 123 stroke-free patients, carotid stenosis ,50% was observed in 94% in the right and 89% in the left internal carotid ... "Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study ...
... and recurrent stenosis. The results of a nonrandomized study with... ... We examined the operative risks and long-term results of carotid endarterectomy for asymptomatic patients in terms of stroke, ... Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. N Engl J Med 1993;328:221-227.CrossRefPubMedGoogle ... Asymptomatic contralateral carotid artery stenosis: A five-year follow-up study following carotid endarterectomy. Surgery 1980; ...
  • Carotid artery stenosis refers to a narrowing of the carotid arteries, the major arteries in the neck that supply the brain with blood from the heart. (news-medical.net)
  • The doctor will also use a stethoscope to listen to the blood flow through the carotid arteries. (news-medical.net)
  • Carotid ultrasonography - This technique uses high intensity sound waves to generate structural images of the carotid arteries that can be used to check for plaque build up and clots. (news-medical.net)
  • Carotid angiography - A catheter is inserted into a vein in the patient's arm or leg and guided towards the carotid arteries. (news-medical.net)
  • A contrast dye is then passed through the catheter and X-ray images of the carotid arteries are taken. (news-medical.net)
  • Your carotid arteries are two large blood vessels in your neck. (medlineplus.gov)
  • If you have carotid artery disease, the arteries become narrow or blocked, usually because of atherosclerosis . (medlineplus.gov)
  • The level of occlusion of your carotid arteries may have produced the stroke like symptoms you had in the past, possibly a transient ischemic attack (TIA). (medhelp.org)
  • The carotid arteries provide the main blood supply to the brain. (medlineplus.gov)
  • Carotid artery stenosis occurs when the carotid arteries become narrowed or blocked. (medlineplus.gov)
  • This prevents plaque, a waxy deposit, from building up in the carotid arteries. (medlineplus.gov)
  • You may also have imaging tests done to see if the blockages in your carotid arteries are becoming worse. (medlineplus.gov)
  • Carotid arteries are located on each side of the neck and extend from the aorta in the chest to the base of the skull. (aans.org)
  • Plaque forms when the internal carotid arteries become blocked by fat and cholesterol build-up. (aans.org)
  • Blockage of the internal carotid arteries can reduce blood supply to the brain and may lead to a stroke. (aans.org)
  • A doctor may detect it through an abnormal sound called a bruit (BROO'e) when listening to the carotid arteries with a stethoscope. (aans.org)
  • Carotid stenosis is common, especially in patients with vascular risk factors or with coexistent pathology of coronary or peripheral arteries [ 1 , 2 ]. (hindawi.com)
  • The carotid arteries, located in the neck, are the major source of oxygen-rich blood flow to the brain. (wisegeek.com)
  • Carotid artery stenosis (CAS) occurs when these arteries become thick and more narrow, hence cutting off some of this necessary blood supply. (wisegeek.com)
  • Detection and treatment of CAS depends on symptoms and the degree to which the carotid arteries are narrowed. (wisegeek.com)
  • Carotid artery stenosis occurs when the carotid arteries narrow. (denverhealth.org)
  • The carotid arteries are major arteries found on each side of the neck. (denverhealth.org)
  • Carotid artery stenosis is caused by the build-up of plaque along the lining of the arteries. (denverhealth.org)
  • The same process that causes obstructions in the heart's arteries can block the carotid arteries in the neck, a disease known as carotid stenosis. (harvard.edu)
  • 70%, stenoses in 53 carotid arteries with balloon angioplasty followed by elective stent implantation. (nih.gov)
  • The main arteries in the neck (the carotid arteries) can become narrowed by fatty deposits. (nice.org.uk)
  • 50% was observed in 94% in the right and 89% in the left internal carotid arteries (ICAs). (hindawi.com)
  • Blood clot formation in any part of the CAROTID ARTERIES. (bioportfolio.com)
  • Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. (bioportfolio.com)
  • Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. (bioportfolio.com)
  • They ascend in the neck, one on each side, and at the level of the upper border of the thyroid cartilage, each divides into two branches, the external (CAROTID ARTERY, EXTERNAL) and internal (CAROTID ARTERY, INTERNAL) carotid arteries. (bioportfolio.com)
  • The carotid arteries are clamped during CEA which may impair the cerebral perfusion. (diva-portal.org)
  • Less common causes are aneurysms, inflammation of arteries (arteritis), and tears (dissection) of the carotid. (carle.org)
  • The health care provider will obtain an ultrasonography of the carotid arteries to evaluate the degree of narrowing of the lumen of the carotids. (carle.org)
  • Occasionally, plaque builds up in neck arteries, usually the largest artery going to the brain, called the carotid artery. (mountsinai.org)
  • An imaging procedure that uses high-frequency sound waves to view the carotid arteries to determine if there is narrowing. (clevelandclinic.org)
  • Carotid angiography (carotid angiogram, carotid arteriogram, carotid angio): During this invasive imaging procedure, a catheter (thin, flexible tube) is inserted into a blood vessel in the arm or leg, and guided to the carotid arteries with the aid of a special X-ray machine. (clevelandclinic.org)
  • Contrast dye is injected through the catheter while X-rays of the carotid arteries are taken. (clevelandclinic.org)
  • This test may be performed to evaluate or confirm the presence of narrowing or blockage in the carotid arteries, determine the risk for future stroke and evaluate the need for future treatment, such as carotid stenting or surgery. (clevelandclinic.org)
  • Magnetic resonance angiogram (MRA): MRA is a type of magnetic resonance image (MRI) scan that uses a magnetic field and radio waves to provide pictures of the carotid arteries. (clevelandclinic.org)
  • This test can provide important information about the carotid and vertebral arteries and the degree of stenosis. (clevelandclinic.org)
  • Computed tomography angiogram (CTA): A test that uses advanced CT technology, along with intravenous (IV) contrast material (dye), to obtain high-resolution, 3D pictures of the carotid arteries. (clevelandclinic.org)
  • CTA images enable physicians to determine the degree of stenosis in the carotid and vertebral arteries and can also assess leading to these arteries as well as the blood vessels in the brain. (clevelandclinic.org)
  • Pressures were measured in the carotid arteries of 61 patients proximal and distal to atherosclerotic plaques which were carefully studied by angiography and anatomical dissection. (ahajournals.org)
  • Fifteen patients (30 carotid arteries) were evaluated, with a diagnosis of transient ischemic attack and/or cerebral infarction. (medigraphic.com)
  • Gruberg L. Carotid Stenting and nature of Atherosclerosis in carotid Arteries. (medigraphic.com)
  • Carotid and vertebral arteries. (medigraphic.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)
  • Coloured three-dimensional (3D) computed tomography (CT) angiography scan in side view of the neck arteries in a 52 year old patient showing a stenosis (narrowing, at centre left) of the carotid artery due to atherosclerosis. (sciencephoto.com)
  • range, 70%-99%) in a total of 19 carotid arteries, which were treated with angioplasty and stent placement. (ajnr.org)
  • In the total 19 stented carotid arteries, 23 procedures were performed (22 stent placement procedures and one repeat angioplasty). (ajnr.org)
  • Atherosclerotic stenosis of common and internal carotid arteries is a well-recognized risk factor for ischemic stroke, and revascularization has been proven to be the main tool of prevention, particularly for patients with stenosis-related symptoms. (biomedsearch.com)
  • The incidence of mural thrombosis following three types of experimental intimal injuries at common carotid arteries, was investigated in a series of 12 dogs. (ebscohost.com)
  • There is only mild hardening of the arteries or plaque in your carotid arteries at this point. (healthtap.com)
  • Your carotid arteries deliver blood to your brain and head. (healthtap.com)
  • Given the presence of carotid artery disease, the carotid arteries are obstructed and the brain fails to receive the necessary oxygen levels that enable it to function. (healthguideinfo.com)
  • Carotid artery stenosis or carotid artery disease pertains to a narrowing activity within the heart's carotid arteries, usually as a result of atherosclerosis or the build-up of plaque. (healthguideinfo.com)
  • Further build-up causes stenosis (narrowing) within the carotid arteries and cause obstruction in the passageways. (healthguideinfo.com)
  • Carotid stenosis, also known as carotid artery disease, is characterized by the narrowing of the carotid arteries, the primary blood vessels that carry oxygenated blood to the brain. (transparencymarketresearch.com)
  • Carotid artery stenosis (CAS) is defined as the presence of significant narrowing of the arteries of the extracranial carotid system due to the presence of atherosclerotic plaque and affects up to 10% of people over 65 years (Goessens et al 2007). (dit.ie)
  • Carotid Stenosis, or Carotid Artery Disease, is a narrowing of the carotid arteries, the two major arteries that carry oxygen-rich blood from the heart to the brain. (iowaclinic.com)
  • In patients with recently symptomatic internal carotid artery stenosis, is magnetic resonance angiography (MRA) accurate for distinguishing arteries with stenosis that are suitable for surgery from occluded arteries or arteries with noncritical stenosis? (acpjc.org)
  • In patients with recently symptomatic internal carotid artery stenosis, magnetic resonance angiography is accurate for distinguishing stenosis of 70% to 99% that is suitable for surgery from occluded arteries or noncritical stenosis. (acpjc.org)
  • Methods: Wistar rat model of hypoperfusion due to severe carotid stenosis was established by binding a stainless microtube to both carotid arteries. (ebscohost.com)
  • Flow patterns and wall shear stress distribution in human internal carotid arteries: the geometric effect on the risk for stenoses. (semanticscholar.org)
  • Asymptomatic people have narrowing of their carotid arteries, but have not experienced a TIA or stroke. (wikipedia.org)
