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Sample records for carotid artery angioplasty

  1. Percutaneous transluminal angioplasty and stenting of carotid arteries: Early results

    Directory of Open Access Journals (Sweden)

    Čolić Momčilo

    2008-01-01

    Full Text Available INTRODUCTION Treatment of carotid stenosis could be surgical: eversion endarterectomy, conventional endarterectomy and patch-plasty, resection with graft interposition and bypass procedure or, in the past few years, carotid artery angioplasty (PTA with stent implantation. OBJECTIVE The aim of this study is to present early results of carotid artery angioplasty and stenting, as well as to identify indications for this procedure. METHOD Twenty-three patients with stenosis of internal carotid artery were included in the prospective study which was performed in the period from July 2006 to July 2007. For PTA and stenting of the carotid artery we used Balloon dilatation catheter Ultra-softTM SV and Carotid WallstentTM MonorailTM. During the procedure, brain protection by embolic protection system Filter Wire EZ was essentially performed. Descriptive statistical methods were performed to present and describe the patient characteristics, risk factors and results. RESULTS 23 patients were examined. In four (17.39% cases there was asymptomatic, while in 19 (82.61% there was symptomatic homodynamic significant stenosis of the internal carotid artery. Four of these 19 patients (17.39% had late restenosis following carotid endarterectomy, four (17.39% important respiratory failure, and 11 (47.83% important heart disease. Patients were followed up for the first 30 postopertive days. In that period, there were no mortality and no needs for surgical conversions. In one case (4.35%, residual stenosis of 30% remained. Two patients (8.70% had TIA and one (4.35% had CVI. CONCLUSION Main indications for PTA and stenting of carotid arteries are: surgically inaccessible lesions (at or above C2; or subclavial; radiation-induced carotid stenosis; prior ispilateral radical neck dissection; prior carotid endarterectomy (restenosis, severe cardiac and pulmonary conditions. Limitations and contraindications to carotid angioplasty and stentning include: significant

  2. Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note

    International Nuclear Information System (INIS)

    Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods. A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset. Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration. In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. (orig.)

  3. Angioplasty of symptomatic high-grade internal carotid artery stenosis with intraluminal thrombus: therapeutic approach

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    Gonzalez, A.; Mayol, A. [Seccion de Neurorradiologia Intervencionista, Servicio de Radiologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Gil-Peralta, A.; Gonzalez-Marcos, J.R. [Servicio de Neurologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Boza, F. [Servicio de Neurofisiologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Ruano, J. [Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain)

    2004-04-01

    Intraluminal thrombus in the internal carotid artery (ICA) is usually found in patients with severe atheromatous stenosis. Having reviewed 300 carotid angioplasties for symptomatic >70% ICA stenosis, we found three patients (1%) with intraluminal thrombus. Conservative treatment with anticoagulants and double antiplatelet coverage can result in lysis of the thrombus without severe risks. Percutaneous transluminal angioplasty and stenting, preferably with distal protection, can be an excellent alternative to carotid endarterectomy. (orig.)

  4. Endovascular treatment with angioplasty or stenting versus endarterectomy in patients with carotid artery stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial.

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-10-01

    Endovascular treatment (angioplasty with or without stenting) is an alternative to carotid endarterectomy for carotid artery stenosis but there are scarce long-term efficacy data showing that it prevents stroke. We therefore report the long-term results of the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS).

  5. Quantitative evaluation of cerebral blood flow by XeCT in stenting angioplasty for carotid artery

    International Nuclear Information System (INIS)

    Objective: To evaluate the hemodynamic characteristics of severe carotid artery stenosis and curative effect of stent angioplasty through XeCT. Methods: From April 2006 to November 2006, 13 patients with severe carotid artery stenoses underwent stent angioplasty in our hospital, including 11 male and 2 females, in an average age of 57.31 ± 6.12. All patients underwent XeCT examination to evaluate the quantitative cerebral blood flow (CBF). The ischemic cortex is categorized into 4 kinds, the normal region, oligemia area, reversible ischemic site and ischemic core center. Measurement and comparison of the changes were taken before and after the therapy. Results: Preoperative XeCT revealed different decrease of CBF in the ipsilateral cortex, especially in MCA distributing territory. Ischemic areas reduced significantly after the stenting angioplasty. Oligemia area reduced from 32.63% to 14.22%. Reversible ischemic area reduced from 13.54% to 8.38%. Normal area increased from 47.51% to 71.13%. But ischemic core center showed no significant changes. Conclusions: XeCT is beneficial for evaluation of the hemodynamic characteristics of carotid artery stenoses and also for accurately demonstrating the curative effects of the stent angioplasty. (authors)

  6. Long-term outcome of endovascular treatment versus medical care for carotid artery stenosis in patients not suitable for surgery and randomised in the Carotid and Vertebral Artery Transluminal Angioplasty study (CAVATAS).

