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Significant national variation exists in defining the degree of stenosis that requires intervention in patients with asymptomatic carotid artery stenosis (ACAS). We aimed to evaluate the risk of perioperative- and 2-year stroke and death in ACAS patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) for severe versus very severe stenosis in a contemporary population.
Results from studies investigating the effect of contralateral carotid artery occlusion (CCO) in patients with carotid artery stenosis undergoing carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) are variable in the literature.
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the 2 current standard treatments for carotid artery stenosis. There is still no well-defined consensus with regard to their superiority. However, the minimally invasive nature of endovascular treatment makes CAS increasingly popular among vascular surgeons.
We hypothesized the inflammatory markers (IM) could be independent predictors of carotid stenosis progression (CSP) after carotid artery stenting (CAS).
It is unclear whether incidental carotid artery calcification (CAC) on radiographs has a defined relationship to clinically significant carotid artery stenosis, and therefore risk of stroke. The primary objective of this study was to ascertain the relationship between dental radiograph detected carotid calcification and carotid artery stenoses ≥ 50% on carotid duplex ultrasound. We conducted an observational study of patients undergoing routine dental orthopantomogram (OPG) examinations. Consecutive patie...
Stroke is a major cause of morbidity or mortality after lung surgery. CAS is useful for detecting carotid artery stenosis, which is one of the causes of stroke. To investigate the frequency of, and risk factors for, preoperative carotid artery stenosis and to determine whether ultrasonographic carotid artery screening (CAS) contributes to preventing postoperative stroke or cardiovascular comorbidities in lung cancer patients.
Recent clinical studies have recently demonstrated a strong association between carotid artery stenosis and coronary artery disease (CAD). However, the clinical impact of carotid plaque composition on CAD remains unclear. This study was aimed to determine the relationship between carotid plaque composition and CAD in patients who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS).
We analyzed the results of internal carotid artery (ICA) stenosis treatment at our institution according to the treatment modality-carotid endarterectomy (CEA) vs. carotid artery stenting (CAS).
Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects the coronary artery, but does not commonly affect the carotid artery. Cerebral infarction (CI) with internal carotid artery stenosis (ICS) in patients with KD had never been reported. We report a patient with CI as a remote phase complication of KD.
Previous studies have identified a relationship between snoring, carotid intima media thickening, and the presence of atherosclerosis. This study examines the correlation between snoring and carotid artery disease through use of duplex ultrasound identifying greater than 50% internal carotid artery stenosis.
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 the consecutive reports for 3191 carotid ultrasound examinations. We tracked 14 indications to determine how often examinations were requested for each indication and correlated each indication with the finding of carotid artery disease.We found 26.5% of all examinations were abnormal; 17.5% of patients showed in...
Carotid artery endarterectomy (CEA) remains the most common surgical intervention for the treatment of symptomatic and asymptomatic carotid artery stenosis. Several studies have shown a lower risk of periprocedural adverse events in statin-users who undergo coronary interventions orcarotid artery stenting.
A meta-analysis found that for internal carotid artery stenosis procedures in elderly patient, the risk of perioperative stroke is significantly higher for carotid artery stenting (CAS) than for carotid endarterectomy (CEA). We retrospectively examined characteristics and perioperative results of CAS for 80 years and over at a single medical center.
The present multi-center retrospective study aimed to compare the outcome of carotid artery stenting (CAS) versus carotid endarterectomy (CEA) among Korean patients with symptomatic extracranial carotid stenosis.
Strokes related to tandem occlusions of the internal carotid artery (ICA) and a major intracranial artery are associated with poor clinical outcome. We evaluated the clinical efficacy of endovascular approach for the management of these lesions. We also compared the clinical outcomes regarding the type of cervical ICA lesions; complete occlusion versus severe stenosis.