  • The internal, common and external carotid arteries are carefully identified, controlled with vessel loops, and clamped. (wikipedia.org)
  • Carotid artery disease is serious because it can block the blood flow to your brain, causing a stroke . (medlineplus.gov)
  • Having carotid artery disease puts you at risk for stroke. (medlineplus.gov)
  • The important thing is that these changes in carotid artery stenting may well impact on the procedural risks - the stroke, death, and myocardial infarction rates seen within 30 days of the procedure - but they may not be terribly important in the long-term durability of surgery vs stenting. (medscape.com)
  • Carotid endarterectomy is a common vascular surgical procedure which may help prevent the risk of having a stroke. (aans.org)
  • Scientific evidence from recent studies supports carotid endarterectomy as an effective method of stroke prevention for people with carotid artery blockage of 70 percent or greater. (aans.org)
  • Both terms, however, only address different phases of activity of the one and the same condition and blur the significant message that carotid stenosis is a most important marker of systemic atherosclerosis, which is accompanied by a much higher risk of cardiovascular events rather than stroke. (hindawi.com)
  • This distinction corresponds to the design and results of previous clinical trials on surgical versus medical treatment of carotid stenosis for stroke prevention as well as of current studies comparing surgical with interventional procedures (angioplasty with or without stent) [ 3 - 8 ]. (hindawi.com)
  • However, careful review of these studies, as well as long-term natural history observations for many decades, shows that carotid stenosis is much more sensitive as marker of systemic atherosclerosis than a cause of stroke [ 9 , 10 ]. (hindawi.com)
  • Only within a small time window, when carotid stenosis shows progression and high plaque vulnerability, either in the presence of or without clinical signs or symptoms, there is a higher incidence of stroke. (hindawi.com)
  • Studies performed since then showed already very early an eminent contrast between a very low incidence of stroke (1-2%/year) and a rather high cardiovascular morbidity and mortality (5-10%/year), in particular in patients with clinically silent presentation (so-called "asymptomatic carotid disease") [ 9 , 10 ]. (hindawi.com)
  • The same is true for the "symptomatic" carotid stenosis too, but with one difference: there is a higher risk of stroke (10-20%) within the first 14-28 days following a cerebrovascular event (TIA or stroke) [ 13 ]. (hindawi.com)
  • After this vulnerable period, the stroke risk declines to that of the "asymptomatic" carotid stenosis. (hindawi.com)
  • The lack of a difference on the primary endpoint, which was initially reported at the American Stroke Association meeting in February, appears to be at odds with the results of the International Carotid Stenting Study (ICSS), also reported in February, which found that endarterectomy was significantly safer than stenting. (medpagetoday.com)
  • Carotid CT angiography (CTA) is the a commonly performed imaging study in stroke centers. (medscape.com)
  • While mild carotid artery stenosis occurs in most people as they age, the greater the blockage, the more chance that those affected will suffer a stroke or a transient ischemic attack (mini-stroke). (wisegeek.com)
  • When a stroke is caused by artery stenosis, usually the artery has narrowed and platelets have accumulated at the narrow point to form a clot. (wisegeek.com)
  • Unfortunately, the first symptom of carotid artery stenosis may be impaired brain function, a mini-stroke, or a full stroke. (wisegeek.com)
  • The goal of treatment is to prevent carotid artery stenosis from causing inadequate blood flow to the brain or causing a stroke. (denverhealth.org)
  • Carotid endarterectomy (CEA) and carotid artery stenting (CAS) can be used to prevent stroke due to arteriosclerotic lesions of the carotid artery. (aerzteblatt.de)
  • The available methods of preventing carotid-associated stroke are optimal medical therapy, carotid endarterectomy (CEA), and stent-based carotid angioplasty (carotid artery stenting, CAS). (aerzteblatt.de)
  • For both CEA and CAS, the maximum permissible rate of periprocedural stroke and death is 3% for asymptomatic stenoses and 6% for symptomatic stenoses ( 1 3 ). (aerzteblatt.de)
  • Drug regimens aimed at controlling lipidemia, hypertension, and blood glucose were effective at preventing major cardiovascular events in about 98% of patients with asymptomatic carotid stenosis, reported J. David Spence, MD, of the Stroke Prevention and Atherosclerosis Research Centre in London, Ontario, and colleagues. (medpagetoday.com)
  • Our findings indicate that with more intensive medical therapy, the stroke risk in asymptomatic carotid stenosis and therefore the potential benefit of revascularization have markedly declined," they wrote. (medpagetoday.com)
  • Carotid artery stenting (CAS) as a viable therapy to treat carotid disease and stroke prevention is growing. (goremedical.com)
  • One of the limitations of carotid stenting is the risk of liberating embolic particles during the procedure that could cause a stroke or compromise cognitive function. (goremedical.com)
  • What are the risk numbers for a stroke with a 50% and 69% carotid blockage, if one follows a protocol of aspirin, statins (medication) and diet versus a vascular surgical intervention in a 60 year old woman? (netwellness.org)
  • The carotid stenosis was one of the higher risk of the ischemia stroke in China.In the mean time ,more and more people accept revascularization because of carotid stenosis.NASCAT indicated that CEA is the 'golden standard' of the therapy of the carotid stenosis.But in china , case the opposite,only little patient receive CEA,on the other hand , most patients received angioplasty. (clinicaltrials.gov)
  • Aug. 17, 2020, 08:00 am News Staff - Asymptomatic carotid artery stenosis is one of several factors for increased stroke risk. (aafp.org)
  • Stroke risk in patients with symptomatic internal carotid artery (ICA) stenosis greater than 70% can be reduced effectively by carotid endarterectomy. (hindawi.com)
  • In most cases, carotid ultrasound is performed in association with TIA or stroke and, in case of significant stenosis, an operative treatment or pharmacotherapy is initiated as a secondary prevention. (hindawi.com)
  • Silent embolic infarcts predict also future ipsilateral stroke in at least moderate asymptomatic carotid stenosis [ 5 ], and elderly with moderate carotid stenosis had a significant ipsilateral cerebral perfusion delay on MRI [ 6 ]. (hindawi.com)
  • The aim of our study was to estimate the presence of silent changes in cerebral blood flow (CBF) in a populations sample of stroke-free elderly men without carotid stenosis or less than 50% and to examine if there was a dose-response relationship between PSV in ICA and a grade of CBF decline. (hindawi.com)
  • We examined the operative risks and long-term results of carotid endarterectomy for asymptomatic patients in terms of stroke, death, and recurrent stenosis. (springer.com)
  • Carotid endarterectomy can be performed safely for asymptomatic patients believed to be at risk for stroke. (springer.com)
  • Asymptomatic carotid bruit and risk of stroke: The Framingham Study. (springer.com)
  • Noninvasive assessment of stroke risk in asymptomatic and nonhemispheric patients with suspected carotid disease. (springer.com)
  • B. There are no externally validated, reliable tools that can determine who is at increased risk of carotid artery stenosis or of stroke when carotid artery stenosis is present. (aafp.org)
  • Despite the evidence on important risk factors for carotid artery stenosis, there are no externally validated, reliable methods to determine who is at increased risk of carotid artery stenosis or of stroke when carotid artery stenosis is present. (aafp.org)
  • CAS is useful for detecting carotid artery stenosis, which is one of the causes of stroke. (bioportfolio.com)
  • Randomised controlled trials (RCT) have demonstrated a net benefit of carotid endarterectomy (CEA) in stroke prevention for patients with severe carotid artery stenosis as compared to best medical treatment. (diva-portal.org)
  • The perioperative stroke or death rate was 4.3% for those with symptomatic and 2.1% for asymptomatic stenosis (the latter decreasing over time). (diva-portal.org)
  • Without strong evidence of benefit, the use of carotid endarterectomy for prophylaxis against stroke rose dramatically until the mid-1980s, then declined. (nih.gov)
  • Our investigation sought to determine whether carotid endarterectomy reduces the risk of stroke among patients with a recent adverse cerebrovascular event and ipsilateral carotid stenosis. (nih.gov)
  • 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. (nih.gov)
  • Extracranial carotid artery stenosis (ECAS) represents an important risk factor for ischemic stroke. (nature.com)
  • To determine baseline clinical and ultrasonographic plaque factors predictive of progression or regression of asymptomatic carotid stenosis and the predictive value of changes in stenosis severity on risk of first ipsilateral cerebral or retinal ischemic events (including stroke). (nih.gov)
  • Progressive asymptomatic carotid stenosis identified a subgroup with about twice the risk of ipsilateral stroke compared with those without progression. (nih.gov)
  • With demonstration of the failure of extracranial-intracranial (EC-IC) bypass to reduce the incidence of stroke in patients with internal carotid artery (ICA) occlusion, controversy continues regarding the best method of stroke prevention in these high-risk persons. (nih.gov)
  • Atherosclerosis is a chronic degenerative disease that can cause intracranial carotid artery stenosis, which is a leading cause of ischemic stroke. (bioportfolio.com)
  • The currently used interventions for carotid artery stenosis in ischemic stroke include internal medication, carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS). (bioportfolio.com)
  • In recent years, CAS has been increasingly used for the treatment of carotid artery stenosis in patients with ischemic stroke because of its minimally invasive procedure, rapid recovery process and wide indications. (bioportfolio.com)
  • Existing evidence on use of Enterprise stent system for intracranial artery stenosis in patients with ischemic stroke mainly focus on case series and case reports. (bioportfolio.com)
  • There is a lack of randomized controlled trial evidence regarding long-term effects of Enterprise stent implantation for the treatment of carotid artery stenosis after ischemic stroke. (bioportfolio.com)
