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Carotid disease treatment modality and its association with post-operative vasoactive medication utilization and hospital length of stay.
J Vasc Surg
January 2025
Southern California Permanente Medical Group, Kaiser Permanente,; University of California, Riverside School of Medicine.
Objective: Carotid artery disease is a major cause of stroke for which the standard treatment has traditionally been a combination of medical management and intervention, including both carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TF-CAS). In recent years, transcarotid artery revascularization (TCAR) has been adopted as a promising treatment following FDA approval in 2015. In terms of stroke reduction, TCAR has been found to have equivalent outcomes with CEA with shorter operative times.
View Article and Find Full Text PDFNovel Fusion Imaging of Muscle, Plaque, Arteries, and Bone Using MR Imaging for Carotid Endarterectomy Patients.
World Neurosurg
January 2025
Department of Neurosurgery, Ken-o-Tokorozawa Hospital, Tokorozawa, Saitama, Japan.
Background: Indications for carotid endarterectomy (CEA) and reduction of complications require evaluation of the plaque properties and location of the distal end of the plaque. High cervical location can be predicted from the anatomy of the vertebral body and mandibular bones, and the locations of the posterior belly of the digastric muscle and stylohyoid muscle. Magnetic resonance (MR) imaging without contrast medium is useful for preoperative evaluation of the plaque, arteries, and bone characterization.
View Article and Find Full Text PDFA cis-regulatory element controls expression of histone deacetylase 9 to fine-tune inflammasome-dependent chronic inflammation in atherosclerosis.
Immunity
January 2025
Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilian-University (LMU), Munich, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance (MHA), Munich, Germany. Electronic address:
Common genetic variants in a conserved cis-regulatory element (CRE) at histone deacetylase (HDAC)9 are a major risk factor for cardiovascular disease, including stroke and coronary artery disease. Given the consistency of this association and its proinflammatory properties, we examined the mechanisms whereby HDAC9 regulates vascular inflammation. HDAC9 bound and mediated deacetylation of NLRP3 in the NACHT and LRR domains leading to inflammasome activation and lytic cell death.
View Article and Find Full Text PDFResolution of Iatrogenic Spinal Accessory Neuropathy Following Delayed Surgical Intervention.
Laryngoscope
January 2025
Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.
We present an interesting case of a 74-year-old female who presented with spinal accessory neuropathy following an ipsilateral right-sided carotid endarterectomy 6 months after the initial injury. Subsequent surgical exploration revealed a surgical clip that had been placed directly across the spinal accessory nerve. Clip removal and neurolysis was subsequently performed, leaving the nerve intact.
View Article and Find Full Text PDFSymptomatic Cervical Carotid Artery Stenosis: Evolving Paradigms in Risk Stratification and Intervention.
Ann Indian Acad Neurol
January 2025
Departments of Clinical Neurosciences and Community Health Sciences, The Hotchkiss Brain Institute, The Mathison Centre for Mental Health Research and Education, and The O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Symptomatic carotid disease, characterized by atherosclerotic or non-atherosclerotic internal carotid artery disease with ipsilateral stroke symptoms, represents a critical condition in stroke neurology. This "hot carotid" state carries a high risk of stroke recurrence, with almost one-fourth of the patients experiencing recurrent ischemic events within 2 weeks of initial presentation. The global prevalence of significant carotid stenosis (conventionally defined as ≥50% narrowing) is estimated at around 1.
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