Background: The measurement of blood velocity in the carotid artery has been the most popular noninvasive method of identifying and classifying carotid stenosis for half a century. Carotid stenosis is an indicator of elevated risk of stroke; anatomic revascularization reduces the chance of stroke by more than half. Controversy persists on how patients with severe carotid stenosis should be selected for anatomic revascularization. Patients with a connected circle of Willis (coW) might not benefit from anatomic revascularization; patients with two segments missing in the coW are most likely to benefit from revascularization.
Methods: Based on this analysis of data from carotid duplex examinations and transcranial Doppler examinations including ophthalmic artery (OA) direction in 28 patients, a refined carotid examination protocol is proposed. This refinement includes Doppler measurement of OA flow direction and documentation of internal carotid artery (ICA) bruit in addition to the adoption of an ICA peak systolic velocity (PSV) criterion exceeding 350 cm/s for identification of the patient most likely to benefit from carotid stenosis treatment.
Results: Sensitivity and specificity of OA direction or carotid bruit are 84.6%±5.4%, 71.4%±2.1% and for PSV >350 cm/s are 84.6%±5.4%, 59.5%±2.3% for predicting contralateral body weakness.
Conclusions: The proposed examination can be performed with the same duplex scanner and scan head currently used for carotid examinations with little additional time.
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http://dx.doi.org/10.21037/atm-23-1681 | DOI Listing |
J 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 PDFAntioxidants (Basel)
January 2025
Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Ansan 15355, Republic of Korea.
This study explores whether molecular hydrogen (H) administration can alleviate cognitive and immunological disturbances in a mouse model of vascular dementia (VaD). Adult male C57BL/6 mice underwent bilateral common carotid artery stenosis to induce VaD and were subsequently assigned to three groups: VaD, VaD with hydrogen-rich water treatment (VaD + H), and Sham controls. Behavioral assessments using open field and novel object recognition tests revealed that VaD mice exhibited anxiety-deficient behavior and memory impairment, both of which were reversed by H treatment.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland.
: In developed countries, stroke is the fifth cause of death, with a high mortality rate, and with recovery to normal neurological function in one-third of survivors. Atherosclerotic occlusive disease of the extracranial part of the internal carotid artery and related embolic complications are common preventable causes of ischemic stroke (IS), attributable to 7-18% of all first-time cases. Osteoprotegerin (OPG), a soluble member of the tumor necrosis factor receptor (TNFR) superfamily, is considered a modulator of vascular calcification linked to vascular smooth muscle cell proliferation and collagen production in atherosclerotic plaques.
View Article and Find Full Text PDFBMC Genomics
January 2025
Department of Vascular Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Background: Vascular cognitive impairment (VCI) is a significant contributor to dementia, yet the precise mechanisms underlying the cognitive decline associated with chronic cerebral hypoperfusion (CCH) remain unclear. This study investigated the molecular and epigenetic changes in the striatum, a brain region critical for motor function and cognition, following chronic hypoperfusion using a bilateral common carotid artery stenosis (BCAS) model in mice.
Methods: RNA-seq was utilized to identify differentially expressed genes (DEGs) associated with hypoperfusion.
Ann Vasc Surg
January 2025
Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL. Electronic address:
Introduction: Carotid artery stenosis is a significant contributor to ischemic strokes, and its surgical management includes carotid artery endarterectomy (CEA), transfemoral carotid artery stenting (TF-CAS), and trans carotid artery revascularization (TCAR). CEA has traditionally been preferred, but TF-CAS and TCAR are also excellent alternative options if the anatomy of the vessels allows them. This study reports our short- and mid-term outcomes after carotid artery revascularization in symptomatic patients at a stroke center.
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