  • Therefore, in this study, the investigators designed a double-blind, randomized, drug control trial to investigate the efficacy of Enterprise stent implantation in the treatment of carotid artery stenosis in patients with ischemic stroke. (bioportfolio.com)
  • In this study, the investigators will use Enterprise stent system to treat carotid artery stenosis in patients with ischemic stroke, which is of important clinical significance for secondary prevention of ischemic stroke. (bioportfolio.com)
  • In addition, there is no long-term follow-up evidence regarding Enterprise stent implantation of carotid artery stenosis after ischemic stroke, so 3-year follow-up will be performed in this study. (bioportfolio.com)
  • Outcomes from this study will add objective, rigorous, double-blind, randomized, controlled long-term follow-up trial evidence to Enterprise stent implantation for the treatment of carotid artery stenosis after ischemic stroke. (bioportfolio.com)
  • 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)
  • To accomplish this aim CREST-H will add on to the NINDS-sponsored CREST-2 trial (parallel, outcome-blinded Phase 3 clinical trials for patients with asymptomatic high-grade carotid artery stenosis which will compare carotid endarterectomy plus intensive medical management (IMM) versus IMM alone (n=1,240), and carotid artery stenting plus IMM versus IMM alone (n=1,240) to prevent stroke and death). (clinicalconnection.com)
  • If cognitive decline can be reversed in these patients, then we will have established a new indication for carotid revascularization independent of the risk of recurrent stroke. (clinicalconnection.com)
  • We aimed to quantify the risk and predictors of ipsilateral ischemic stroke in patients with symptomatic carotid stenosis awaiting revascularization (carotid endarterectomy [CEA] or carotid artery stenting) by pooling individual patient data from recent prospective studies with high rates of treatment with modern stroke prevention medications. (diva-portal.org)
  • Patients with symptomatic 50%-99% carotid stenosis eligible for carotid revascularization were included and followed for early recurrent ipsilateral stroke or retinal artery occlusion (RAO). (diva-portal.org)
  • On multivariable Cox regression, recurrence was associated with older age (adjusted hazard ratio [HR] per 10-year increase 1.5, p = 0.02) with a strong trend for association with cerebral (stroke/TIA) vs ocular symptoms (adjusted HR 2.7, p = 0.06), but not degree of stenosis, smoking, vascular risk factors, or medications. (diva-portal.org)
  • 3 ). In 1991, the North American Symptomatic Carotid Endarterectomy Trial (NASCET) demonstrated the unequivocal benefit of endarterectomy over medical management in symptomatic patients with severe carotid stenosis of at least 70% (17% absolute risk reduction of ipsilateral stroke over 2 years). (ajnr.org)
  • More recently, the benefit of carotid endarterectomy in patients with symptomatic but more moderate stenosis of 50%-69% has been reported (6.5% absolute risk reduction of ipsilateral stroke over 5 years) ( 4 ). (ajnr.org)
  • The Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS) did not show a significant difference in stroke or death rate between the two techniques ( 5 ). (ajnr.org)
  • Carotid stenoses ≥50% are associated with increased risk for stroke that can be reduced by prophylactic carotid endarterectomy (CEA). (diva-portal.org)
  • What is carotid artery stenosis and stroke? (healthtap.com)
  • To examine the relationship between carotid artery stenosis, other risk factors, and lacunar stroke. (neurology.org)
  • Carotid artery stenosis in patients presenting with lacune stroke may be coincidental or causal. (neurology.org)
  • The risk and cause of subsequent stroke, and benefit of carotid endarterectomy (CE) is unknown. (neurology.org)
  • Stroke in patients entering the North American Symptomatic Carotid Endarterectomy Trial were classified as nonlacunar, possible lacune (symptoms without CT lacunae), or probable lacune (symptoms with CT lacunae). (neurology.org)
  • For patients with 50 to 99% ICA stenosis, the relative risk reductions (RRRs) in stroke from CE were 35% when the presenting stroke was probable lacunar versus 61% when the stroke was nonlacunar. (neurology.org)
  • Patients presenting with lacunar stroke more often had milder ICA stenosis. (neurology.org)
  • Although CE reduced the risk of stroke in all patients with 50 to 99% ICA stenosis, lesser benefits were observed in patients presenting with lacunar stroke. (neurology.org)
  • 11 The current study examined the role of internal carotid artery (ICA) stenosis and other vascular risk factors in the presence of lacunar stroke, and for the first time examined the outcome in medically or surgically treated patients presenting with lacunar syndrome and ICA stenosis. (neurology.org)
  • Knowledge about carotid stenosis symptoms is essential especially because these may indicate the future occurrence of a full-blown stroke. (healthguideinfo.com)
  • Some of the most common carotid stenosis symptoms include sudden bouts of weakness and muddled speech, which largely indicate an increased risk of experiencing stroke. (healthguideinfo.com)
  • At times, carotid stenosis can bring about symptoms of transient ischemic attack (TIA) - a "mini" or temporary stroke that cautions the possibility of a full-blown stroke in the future. (healthguideinfo.com)
  • The worst effect of carotid stenosis is a full-blown stroke. (healthguideinfo.com)
  • Cases with permanent carotid stenosis or occlusion showed annual rates of 0.7% for ipsilateral carotid territory stroke and of 1.4% for any stroke. (lu.se)
  • Cases with transient carotid stenosis or occlusion showed annual rates of 0.3% for ipsilateral carotid territory stroke and of 0.6% for any stroke. (lu.se)
  • CONCLUSIONS: This study suggests that ICAD has a benign long-term prognosis with low rates of ipsilateral carotid territory and any stroke and that the stroke rate in ICAD is not related to the persistence of severe carotid stenosis or occlusion. (lu.se)
  • Stenosis can worsen over time to completely block the carotid artery which could lead to stroke, a medical emergency that occurs when the blood supply to the brain is interrupted or seriously reduced. (transparencymarketresearch.com)
  • Over 500,000 new cases of stroke are reported in the U.S. each year, and carotid stenosis is estimated to cause 20% to 30% of these. (transparencymarketresearch.com)
  • Increase in patient awareness about early detection, prevention, and treatment of heart attacks and stroke are also expected to boost the global carotid artery stenosis market. (transparencymarketresearch.com)
  • Carotid artery stenting has proven to be a safe and effective treatment to reduce the risk of stroke. (transparencymarketresearch.com)
  • We aimed to investigate Siena CAS risk score value for predicting stroke risk in ICA stenosis patients underwent CAS and explore additional factors for improving accuracy of scoring system. (medworm.com)
  • BACKGROUND: Carotid artery stenosis is one of the risk factors for transientischaemic attack (TIA) and stroke. (medscimonit.com)
  • Patients with severe OSA, in whom loud snoring is common, have a well-established increased risk of carotid artery stenosis that in turn is considered a risk factor for stroke. (enttoday.org)
  • This raises the question of whether patients with primary snoring should in fact undergo screening for carotid artery intimal thickening and stenosis as a potential means of stroke prevention. (enttoday.org)
  • HONOLULU, HI-Results of carotid revascularization with either surgery or stenting stand up well over the long term, with very low rates of stroke through up to a decade of follow-up, new data from the Carotid Stenosis Trialists' Collaboration show. (tctmd.com)
  • Because stroke outside the territory of the treated carotid is not lower, the low rates of ipsilateral stroke may in part be from the endarterectomy and from the stent and not just from advances in medical management and the decline in cigarette smoking," Brott said. (tctmd.com)
  • He highlighted the declining stroke rates in carotid revascularization trials over time. (tctmd.com)
  • Patients with a carotid-territory, nondisabling ischemic stroke, transient ischemic attack, or retinal infarction within 6 months were included if, after a carotid angiogram, the local neurologist and surgeon were "substantially uncertain" about whether to recommend endarterectomy for the relevant ipsilateral artery. (acpjc.org)
  • The distinction between occluded and severely stenotic vessels is crucial because occlusions cannot be treated surgically, whereas severe stenosis has a high risk for stroke and can be surgically repaired. (acpjc.org)
  • Methods: All patients who underwent carotid angioplasty and stenting after or during a recent admission with acute ischemic stroke, at a tertiary care hospital, from Jun 2012 to August 2015 were retrospectively identified from a prospectively maintained database. (ovid.com)
  • Conclusion: A fixed low dose heparin protocol during carotid angioplasty and stenting ay be safe and effective, especially in patients with recent ischemic stroke. (ovid.com)
  • Carotid Artery Stenosis: Surgery, Stent, or Nonsurgical Stroke Prevention? (skepdoc.info)
  • Carotid endarterectomy (CEA) is a surgical procedure used to reduce the risk of stroke from carotid artery stenosis (narrowing the internal carotid artery). (wikipedia.org)
  • An alternative procedure is carotid stenting, which can also reduce the risk of stroke for some patients. (wikipedia.org)
  • Carotid endartectomy itself can cause strokes, so to be of benefit in preventing strokes over time, the risks for combined 30-day mortality and stroke risk following surgery should be (wikipedia.org)
  • In symptomatic patients with a 70-99% stenosis, for every six people treated, one major stroke would be prevented at two years (i.e. a number needed to treat (NNT) of six). (wikipedia.org)
  • The annual risk of stroke in patients with asymptomatic carotid disease is between 1% and 2%, although some patients are considered to be at higher risk, such as those with ulcerated plaques. (wikipedia.org)
  • The most feared complication of carotid endarterectomy is stroke. (wikipedia.org)
  • The procedure should be avoided when: There is complete internal carotid artery occlusion The person has a previous complete hemispheric stroke on the ipsilateral and complete cerebrovascular territory side severe neurologic deficits (NIHSS>15), because there is no brain tissue at risk for further stroke damage. (wikipedia.org)