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-01-01

    Optimal treatment of carotid stenosis in patients not suitable for surgery is unclear. The Carotid and Vertebral Artery Transluminal Angioplasty study contained a trial comparing medical and endovascular treatment in patients not suitable for surgery.

  7. Stent-assisted angioplasty for atherosclerotic stenosis of the carotid artery. An overview

    International Nuclear Information System (INIS)

    For symptomatic stenosis of the carotid artery the invasive options for treatment (by means of stent or operation) are superior to conservative medical treatment. Recent multi-center randomized controlled trials, which will be presented here, indicate that stenting in the treatment of symptomatic carotid stenosis is neither safer nor more effective than carotid endarterectomy. When carried out by an experienced interventionalist stent-assisted angioplasty (CAS) is an alternative to carotid endarterectomy. Subgroup-analysis indicates that for patients older than 70 years of age invasive techniques should be the method of choice. In the case of contralateral high-grade stenosis or occlusion, CAS is the method of choice. For patients treated by stenting, the periprocedural complication rate is not influenced by the use of protection systems. The present results on symptomatic carotid stenosis should not be transferred to the therapy of asymptomatic carotid stenosis. A 3-armed study (SPACE2) on the comparison of the best medical treatment with the invasive treatment modalities (CAS or CEA) is in preparation and will be started in 2 months. (orig.)

  8. Percutaneous transluminal angioplasty in a patient with internal carotid artery stenosis following gamma knife radiosurgery for recurrent pituitary adenoma

    OpenAIRE

    Hidemichi Ito; Hidetaka Onodera; Taigen Sase; Masashi Uchida; Hiroyuki Morishima; Kotaro Oshio; Takashi Shuto; Yuichiro Tanaka

    2015-01-01

    Background: Intracranial vascular complications following radiosurgery are extremely rare. Case Description: We report a case of stenosis in the internal carotid artery 5 years after gamma knife radiosurgery for a recurrent pituitary adenoma. Percutaneous transluminal angioplasty was performed successfully with anatomical and functional improvement. Conclusion: These results suggested the importance of monitoring for arterial stenosis in the long-term follow-up. Moreover, this is the ...

  9. Carotid angioplasty with cerebral protection

    International Nuclear Information System (INIS)

    Background. Carotid endarterectomy (CEA) is widely used in the management of high-grade carotid stenosis. It is a surgical procedure requiring general anaesthesia and is suitable only for lesions located at or close to the carotid bifurcation. It may develop complications, such as stroke, death, cranial nerve palsies, wound haematoma and cardiac complications. The risk of complications is increased in patients with recurrent carotid artery stenosis following CEA, in subjects undergoing radiotherapy to the neck, and in patients with cardiopulmonary disease. The drawbacks of CEA have led physicians to search for alternative treatment options. Carotid angioplasty and stenting (CAS) is less invasive than CEA. The method is particularly suitable for the treatment of recurrent stenosis after previous CEA and distal internal artery stenosis, which is inaccessible for CEA. CAS does not cause cranial nerve palsies. Moreover, it does not require general anaesthesia and causes lower morbidity and mortality in patients with severe cardiopulmonary disease. The complications of CAS include stroke due to distal immobilisation of a plaque or thrombus dislodged during the procedure, abrupt vessel occlusion due to thrombosis, dissection or vasospasm, and restenosis due to intimal hyperplasia. CAS is a relatively new procedure; therefore, it is essential to establish its efficacy and safety before it is introduced widely into clinical practice. Patients and methods. In Slovenia, we have also started with carotid angioplasty by the study: Slovenian Carotid Angioplasty Study (SCAS). We performed CAS in 17 patients (12 males and 5 females) aged from 69 to 82 years. All patients were symptomatic with stenosis greater than 70 %. 10 patients suffered transient ischemic attacks, 4 patients minor strokes and 3 patients amaurosis fugax. Results. Technical success (< 30 % residual stenosis) was achieved in all cases. In 14 patients, no residual stenosis was found, in 2 patients a 15 % residual

  10. Angioplasty treatment and stent implant vs. surgical treatment in patients with stenosis of the cervical carotid artery

    International Nuclear Information System (INIS)