Carotid artery injury and stroke secondary to prolonged retraction remains an extremely rare complication in anterior cervical discectomy and fusion (ACDF). However, multiple studies have demonstrated that carotid artery retraction during the surgical approach may alter the normal blood flow, leading to a significant reduction in the cross-sectional area of the vessel. Others have suggested that dislodgment of atherosclerotic plaques following manipulation of the carotid artery can be a potential risk for i...
Using angled fenestrated clips for posteromedially projecting internal carotid artery (ICA) aneurysms may allow the surgeon to simultaneously obliterate the aneurysmal neck and preserve the branching artery by applying the blade of the clip parallel to the ICA. However, using these clips when the aneurysm neck involves the branching artery may have a risk of branching artery stenosis, occlusion, or incomplete obliteration of the aneurysm.
The Dutch Audit for Carotid Interventions (DACI) registers all patients undergoing interventions for carotid artery stenosis in the Netherlands. This study describes the design of the DACI and results of patients with a symptomatic stenosis undergoing carotid endarterectomy (CEA). It aimed to evaluate variation between hospitals in process of care and (adjusted) outcomes, as well as predictors of major stroke/death after CEA.
The search for etiology of stroke in a young patient may present a diagnostic challenge. In rare cases, chronic trauma to the carotid artery may be the cause of cerebral thromboembolic events. The hyoid bone lies in close proximity to the carotid artery bifurcation, and anatomic variants have been implicated in carotid compression, stenosis, dissection, and pseudoaneurysm. We report a case of recurrent strokes in a 32 year-old woman due to an elongated hyoid bone causing thrombus formation in her right inte...
Assessment of the Cerebral Hemodynamic Benefits of Carotid Artery Stenting for Patients with Preoperative Hemodynamic Impairment Using Cerebral Single Photon Emission Computed Tomography (SPECT) and Carbon Dioxide Inhalation.
BACKGROUND The aim of this study was to evaluate the effects of carotid artery angioplasty and carotid artery stenting (CAS) on cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) in patients with preoperative cerebrovascular hemodynamic impairment. MATERIAL AND METHODS Seventeen patients with unilateral severe internal carotid artery (ICA) stenosis and ipsilateral CVR impairment underwent CAS. CBF and CVR were measured by single photon emission computed tomography (SPECT) with inhalation of carb...
Catheter-based intravascular near-infrared spectroscopy (NIRS) detects a lipid signal from atherosclerotic plaque. The aim of this study was to describe the effect of carotid artery stenting (CAS) on the lipid signal in a carotid stenosis.
Atherosclerosis of the internal carotid artery is an important cause of disabling ischemic stroke and therefore constitutes a major medical, social, and economic issue. Although advances in vascular imaging modalities during the last decades allow to risk stratify patients not solely on the degree of carotid artery stenosis but also based on 'high risk' features, there still remains a controversy over patient selection for carotid artery revascularization. Among other features of plaque vulnerability, there...
Agenesis, aplasia and hypoplasia of the internal carotid artery are rare congenital malformations. They are usually asymptomatic and incidentally discovered through ultrasound or imagistic tests. The aim of this study is to improve their management in our Departments. We report here the case of a 39-year-old woman addressed to our ambulatory in 2013 for benign symptoms like dizziness and headache. Imagistic findings (magnetic resonance imaging of the brain, and cervical spine, and magnetic resonance angiogr...
Carotid atherosclerotic plaque occurs predominantly at the outer wall of carotid sinus, and computational fluid dynamics (CFD) plays important roles in explaining plaque formation. This study was to investigate the hemodynamic factors in affecting carotid atherosclerotic stenosis.
We report four cases of painful Horner's syndrome due to carotid artery dissection. A lesion on oculosympathic pathway causes Horner's syndrome. A painful Horner's syndrome needs a prompt exploration by tomodensitometry or magnetic resonance imaging to exclude carotid artery dissection. Actually, carotid artery dissection leads to stroke or cerebral ischemic symptoms, mainly in the first two weeks. The treatment is based on anticoagulants or antiplatelet agents.