  • Carotid stenosis is a narrowing or constriction of the inner surface (lumen) of the carotid artery, usually caused by atherosclerosis. (ebi.ac.uk)
  • ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology. (bioportfolio.com)
  • To collect safety data of [F-18]RGD-K5 in participants with carotid atherosclerosis. (clinicaltrials.gov)
  • Carotid stenosis usually occurs secondary to longstanding atherosclerosis. (healthtap.com)
  • Recurrent carotid stenosis: results of this asymptomatic carotid atherosclerosis study. (springer.com)
  • Carotid atherosclerosis is very important in the pathogenesis of cerebral ischemia. (springer.com)
  • Bonanno L, Marino S, Bramanti P, Sottile F (2015) Validation of a computer-aided diagnosis system for the automatic identification of carotid atherosclerosis. (springer.com)
  • The utility in screening heavy snorers for carotid atherosclerosis and IMT might thus truly lie in initiating treatment early and preventing or at least slowing the progression of carotid atherosclerosis. (enttoday.org)
  • One treatment for carotid artery stenosis: stent placement The carotid artery in the neck is a common site of atherosclerosis. (skepdoc.info)
  • MRI of head/neck shows 70% occlusion right internal carotid. (medhelp.org)
  • Variables associated with increased risk included older age, higher ASA class (ASA = American Society of Anesthesiologists), symptomatic vs. asymptomatic stenosis, 50 69% stenosis, and contralateral carotid occlusion (for CEA only). (aerzteblatt.de)
  • or I65.3 Occlusion and stenosis of multiple and bilateral precerebral arteriesflutter would be recorded. (nice.org.uk)
  • One approach, endarterectomy of stenotic lesions of the contralateral carotid bifurcation, has been used for 145 patients with ICA occlusion during the past 25 years. (nih.gov)
  • In addition, carotid endarterectomy is not suitable for patients with high-position or tandem carotid artery stenosis or carotid artery stenosis complicated by contralateral carotid artery occlusion. (bioportfolio.com)
  • 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)
  • Threshold values provide guidelines for CTA interpretation when assessing carotid artery disease and the presence of near-occlusion. (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)
  • 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)
  • 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)
  • 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)
  • 5 Near-occlusion was defined as any decrease in the expected diameter of the distal ICA above a severe stenosis. (ajnr.org)
  • However, very few articles studied the value of the oculopneumoplethysmography in detecting the postendarterectomy stenosis, whether immediate postoperative occlusion or recurrent carotid artery stenosis. (ebscohost.com)
  • The purpose of this paper is to study the value of the OPG/Gee in detecting the postoperative carotid stenosis or occlusion. (ebscohost.com)
  • OBJECTIVE: To compare the rate of ischemic events and intracranial hemorrhage in the long-term follow-up of patients with persistent and transient severe stenosis or occlusion of the internal carotid artery (ICA) due to spontaneous dissection (ICAD). (lu.se)
  • METHODS: One hundred and sixty-one consecutive patients with unilateral ICAD causing severe stenosis or occlusion were examined clinically and by ultrasound 1 year after symptom onset. (lu.se)
  • Forty-six cases with persistent and 46 age- and latency-matched cases with transient (recanalization complete or less than 50% stenosis) severe stenosis or occlusion of the ICA were enrolled. (lu.se)
  • RESULTS: Antithrombotic therapy and follow-up were similar in patients with permanent (6.2 +/- 3.4 years) and transient (7.2 +/- 4.3 years) severe stenosis or occlusion of the ICA. (lu.se)
  • Based on Doppler examinations,the patients were divided into 4 groups according to the following degrees of stenosis: 40-59%, 60-79%,80-99% stenosis, and occlusion. (medscimonit.com)
  • 60% and 4% had occlusion of the relevant internal carotid artery. (medscimonit.com)
  • Contralateral carotid artery occlusion. (wikipedia.org)
  • In most cases, carotid stenosis is the result of atherosclerotic changes of the vessel wall. (hindawi.com)
  • Davis and Donnan noted, "This trend has been seen in an earlier trial and may reflect some of the increased technical challenges of stenting in older patients, such as the atherosclerotic burden in the internal carotid artery and aortic arch and increased arterial tortuosity. (medpagetoday.com)
  • Asymptomatic carotid atherosclerotic stenosis is associated with impaired mobility and cognitive function that are accompanied by an increased risk of falls in older adults," Anthony and colleagues wrote in an abstract. (healio.com)
  • The atherosclerotic extracranial carotid artery causes moderate to severe stenosis and usually remains silent until triggering acute cerebral ischemia via distal atheroembolization or, less commonly, arterial thrombosis 7 . (nature.com)
  • Determine the sensitivity and specificity of ultrasound, AngioCT and digital angiography in the diagnosis of carotid atherosclerotic disease. (medigraphic.com)
  • These patients were examined with carotid ultrasound for presence or absence of SCS and their medical background regarding atherosclerotic related diseases and risk factors was reviewed. (diva-portal.org)
  • Atherosclerotic plaque in the cervical carotid artery is the most common cause of carotid stenosis. (transparencymarketresearch.com)
  • In this work, we propose a novel dedicated phantom that can be used for both US and MRI scanners to evaluate carotid atherosclerotic lesions. (springer.com)
  • Cai JM, Hatsukami TS, Ferguson MS, Small R, Polissar NL, Yuan C (2002) Classification of human carotid atherosclerotic lesions with in vivo multicontrast magnetic resonance imaging. (springer.com)
  • Kampschulte A, Ferguson MS, Kerwin WS, Polissar NL, Chu B, Saam T, Hatsukami TS, Yuan C (2004) Differentiation of intraplaque versus juxtaluminal hemorrhage/thrombus in advanced human carotid atherosclerotic lesions by in vivo magnetic resonance imaging. (springer.com)
  • Yuan C, Mitsumori LM, Beach KW, Maravilla KR (2001) Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions. (springer.com)
  • This finding carries clinical significance considering the robust body of data from the OSA literature showing that effectively managing OSA and snoring can at least partially reverse intimal thickness changes and the carotid atherosclerotic process. (enttoday.org)
  • All carotid revascularization procedures for clinically asymptomatic stenosis (indication group A, IG-A) and for clinically symptomatic stenosis (indication group B, IG-B) from the reporting years 2009 2014 (CEA) and 2012 2014 (CAS) were included. (aerzteblatt.de)
  • Establish the data bank of carotid stenosis revascularization (CAS and CEA) in China ,in order to get best quality control of the therapy, as well as confirm the standard treatment for carotid stenosis. (clinicaltrials.gov)
  • Although the task force members identified two trials that compared carotid revascularization with best medical treatment for asymptomatic CAS and seven studies that examined the harms associated with revascularization of asymptomatic CAS, they were unable to identify any eligible studies that directly examined the benefits or harms of screening. (aafp.org)
  • Population-based screening trials addressing the benefits and harms of screening for carotid artery stenosis have never been conducted,' the task force concluded, adding that since the last literature review, 'little new indirect evidence has emerged that answers the critical question of whether carotid revascularization is superior to contemporary best medical management. (aafp.org)
  • 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)
  • Randomized trials are needed to determine the benefits and safety of urgent vs subacute carotid revascularization within 14 days after symptom onset. (diva-portal.org)
  • Although it did not randomize patients, the ARCHeR(Acculink for Revascularization of Carotids in High-Risk patients) study is the basis for the only FDA-approved stent. (ajnr.org)
  • The Carotid Revascularization Endarterectomy versus Stent Trial and the International Carotid Stent placement Study (ICSS, or CAVATAS-2) are ongoing. (ajnr.org)
  • The author defends his affirmative response to the question of whether revascularization should be considered a strategy of choice for patients with asymptomatic carotid stenosis. (ebscohost.com)
  • To determine if patients with extracranial carotid stenosis have improved blood flow and cognitive function following carotid revascularization. (cns.org)
  • Carotid stenosis patients with baseline blood flow impairment were more likely to have improvement in flow following revascularization. (cns.org)
  • Understanding how carotid revascularization improves cerebral blood flow and the association between blood flow and cognitive function may make it possible to stratify populations of patients with carotid stenosis in terms of degree of flow impairment to better understand which patients stand to benefit cognitively from carotid revascularization. (cns.org)
  • 1. Describe how carotid revascularization affects cognitive outcome in patients with carotid artery stenosis. (cns.org)
  • 2. Discuss improvement in cerebral blood flow among patients who undergo carotid revascularization for carotid artery stenosis. (cns.org)
  • Recently, the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) published extended 10 year results. (cns.org)
  • Brott underscored the importance of looking at the longer-term durability of carotid revascularization by noting that at age 70, average life expectancy is 15 years. (tctmd.com)
  • The subject choice:All registered patients must be signed informed consent to register for non intrusive research this study ,the researchers during the study period should be continuous registration in patients undergoing surgical treatment of carotid stenosis, to ensure that the selected participants reflect the target patient population. (clinicaltrials.gov)
  • Elective stenting of carotid artery stenosis in patients with severe coronary artery disease. (nih.gov)
  • CT angiography show stenosis. (medhelp.org)
  • Carotid duplex ultrasonography, computed tomographic angiography (CTA), or magnetic resonance angiography (MRA) of the carotid artery may be most appropriate in a specific case (see the images below). (medscape.com)
  • However, none of the studies evaluating carotid auscultation used angiography as the preferred test, and only two studies involved patients from the general population. (aafp.org)
  • CT angiography (CTA) is convenient and accurately quantifies internal carotid artery (ICA) stenosis. (ajnr.org)
  • Patients with infarcts compatible with lacunes were not excluded from randomization as long as carotid lesions appropriate to the symptoms were present on angiography. (neurology.org)
  • Detection of internal carotid artery stenosis: comparison of MR angiography, color Doppler sonography, and arteriography. (harvard.edu)
  • CT angiography is now the primary modality for correlation of carotid DUS with 85% of vascular laboratories using the NASCET methodology for analysis. (onlinejacc.org)
  • Use of magnetic resonance angiography to select candidates with recently symptomatic carotid stenosis for surgery: systematic review. (acpjc.org)
  • Studies assessing the accuracy of carotid artery stenosis detection should be done by comparing the reference standard, currently biplanar contrast angiography, with the investigation of interest, MRA, for all degrees of stenosis. (acpjc.org)
  • A combination of non-invasive tests consisting of Doppler ultrasound carotid velocity assessment carotid phono-angiography and directional Doppler supra-orbital flow evaluation was used to , detect internal Carotid stenosis of 50% or more in patients with symptoms suggestive of cerebrovascular disease. (journals.co.za)
  • Carotid artery was detected by computed tomography angiography, and cranial CT?MRI were performed. (cnki.com.cn)
  • Although duplex imaging helps in the detection of carotid lesions in asymptomatic patients, the cost and risk associated with potentially unnecessary follow-up testing and the risk of unnecessary surgical procedures are arguments againt the wider application of carotid sonography in asymptomatic indivduals. (medscape.com)
  • Additionally, asymptomatic patients with carotid stenosis could benefit from primary preventive operative treatment with carotid endarterectomy in presence of a hemodynamically significant 60-99% ICA stenosis [ 1 - 3 ]. (hindawi.com)
  • The natural history of carotid arterial disease in asymptomatic patients with cervical bruits. (springer.com)
  • Carotid artery stenting versus endarterectomy for the treatment of both symptomatic and asymptomatic patients with carotid artery stenosis: 2 years' experience in a high-volume center. (bioportfolio.com)
  • Dr. Cote and colleagues [1] recently reported that aspirin therapy had no effect on the incidence of vascular events or death in asymptomatic patients with carotid narrowing (hazard ratio, 0.90 [95% CI, 0.62 to 1.33]. (annals.org)
  • It is reasonable to prefer endarterectomy (CEA) over stenting in asymptomatic patients with greater than 70% stenosis.The panel had grade A evidence for that recommendation. (blogspot.com)
  • Although they do not recommend screening for carotid obstruction in asymptomatic patients, many folks will be getting ultrasound exams of their necks,abdomens and doppler exams for vascular disease of the lower extremities as roaming, proprietary groups are frequenting churches and other sites.So when your patient for whom you did not recommended screening shows up with a report suggesting significant blockage you have a good resource to consult. (blogspot.com)
  • 8 of 26 studies met these additional criteria: All patients in the study received the diagnostic standard, the method used to determine the degree of stenosis was described, no asymptomatic patients were included, and the time between examinations did not exceed 1 month. (acpjc.org)
  • Carotid stenosis can either have symptoms (ie, be symptomatic), or be found by a doctor in the absence symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients. (wikipedia.org)
  • Unlike asymptomatic patients, symptomatic people with mild carotid stenosis (50-69%) still benefit from endarterectomy, albeit to a lesser degree, with a NNT of 22 at five years. (wikipedia.org)
  • As for patients with mild carotid artery stenosis, internal medication is generally recommended. (bioportfolio.com)
  • I'm pleased to be with Dr Richard Bulbulia, who is a consultant vascular surgeon at the University of Oxford and co-PI of the ACST-2 trial , which was designed to study carotid artery stenting vs carotid endarterectomy, and was a hotline presentation at the European Society of Cardiology meeting. (medscape.com)
  • Thanks to the hard work of our network of collaborators across Europe and wider afield, we randomized 3625 patients in whom carotid intervention was considered necessary by the managing clinician at these local sites to either surgery or stenting. (medscape.com)
  • I suspect that there's been quite a bit of iteration in carotid artery stenting over the years, but it seems like in the past carotid artery stenting may have been reserved for higher-risk patients. (medscape.com)
  • The nice thing about doing a trial over 13 years is that we probably captured and possibly reflect the evolution of carotid artery stenting. (medscape.com)
  • For patients with carotid stenosis, carotid stenting was as effective as endarterectomy, the randomized, controlled CREST trial showed. (medpagetoday.com)
  • In the meantime, carotid endarterectomy remains the preferred treatment for most patients, they wrote, although they did not rule out stenting as an option. (medpagetoday.com)
  • CREST randomized patients with symptomatic or asymptomatic carotid stenosis to stenting with the RX Acculink stent and an embolic-protection device (1,262 patients) or endarterectomy (1,240 patients) at 108 centers in the U.S. and nine in Canada. (medpagetoday.com)
  • Another surgery that may be done is carotid angioplasty and stenting. (denverhealth.org)
  • A less-invasive option, called carotid stenting, involves inserting a catheter into an artery in the groin, advancing it to the carotid artery, opening the blockage with a balloon, and leaving behind a wire cage (or stent) to hold the artery open. (harvard.edu)
  • Our preliminary results indicate that carotid artery stenting in patients with concomitant severe coronary artery disease is feasible, safe, and may be an alternative to combined carotid and coronary surgery. (nih.gov)
  • Carotid before coronary stenting: the way forward? (nih.gov)
  • Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the 2 current standard treatments for carotid artery stenosis. (bioportfolio.com)
  • Changes in E-Selectin Levels Predict Carotid Stenosis Progression after Carotid Artery Stenting. (bioportfolio.com)
  • We hypothesized the inflammatory markers (IM) could be independent predictors of carotid stenosis progression (CSP) after carotid artery stenting (CAS). (bioportfolio.com)
  • The other approach is carotid artery stenting, which is similar to using coronary stents to treat cardiovascular disease. (mountsinai.org)
  • For Germany, regional variation of procedure rates of carotid endarterectomy (CEA) and carotid artery stenting (CAS) performed for carotid stenosis have so far not been analyzed at a national level. (uni-muenchen.de)
  • The author offers recommendations for examining asymptomatic individuals and for carotid artery disease (CAD) treatment options using carotid endarterectomy or carotid angioplasty with stenting. (ebscohost.com)
  • Systematic Review of Early Recurrent Stenosis After Carotid Angioplasty and Stenting. (ebscohost.com)
  • Carotid angioplasty and stenting (CAS) has emerged as an alternative to endarterectomy (CEA) for the treatment of carotid artery disease. (ebscohost.com)
  • In-stent recurrent stenosis after carotid artery stenting: life table analysis and clinical relevance. (springer.com)
  • Redo surgery or carotid stenting for restenosis after carotid endarterectomy: results of two different treatment strategies. (springer.com)
  • After more than a decade of clinical trials specifically comparing the two approaches, the choice of carotid artery stenting (CAS) or endarterectomy (CEA) for patients with asymptomatic or symptomatic carotid stenosis continues to be debated. (tctmd.com)
  • Introduction Carotid intervention in the form of endarterectomy or stenting is the current standard of care for the majority of patients with symptomatic high-grade carotid stenosis. (bmj.com)
  • Methods and analysis We will systematically search Medline, Embase, PubMed and the Cochrane libraries for all studies with data from RCTs that included women and compared either endarterectomy with stenting or revascularisation (by means of endarterectomy or stenting) with medical therapy in patients with symptomatic carotid stenosis. (bmj.com)
  • Background: Siena carotid artery stenting (CAS) risk score is developed based on Chinese internal carotid artery (ICA) stenosis patients recruited in Italy, whether it is equally applicable in Chinese remains unknown. (medworm.com)
  • Carotid endarterectomy versus carotid angioplasty with or without stenting for treatment of carotid artery stenosis: an updated meta-analysis of randomized controlled trials. (biomedsearch.com)
  • Differences in long-term outcomes between stenting and endarterectomy for significant carotid artery stenosis remain unclear. (cns.org)
  • This study adds important long-term evidence that stenting may achieve similar outcomes as endarterectomy for patients with significant carotid artery stenosis. (cns.org)
  • The early advantage for carotid endarterectomy, however, means that stenting should be reserved for select patients, one expert says. (tctmd.com)
  • What that shows, Brott said, is "a safety advantage of carotid surgery over carotid stenting but an equivalent durability. (tctmd.com)
  • Though newer stenting techniques-including access through the carotid artery with flow reversal to avoid showering the brain with microemboli-could be safer, the message from this study "is that you're better off with endarterectomy," commented J. David Spence, MD (Robarts Research Institute, London, Canada). (tctmd.com)
  • B ecause the periprocedural risk all happens at the beginning and then [the curves are] level," he told TCTMD, "stenting should be reserved for selected patients with particular factors that make stenting safer, such as a very high stenosis, previous radiation or surgery causing fibrosis and scarring in the region of the surgery, and very high periprocedural risk like unstable angina. (tctmd.com)
  • This study was a preplanned analysis of pooled individual patient data from four trials that have compared stenting and endarterectomy for patients with symptomatic carotid artery stenosis. (tctmd.com)