    Angioplasty with stent implant is a less invasive procedure than surgical intervention in the treatment of significant stenosis of the common cervical carotid artery (common and internal) (5). Currently the major published studies, in which angioplasty and surgical treatment are compared, show similar results in the major events, as cerebrovascular accidents and mortality, but a greater significant difference in the apparition of acute myocardial infarction, during surgical intervention (5,11). The objective of this study is to compare in both treatment methods the major and minor clinical events, like cerebrovascular accident, acute myocardial infarction, death, bradycardia, hypotension and encephalopathy during the intervention, the hospitalization and the follow-up year, as well as the re-intervention, the time of hospital stay and the complications of the surgical incision. Materials and methods: in this study of historical cohort, 46 patients with significant stenosis of the cervical carotid arteries, who were subjected to intervention from January 1st 2001 to December 31st 2003, were included. 21 patients were treated with angioplasty and stent implant and 25 with surgery (endarterectomy) Results: 1 (4.8%) major cerebrovascular accident occurred during angioplasty, whereas none occurred in the patients treated with surgery. 1 (4%) acute myocardial infarction occurred during intervention in the group of patients treated with surgery, and none in the patients treated with angioplasty. No deaths occurred in any of the groups during intervention, hospitalization and the follow-up year. After 8 months 1 (4%) patient treated with surgery was intervened again with angioplasty and stent implant. There were no statistically significant differences between both groups during hospitalization, and in the apparition of minor complications as bradycardia and hypotension. 2 (8%) complications related to the incision of the neck compromising cranial nerves, occurred in the

  11. Effects of ilexonin a on IL-6 and M-CSF following ballon angioplasty in rabbit common carotid artery

    International Nuclear Information System (INIS)

    Objective: To observe the effects of ilexonin A(IA) on IL-6 and M-CSF following ballon angioplasty in rabbit common carotide artery to provide experimental basis for percutaneous coronary interventions. Mehtods: 30 Japanese rabbits were fed with high cholesterol food for 4 weeks. Then they were divided into three groups randomly. Each group had ten rabbits. 1) Control group: the incision was sew directly after right carotide artery of the rabbit was seeked. 2) Balloon dilation group: the proximal of the carotide artery was cuted, the ballon was delivered and distended, after it was drawn repeatly, the incision was closed. 3) IA therapy group: operation was the same to the balloon dilation group, then IA was administered in vein. All of them were fed with high cholesterol diet for 4 weeks and the blood samples were collected 1 d before the operation and 1 d, 1,2,4 weeks after the operation. The serum IL-6 and M-CSF levels were determined with radioimmunoassay. The pathological changes of injuried artery were observed. Results: 1) The IL-6 level in balloon dilation group was higher than that in IA therapy group after the operation (P<0.05), and came back later to preoperation level. 2) Though the M-CSF level in IA therapy group was increased, but it was lower than that in dilation group (P<0.05). 3) The pathological results demonstrated that the artery endothelial in control group was smooth and no foam cell in sight. In bolloon dilation group, the endangium was thickened, the vascular smooth muscle cells proliferated, there were many foam cells and the lumen was constrictive. In IA therapy group, the number of foam cells reduced, the constrictive degree of lumen was alleviated. Conclusion: IA can redece the levels of serum IL-6 and M-CSF and inhibit the proliferation of vascular smooth muscle cells following ballon angioplasty. (authors)

  12. Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial.

    LENUS (Irish Health Repository)

    Bonati, Leo H

    2009-10-01

    In the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), early recurrent carotid stenosis was more common in patients assigned to endovascular treatment than it was in patients assigned to endarterectomy (CEA), raising concerns about the long-term effectiveness of endovascular treatment. We aimed to investigate the long-term risks of restenosis in patients included in CAVATAS.

  13. Percutaneous endoluminal angioplasty of post endarterectomy carotid stenoses

    International Nuclear Information System (INIS)

    Percutaneous transluminal angioplasty of the carotid artery was performed in four patients with recurrent stenosis following endarterectomy. Balloon catheter dilatation was successful in 3 of the 4 lesions. Post dilatation angiography demonstrated an increase in luminal diameter: there were no neurological complications with the procedure. PTA appears to be an effective method of treating recurrent stenosis following carotid endarterectomy. (orig.)

  14. Carotid Artery Screening

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  15. Cervical carotid pseudoaneurysm: A carotid artery stenting complication

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    Raso, Jair; Darwich, Rogerio; Ornellas, Carlos; Cariri, Gustavo

    2011-01-01

    Background: As carotid artery stenting becomes increasingly used, more complications are likely to occur. We present a case of Staphylococcus septicemia and pseudoaneurysm arising in the neck portion of the carotid artery after stenting. