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Symptomatic 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.
View Article and Find Full Text PDFHigh Middle Cerebral Artery Wall Shear Stress in Branch Atheromatous Disease: A Computational Fluid Dynamics Analysis.
J Atheroscler Thromb
January 2025
Department of Neurology, National Cerebral and Cardiovascular Center.
Aim: Branch atheromatous disease (BAD), characterized by the occlusion of perforating branches near the orifice of a parent artery, often develops early neurological deterioration because the mechanisms underlying BAD remain unclear. Abnormal wall shear stress (WSS) is strongly associated with endothelial dysfunction and plaque growth or rupture. Therefore, we hypothesized that computational fluid dynamics (CFD) modeling could detect differences in WSS between BAD and small-vessel occlusion (SVO), both of which result from perforating artery occlusion/stenosis.
View Article and Find Full Text PDFRandomized Clinical Trial of Extending the Time Window of Endovascular Therapy in the Triage of Late Presenting Stroke Beyond 24 h (SKIP-EXTEND): Rationale and Study Protocol.
Neurol Med Chir (Tokyo)
January 2025
Department of Neurology, Nippon Medical School.
The therapeutic time window for endovascular therapy in acute stroke patients with large-vessel occlusion was extended to 24 hours from onset. Although a retrospective study showed the efficacy of endovascular therapy beyond 24 hours from the last known well, it remains unclear whether endovascular therapy is effective. Extending the time window of Endovascular therapy in the Triage of Late Presenting Strokes beyond 24 h (SKIP-EXTEND trial) aimed to clarify the efficacy of endovascular therapy compared to the best medical management.
View Article and Find Full Text PDFThe acute management of penetrating carotid artery injuries-A systematic review.
Ann Vasc Surg
January 2025
Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
Background: Penetrating carotid artery injuries (CAI) are rare with high morbidity and mortality. We aimed to perform a systematic review of the published literature to evaluate the workup and management of penetrating CAI.
Methods: Studies of acute management of adult trauma patients with penetrating common or internal carotid artery injuries on MEDLINE or EMBASE from 1946 through July 2024 were included following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement methodology.
Giant, unruptured, partially thrombosed right MCA aneurysm treated with 2 bypasses and excision.
World Neurosurg
January 2025
Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. Electronic address:
Aneurysms of the middle cerebral artery (MCA) account for up to 40% of all unruptured intracranial aneurysms [1-3] and 14% to 20% of ruptured ones. [4-5] Giant MCA aneurysms are rare, representing 10% of cases [6], but carry an aggressive natural history, with the UCAS Japan study reporting an annual rupture rate of ∼ 17%. [7].
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