  • Long term functional equivalence of carotid endarterectomy and stenting for symptomatic stenosis. (spinesection.org)
  • The ICSS trial randomized 1710 patients across 50 centers with symptomatic carotid artery disease to stenting versus endarterectomy. (spinesection.org)
  • Introduction: Appropriate dosing of anticoagulation during carotid angioplasty and stenting remains unstudied. (ovid.com)
  • Transcarotid/transcervical revascularisation (TCAR) is an alternative to carotid endarterectomy (CEA) and transfemoral carotid stenting (tfCAS). (physiciansweekly.com)
  • Carotid artery stenting is an alternative to carotid endarterectomy in cases where endarterectomy is considered too risky. (wikipedia.org)
  • It was this streamlined design where we integrated trial processes into routine clinical practice that allowed us to complete the largest carotid surgery trial today. (medscape.com)
  • ACST-2, as I said, is the largest-ever carotid surgery trial to date, but it's not really large enough to look at subgroups in a meaningful way. (medscape.com)
  • In contrast, carotid surgery, which has been around for almost 70 years, is a pretty established technique. (medscape.com)
  • The usefulness of carotid arterial screening has been demonstrated in patients prior to elective surgery. (medscape.com)
  • There is good evidence in support of an evaluation for carotid stenosis prior to coronary arterial bypass surgery. (medscape.com)
  • Asymptomatic carotid artery stenosis confers mobility impairment and cognitive dysfunction and increases the risk for falls, according to data presented at the Society for Vascular Surgery Vascular Annual Meeting. (healio.com)
  • To evaluate the feasibility and safety of elective carotid stent implantation in patients with carotid stenoses and concomitant coronary artery disease, as an alternative to combined carotid and coronary surgery. (nih.gov)
  • European Carotid Surgery Trialists' Collaborative Group. (springer.com)
  • MRC European Carotid Surgery Trial: Interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. (springer.com)
  • The case against surgery for asymptomatic carotid stenosis. (springer.com)
  • In selected trial participants with asymptomatic carotid artery stenosis, surgery can reduce the absolute incidence of all strokes or perioperative death by approximately 3.5% compared with (outdated) medical management. (aafp.org)
  • Surgery for carotid stenosis is called carotid endarterectomy (CEA). (carle.org)
  • As with many cerebrovascular diseases, we at Mount Sinai can treat carotid artery stenosis in two ways: through surgery or endovascular techniques. (mountsinai.org)
  • Surgery to treat carotid artery stenosis is called a carotid endarterectomy. (mountsinai.org)
  • 0.01) in patients given aspirin, 80 mg/d, compared with those who had carotid endarterectomy and received no aspirin (most myocardial infarctions were unrelated to surgery). (annals.org)
  • A total of 1121 patients with asymptomatic carotid stenosis of 50% to 99% in relation to the bulb diameter (European Carotid Surgery Trial [ECST] method) underwent six monthly clinical assessments and carotid duplexes for up to 8 years (mean follow-up, 4 years). (nih.gov)
  • Neale ML. Chambers, et al: Reappraisal of duplex criteria to asses significant carotid stenosis with special reference to reports from The North American Symptomtic carotid and arterectomy trial and European carotid Surgery trial. (medigraphic.com)
  • Durability of surgery for restenosis after carotid endarterectomy. (springer.com)
  • We performed a systematic review and meta-analysis of randomized controlled trials to compare the safety and efficacy of endovascular techniques with surgery for carotid stenosis. (biomedsearch.com)
  • 323 with severe stenosis and 155 with mild stenosis were randomized to no immediate surgery (60:40 randomization). (acpjc.org)
  • The surgery group received carotid endarterectomy (median delay, 12 days after randomization). (acpjc.org)
  • However, considerable doubt arose about a net benefit to society, given the high risk of surgery reported from some communities and the reported high frequency of inappropriate indications for carotid endarterectomy. (acpjc.org)
  • Unoperated asymptomatic significant internal carotid artery stenosis: A review of 182 instances. (springer.com)
  • No TIA patient had significant internal carotid artery stenosis, and CT was normal except in one patient, although magnetic resonance imaging (MRI) performed 3 years after the testing was abnormal in 4/8 cases. (lu.se)
  • The study shows that hemispheric TIAs in patients without significant internal carotid artery stenosis may result in persistent focal cognitive impairment. (lu.se)
  • In the 1980s, with the introduction of vascular ultrasound, the true dimensions of carotid disease became apparent. (hindawi.com)
  • Duplex carotid ultrasound remains useful in the initial evaluation of symptomatic patients who present with nonspecific symptoms that may be related to stenotic or embolic carotid stenosis. (medscape.com)
  • If a bruit is noted, the patient will likely undergo a Doppler ultrasound of the carotid artery to confirm stenosis. (wisegeek.com)
  • Carotid ultrasound was performed at age 81, and cerebral blood flow (CBF) was measured with SPECT at age 82. (hindawi.com)
  • When estimating cerebral blood supply and carotid stenosis with ultrasound in the elderly, one must be aware, that age and DBP-level decrease PSV, while SBP and pulse pressure increase PSV in elderly [ 8 , 9 ]. (hindawi.com)
  • Carotid Ultrasound Examinations: Indications Correlated With Abnormal Findings. (bioportfolio.com)
  • Doppler ultrasound, Angiotomography, carotid stenosis. (medigraphic.com)
  • Howard G, Chambless LE, et al: An approach for the use of Doppler ultrasound as a screnning tool for hemodynamically significant stenosis (despite heterogeneity of Doppler permance) A multicenter experience. (medigraphic.com)
  • Group B comprised patients with ultrasound verified SCS, examined with PR prior to carotid endarterectomy. (diva-portal.org)
  • Presence of carotid bruit and carotid ultrasound. (healthtap.com)
  • In general, it would seem reasonable based on the available evidence to propose that loud snorers, and in particular female loud snorers, be offered a carotid ultrasound during the management process of their snoring. (enttoday.org)
  • Pulsed Doppler ultrasound data are acquired at a 1 mm grid spacing throughout the lumen of the carotid bifurcation. (spie.org)
  • Carotid duplex ultrasound (DUS) is widely used for diagnosis of internal carotid artery (ICA) stenosis and therapeutic decisions are made solely on the basis of DUS findings. (onlinejacc.org)
  • The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Carotid artery stent placement for asymptomatic extracranial carotid stenosis. (nice.org.uk)
  • NICE has also produced guidance on carotid artery stent placement for symptomatic extracranial carotid stenosis (NICE interventional procedure guidance 389, April 2011). (nice.org.uk)
  • It replaces the previous guidance on carotid artery stent placement for carotid stenosis (NICE interventional procedures guidance 191, September 2006). (nice.org.uk)
  • In light of their high surgical risk, carotid angioplasty and stent placement may be preferred in patients with radiation-associated carotid stenosis. (ajnr.org)
  • The purpose of this study was to determine the procedural complication rate, patency, and clinical outcomes after carotid angioplasty and stent placement in this small group of high-risk patients. (ajnr.org)
  • Angioplasty and stent placement have low rates of complications and restenosis in the treatment of radiation-associated carotid occlusive disease. (ajnr.org)
  • Carotid angioplasty and stent placement, however, have become increasingly used during the past two decades and are gaining wider acceptance. (ajnr.org)
  • A few multicenter randomized trials comparing carotid endarterectomy with angioplasty and stent placement have been inconclusive. (ajnr.org)
  • Stent placement and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) found that carotid stent placement with a cerebral protection device was not inferior to endarterectomy in a population of high-risk patients ( 7 ). (ajnr.org)
  • Carotid angioplasty with or without stent placement (CAS) has been proposed as an alternative to carotid endarterectomy (CEA) for the treatment of carotid artery stenosis. (biomedsearch.com)
  • Carotid artery disease often does not cause symptoms until the blockage or narrowing is severe. (medlineplus.gov)
  • Severe blockage is called carotid stenosis. (aans.org)
  • All patients had severe coronary artery disease, and/or mitral insufficiency, aortic stenosis, rhythm disorders or generalized arteriosclerosis. (nih.gov)
  • One hundred consecutive patients with severe but asymptomatic carotid artery stenosis out of a total of 514 patients undergoing carotid endarterectomy were entered into this study. (springer.com)
  • Asymptomatic severe carotid stenosis. (springer.com)
  • angioCT is useful in the diagnosis of moderate and severe stenosis. (medigraphic.com)
  • Accuracy and prognostic consequences of ultrasonography in identifying severe carotid artery stenosis. (medigraphic.com)
  • 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)
  • But you have to question whether it's clinically that relevant, especially as carotid endarterectomy has a higher risk of cranial nerve injury, which can result in a severe disability, and bleeding. (tctmd.com)
  • This is an angiogram of the left common carotid artery (both front-to-back and side views) showing a severe narrowing (stenosis) of the internal carotid artery just beyond the division of the common carotid artery into the internal and external branches. (stlukes-stl.com)
  • Carotid endarterectomy was beneficial for patients with recent, nondisabling cerebral ischemic events and ipsilateral severe (70% to 99%) carotid stenosis. (acpjc.org)
  • Although MRA was accurate in the identification of severe (70% to 99%) stenosis in this study, the key question is whether MRA alone or in addition to duplex ultrasonography is as effective or as cost-effective as duplex ultrasonography alone in the routine investigation of suspected carotid stenosis. (acpjc.org)
  • Background and Purpose: Complications due to brain edema and breakdown of blood brain barrier are an important factor affecting the treatment effects of patients with severe carotid stenosis. (ebscohost.com)
