Current management of patients with carotid artery stenosis is based on well-established guidelines, including surgical procedures - carotid endarterectomy (CEA) and endovascular carotid artery stenting (CAS) - and optimal medical treatment alone. Outcomes in the postprocedural period after CAS and CEA are similar, suggesting strong clinical durability for both treatments. Recent advances, which include the emergence of novel endovascular treatment tools and techniques, combined with more recent randomised trial data shed new light on optimal patient selection and treatment in contemporary practice. Improved, modern technologies including enhanced embolic protection devices and dual-layered micromesh stents yield better outcomes and should result in further improvements in CAS. In centres of excellence, nowadays, the majority of patients with severe carotid artery stenosis can be successfully treated with either CEA or CAS.
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http://dx.doi.org/10.4244/AIJ-D-23-00009 | DOI Listing |
J Clin Med
January 2025
Institute of Cardiology, Istanbul University-Cerrahpaşa, 34098 Istanbul, Türkiye.
: Familial hypercholesterolemia (FH) is a monogenic dyslipidemia that leads to early cardiovascular events. Subclinical atherosclerosis refers to the formation of atheromatous plaques in arterial beds before any clinical events. In our study, we investigated the presence, extent, and independent predictors of subclinical atherosclerosis among patients diagnosed with FH.
View Article and Find Full Text PDFJ Clin Med
January 2025
Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy.
: Carotid artery stenosis (CAS) is one of the main causes of stroke, and the vulnerability of plaque has been proved to be a determinant. A joint analysis of shear wave elastography, a radiofrequency echo-based wall tracking technique for arterial stiffness evaluation, and of autonomic and baroreflex function is proposed to noninvasively, preoperatively assess plaque vulnerability in asymptomatic CAS patients scheduled for carotid endarterectomy. : Elastographic markers of arterial stiffness were derived preoperatively in 78 CAS patients (age: 74.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland.
The interrelationship of thyroid volume and function with features of cardiovascular dysfunction has already been investigated but some aspects remain unclear, especially in terms of subclinical cardiovascular dysfunction in euthyroid patients. Intima-media thickness (IMT) measurement in ultrasound B-mode imaging in different vascular beds (most frequently within the common carotid artery) is one of the most important tools for the detection of subclinical atherosclerosis in both clinical practice and research. This article aimed to present the results of our research on the association between the thyroid evaluation parameters and the IMT measured in both the carotid and femoral arteries in euthyroid patients aged 18 to 65 years taking into account the influence of diabetes, hypertension, and excess body mass.
View Article and Find Full Text PDFJ Clin Med
January 2025
Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Universitaire de Sherbrooke, 12e Avenue Nord, Porte 6, Sherbrooke, QC J1H 5N4, Canada.
: Cerebral intra-arterial chemotherapy (CIAC) has been demonstrated to achieve tumoricidal concentrations in cerebral tumour cells that are otherwise unachievable due to the presence of the blood-brain barrier. In this study, we sought to analyze the safety of CIAC in a cohort of patients treated at the Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke (CIUSSS-CHUS). : Treatments consisted of monthly CIAC.
View Article and Find Full Text PDFCancers (Basel)
January 2025
Department of Neurosurgery, Institute of Science Tokyo Hospital, Tokyo 1130034, Japan.
: Resection of tumors invading the cavernous sinus (CS) carries a risk of injury to the cranial nerves and internal carotid artery. Therefore, radical surgery involving lesions around the CS remains challenging, especially for lesions invading the CS, optic sheath, and oculomotor cave. Here, we describe a surgical strategy for meningiomas invading these structures and report on the clinical outcomes.
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