  • In this study, we investigated the protective effects of ischemic postconditioning on brain edema and disruption of blood brain barrier via establishing rat model of hypoperfusion due to severe carotid stenosis. (ebscohost.com)
  • Conclusions: Ischemic postconditioning is an effective method to prevent brain edema and improve BBB permeability and could be used during relief of severe carotid stenosis. (ebscohost.com)
  • In this study, we used a rat model to imitate severe bilateral carotid stenosis in humans. (ebscohost.com)
  • Results The percentage of patients with severe stenosis of extracranial internal carotid artery in patients with hypertension complicated with type 2 diabetes mellitus were significantly higher than that in patients with hypertension or DM. (cnki.com.cn)
  • The patients with severe stenosis of extracranial internal carotid artery were prone to develop cerebral infarction. (cnki.com.cn)
  • The use of carotid duplex ultrasonography has been widely recommended as a sceening examination. (medscape.com)
  • However, a recent review and meta-analysis published by the U.S. Preventive Services Task Force recommended against the usefulness of carotid duplex ultrasonography as a screening test in asymptomatic individuals. (medscape.com)
  • The detection of a carotid bruit is a common physical examination finding that may lead to a referral for carotid duplex ultrasonography. (medscape.com)
  • Duplex carotid sonography in a patient with sudden onset of aphasia. (medscape.com)
  • Carotid duplex ultrasonography (US) is a noninvasive means by which to estimate the degree of cervical carotid stenosis. (medscape.com)
  • with a carotid duplex. (netwellness.org)
  • The severity of carotid disease was determined by duplex scanning and confirmed arteriographically. (springer.com)
  • Our purpose was to evaluate the clinical indications for carotid duplex ultrasonography and determine for each indication how often carotid artery disease was identified.We retrospectively reviewed th. (bioportfolio.com)
  • ECAS was assessed by performing carotid duplex sonography at baseline (2010-2011) and during the follow-up (2012-2013). (nature.com)
  • Diagnostic criteria for carotid duplex sonography. (medigraphic.com)
  • Cerebrovascular Duplex Scan reveals bilateral homogeneous plaque present in carotid bulbs. (healthtap.com)
  • 70%. The primary aim of the study is to determine if asymptomatic carotid artery disease causing a 50-69% internal carotid artery stenosis (ICAS) typically progressed to a >70% stenosis, thereby evaluating the necessity of annual Colour Duplex follow-up in patients presenting with a 50-69% stenosis. (dit.ie)
  • All Carotid Duplex scans performed in the Vascular Laboratory in the Mater Misericordiae University Hospital (MMUH) from January 2007 and December 2009 were retrospectively reviewed by the same experienced vascular physiologist. (dit.ie)
  • Studies are typically done in patients already suspected of having substantial stenosis by the presence of a bruit or stenosis on duplex ultrasonography. (acpjc.org)
  • As a consequence, early diagnosis and followup during best medical treatment, life-style management, regular cardiovascular assessment, and good control of all vascular risk factors should be recommended in all patients with carotid stenosis-whether identified in the long-lasting "silent" or short-lasting "vulnerable" period lasting only a few weeks after cerebral ischemia. (hindawi.com)
  • The detection of a clinically significant carotid stenosis represents an important first step in the prevention of cerebral infarction. (medscape.com)
  • The carotid CTA (neck CTA) is most often combined with an intracranial CTA in order to exclude a proximal thrombosis or embolization within the anterior cerebral circulation. (medscape.com)
  • In elderly with cerebral ischemia, larger diameters of common carotid artery and lower PSV have been observed, probably due to increased intracerebral circulatory resistance [ 10 , 11 ]. (hindawi.com)
  • Cerebral infarction (CI) with internal carotid artery. (bioportfolio.com)
  • Tolerance to carotid clamping during CEA under general anaesthesia was evaluated in 62 patients measuring cerebral oximetry, transit time volume flowmetry and stump pressure. (diva-portal.org)
  • We aim to determine whether cognitive impairment attributable to cerebral hemodynamic impairment in patients with high-grade asymptomatic carotid artery stenosis is reversible with restoration of flow. (clinicalconnection.com)
  • Ouhlous M, Flach HZ, de Weert TT, Hendriks JM, van Sambbek MRHM, Dippel DWJ, Pattynama PMT, van der Lugt A (2005) Carotid plaque composition and cerebral infarction: MR imaging study. (springer.com)
  • Many clinicians believed that persons with cerebral ischemic symptoms associated with high-grade carotid stenosis benefited from carotid endarterectomy. (acpjc.org)
  • Results: The increased brain water content and cerebral concentration of EB and NaF were suppressed by administration of ischemic postconditioning prior to relief of carotid stenosis. (ebscohost.com)
  • Ischemic Postconditioning Alleviates Neuronal Injury Caused by Relief of Carotid Stenosis in a Rat Model of Cerebral Hypoperfusion. (ebscohost.com)
  • In this paper, we investigate the effects of near-infrared light therapy (NILT) for the recovery of blood flow of mice with cerebral hypoperfusion, which is a key mechanism leading to vascular dementia, induced by bilateral common carotid artery stenosis (BCAS). (spie.org)
  • Objective To study the relationship between cerebral infarction and stenosis of extracranial internal carotid artery in patients with hypertension(HT) complicated with type 2 diabetes mellitus(DM). (cnki.com.cn)
  • The stenosis of carotid artery is correlated with the incidence of cerebral infarction. (cnki.com.cn)
  • nine patients had bilateral stenoses of which two received stents bilaterally. (nih.gov)
  • Sixteen of these had bilateral and 66 had unilateral carotid endarterectomy. (ebscohost.com)
  • All patients who presented with unilateral or bilateral asymptomatic internal carotid artery stenosis of 50-69% on their first visit were included in this study and followed up until December 2011. (dit.ie)
  • The effects of early relief of heavy bilateral carotid stenosis and ischemic postconditioning on hippocampus CA1 neurons are still unclear. (ebscohost.com)
  • Comparison of carotid imaging methods. (medscape.com)
  • Calculating carotid stenosis to less than 50% could be made by radiologic or sonographic methods. (hindawi.com)
  • 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)
  • Agreement between 3.0 T and other methods results poor, and this could be due to the fact that the 3.0 T has a better resolution compared to a US and MR 1.5 T. These methods seem to have similar efficacies for the evaluation of vessel stenosis, legitimizing the use of the developed phantom as a versatile and reproducible instrument that could be used during quality controls programs. (springer.com)
  • Methods: Totally 401 patients with ICA stenosis who underwent CAS were enrolled. (medworm.com)
  • Plaque often builds up at that division, and causes a narrowing (stenosis). (ebi.ac.uk)
  • Plaque can also build up at the origin of the carotid artery at the aorta. (ebi.ac.uk)
  • Carotid endarterectomy is a surgical procedure in which the surgeon opens the artery and clears out plaque formation and blockages. (wisegeek.com)
  • Measurement of peak systolic velocities (PSVs) in ICA has been used worldwide, and maximal PSV, defined between 1.25-1.4 m/s, was used delimitate stenosis to maximum 50%, sometimes with mandatory plaque or intimal thickening visible [ 7 ]. (hindawi.com)
  • The aim of this study was to analyze the possible relationships among neovascularization, relevant angiogenic factors, and plaque vulnerability in patients with advanced carotid artery stenosis. (nii.ac.jp)
  • Our results show a close association between neovascularization, expression of angiogenic factors, inflammation, and plaque vulnerability in patients with advanced carotid stenosis. (nii.ac.jp)
  • Younger age, high grades of stenosis, absence of discrete white areas in the plaque, and taking lipid lowering therapy were independent baseline predictors of increased incidence of regression. (nih.gov)
  • High serum creatinine, male gender, not taking lipid lowering therapy, low grades of stenosis, and increased plaque area were independent baseline predictors of progression. (nih.gov)
  • To assess if RGD-K5 uptake is visualized in carotid plaque by Positron Emission Tomography. (clinicaltrials.gov)
  • This trial will be the first trial for the Investigation Product (IP), [F-18]RGD-K5 for carotid plaque imaging and will be conducted as a Phase II trial since this compound has already been tested in humans for phase I and phase II imaging. (clinicaltrials.gov)
  • This will be a pilot prospective cohort study where the increased expression of integrin may be seen on the F-18 RGD-K5 PET imaging scans looking at carotid plaque in participants with carotid artery stenosis. (clinicaltrials.gov)
  • Procedures: Informed consent (ICF), eligibility blood labs, collection of demographic information and medical history, physical examination, vital signs, 12-lead Electrocardiograms (ECGs), dosing with [F-18]RGD-K5, PET imaging scan, 24 hour follow up to collect adverse events, and plaque immunohistochemical characterization after Carotid Endarterectomy (CEA). (clinicaltrials.gov)
  • No evidence stenosis/plaque in ICA. (healthtap.com)
  • What does this mean: Impression: Minimal plaque within the right carotid bulb with no Radiology Report hemodynamically significant stenosis. (healthtap.com)
  • Patient with TIA history, what does it mean to have a small calcified plaque is present in right carotid bulb, however, without causing significant ar? (healthtap.com)
  • My mother is 65 yrs old and was noticed eccentric mixed plaque at carotid bulb extending to ICA and significant narrowing 100% on right side.pl hlp? (healthtap.com)
  • As the build-up of fatty materials increases, it eventually forms a plaque under the carotid arterial wall's inner lining. (healthguideinfo.com)
  • Plaque area at carotid and common femoral bifurcations and prevalence of clinical cardiovascular dis. (biomedsearch.com)
  • Also called carotid artery disease, carotid stenosis is caused by a buildup of plaque inside the artery wall that reduces blood flow to the brain. (iowaclinic.com)
  • The lumen of the internal carotid artery is opened, and the atheromatous plaque substance removed. (wikipedia.org)
  • To determine whether recurrent stenosis following carotid endarterectomy could be reduced by pre- and post-operative oral administration of platelet-inhibiting drugs. (clinicaltrials.gov)
  • To conclude, the OPG/Gee is a valuable tool in detecting immediate postendarterectomy thrombosis or recurrent stenosis. (ebscohost.com)
  • Recurrent stenosis after carotid endarterectomy. (springer.com)
  • Frequency and management of recurrent stenosis after carotid artery stent implantation. (springer.com)
  • correlation of ocular pulse amplitude with the degree of carotid stenosis is made by a new method. (arvojournals.org)
  • Other causes (e.g., dissection, often observed in patients under 55 years of age) only account for a small fraction of carotid lesions. (hindawi.com)
  • Arteriosclerotic lesions of the extracranial portion of the carotid artery are the cause of 10 20% of all ischemic strokes. (aerzteblatt.de)
  • Natural history of nonstenotic symptomatic ulcerative lesions of the carotid artery. (springer.com)
  • The natural history of asymptomatic carotid artery occlusive lesions. (springer.com)
  • a) Type 1 lesions-This basic lesion filled the bulb of the internal carotid artery near its origin, causing a 1 to 2 cm smooth elliptical encroachment on the lumen. (ahajournals.org)
  • b) Type 2 lesions-Short localized areas of thickening in addition to the basic lesion caused bar-like defects of the lumen at the origin of the internal carotid artery or near the distal end of the lesion. (ahajournals.org)
  • Carotid disease has been reported to produce these lesions by embolic 7 or hemodynamic 8 mechanisms. (neurology.org)
  • Asymptomatic contralateral carotid artery stenosis: A five-year follow-up study following carotid endarterectomy. (springer.com)
  • If CAS is present but blocking less than 50% of the artery, treatment includes reducing risk factors for further stenosis, like smoking cessation, lower fat diets, and prescribed exercise. (wisegeek.com)
  • The goals of carotid imaging are early detection, clinical staging, surgical road mapping, and postoperative therapeutic surveillance (see the images below). (medscape.com)
  • Surgical and Endovascular Treatment of Extracranial Carotid. (aerzteblatt.de)
  • Surgical versus nonoperative treatment of asymptomatic carotid stenosis. (springer.com)
  • Those assigned to surgical treatment underwent carotid endarterectomy performed by neurosurgeons or vascular surgeons. (nih.gov)
  • While for many years surgical carotid endarterectomy (CEA) has been considered the gold-standard strategy to restore vascular patency, recently the endovascular treatment through percutaneous angioplasty and stent implantation (CAS) has become a valid alternative. (biomedsearch.com)
  • The emphasis is on surgical management of the recurrent carotid disease. (springer.com)
  • Due to the authors' extensive experience in re-operative management of the carotid disease, the intricacies and step-by-step surgical approach are described, including pitfalls and complications. (springer.com)
  • Endovascular versus surgical treatment in patients with carotid stenosis in the carotid and vertebral artery transluminal angioplasty study (CAVATAS): a randomized trial. (springer.com)
  • A systematic review is needed to summarise the existing data and to answer the question of whether a women-only trial for symptomatic patients with ipsilateral carotid stenosis is scientifically necessary and ethically permissible. (bmj.com)
  • To assess the effect of carotid endarterectomy on the duration of nondisabled survival in patients with recent, nondisabling, cerebrovascular ischemic events and ipsilateral carotid stenosis. (acpjc.org)
  • Explain to interested patients that asymptomatic carotid stenosis refers to blockages of the main artery serving the brain that do not cause obvious symptoms. (medpagetoday.com)
  • 47 men) without outward symptoms of carotid stenosis and after carotid ultrasonography stratified them into three groups: no carotid stenosis (n = 54), moderate carotid stenosis (n = 17) and high-grade carotid stenosis (n = 9). (healio.com)
  • What Are the Symptoms of Carotid Stenosis? (carle.org)
  • Treatment depends on the degree of stenosis and symptoms. (carle.org)
  • It's usually done in people with recent symptoms and 70% to 99% stenosis if their life expectancy is more than 5 years. (carle.org)
  • There may not be any symptoms of carotid artery disease. (clevelandclinic.org)
  • The North American Symptomatic Carotid Endarterectomy Trial (NASCET) was a large, randomized trial that evaluated the benefit of carotid endarterectomy (CE) in patients with ICA stenosis who had symptoms in the appropriate territory. (neurology.org)
  • Majority of those who have carotid stenosis during the disease's early stages do not experience carotid stenosis symptoms. (healthguideinfo.com)
  • When apparent signs and symptoms of carotid stenosis occur, however, this is usually indicative of a more serious state. (healthguideinfo.com)
  • Operative vs. nonoperative management of symptomatic high-grade internal carotid artery stenosis: Improved results with endarterectomy. (springer.com)
  • The images are taken from the common carotid artery. (medscape.com)
  • Retrieved on May 29, 2020 from https://www.news-medical.net/health/Carotid-Artery-Stenosis-Diagnosis.aspx. (news-medical.net)
  • 1. The correct answer is E . The USPSTF recommends against screening for asymptomatic carotid artery stenosis in the general population. (aafp.org)
  • 3. The correct answer is D . The harms of screening for asymptomatic carotid artery stenosis outweigh the benefits. (aafp.org)
  • February 2, 2021 - The U.S. Preventive Services Task Force released today a final recommendation statement on screening for asymptomatic carotid artery stenosis. (uspreventiveservicestaskforce.org)
  • A. Screen using carotid ultrasonography. (aafp.org)
  • A. Screening for carotid artery stenosis with ultrasonography yields many false-positive results. (aafp.org)
  • C. The sensitivity and specificity of screening for carotid artery stenosis with ultrasonography are low. (aafp.org)
  • 2. The correct answers are A and B . Screening with ultrasonography has high sensitivity and specificity for detecting carotid artery stenosis. (aafp.org)
  • However, because of the low prevalence of carotid artery stenosis in the general population (0.5% to 1%), screening with ultrasonography yields many false-positive results. (aafp.org)
  • Impact of Preoperative Ultrasonography Screening For Carotid Artery Stenosis in Lung Cancer Patients. (bioportfolio.com)
  • OBJECTIVES: The overall benefit of carotid endarterectomy (CEA) is dependent on the outcome from the procedure. (diva-portal.org)
  • Imaging tests can confirm whether you have carotid artery disease. (medlineplus.gov)
  • Making certain changes to your diet and exercise habits can help treat carotid artery disease. (medlineplus.gov)
  • It is ranked as the third most common cause of death in the United States, after heart disease and cancer, and about one third of all strokes are related to carotid occlusive disease. (medscape.com)
  • The clincial management of coronary artery disease , peripheral arterial stenosis, and hypertension are likely to delay the development of carotid arterial stenosis. (medscape.com)
  • B. There is clear evidence that early identification of asymptomatic carotid artery stenosis leads to benefits by adding or increasing medication doses beyond standard medical therapy for cardiovascular disease prevention. (aafp.org)
  • Unusual clinical sequalae of Kawasaki disease - symptomatic extracranial Internal carotid stenosis in young adult: A case report. (bioportfolio.com)
  • Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects the coronary artery, but does not commonly affect the carotid artery. (bioportfolio.com)
  • How is carotid artery disease diagnosed? (clevelandclinic.org)
  • An abnormal rushing sound, called a bruit (pronounced BROO-ee), may indicate carotid artery disease. (clevelandclinic.org)
  • This is the most common test utilized to evaluate for the presence of carotid artery disease. (clevelandclinic.org)
  • Internal medication for carotid artery stenosis is mainly performed to reduce risk factors for cerebrovascular disease, including anti-platelet aggregation, anticoagulation, lowering blood lipid and blood pressure, controlling blood glucose and improving living habits. (bioportfolio.com)
  • In a blinded protocol, 268 carotid artery CTAs for known or suspected carotid disease were independently evaluated by 2 neuroradiologists. (ajnr.org)
  • We hypothesize that hemodynamically significant "asymptomatic" carotid disease may represent one of the few examples of treatable causes of cognitive impairment. (clinicalconnection.com)
  • Approximately 25% of strokes are caused by carotid occlusive disease. (ajnr.org)
  • Recurrent carotid disease occurs in 4-10% of patients following carotid endarterectomy. (springer.com)
  • Managing recurrent carotid artery disease with redo carotid endarterectomy: a 10-year retrospective case series. (springer.com)
  • In: Hans S. (eds) Extracranial Carotid and Vertebral Artery Disease. (springer.com)
  • The result of this comprehensive review will provide useful information on whether further RCTs are required to study a women-only population with symptomatic carotid disease. (bmj.com)
  • Recent studies, however, have suggested a possible unique link between loud snoring and carotid artery stenosis, even in patients without OSA or with only very mild disease. (enttoday.org)
  • Planned subgroup analysis based on revascularisation technique, degree of stenosis and timing of intervention from the index event will be conducted with enough data. (bmj.com)
  • First descriptions of carotid stenosis related to cerebrovascular events date back to T. Willis (1621-1675) and J. J. Wepfer (1620-1695). (hindawi.com)
  • Programa Nacional para la prevenci n y control de la Enfermedad Cerebrovascular en Cuba. (medigraphic.com)
  • Asymptomatic carotid atheroesclerosis study (ACAS) group: Endarterectomy for asymptomatic carotid stenosis. (medigraphic.com)
  • CONCLUSIONS: Theprevalence of significant carotid artery stenosis on the relevant side in patients with TIA was quitelow: only 5% had a degree of stenosis where carotid endarterectomy should be considered. (medscimonit.com)
  • A carotid Doppler sonography was performed in 114 patientswith TIAs in the internal carotid artery territory and a mean age of 60 years. (medscimonit.com)
  • To evaluate the safety and efficacy of the Bard ViVEXX Carotid Stent and Emboshield BareWire Rapid Exchange Embolic Protection System in the treatment of extracranial carotid artery stenos. (bioportfolio.com)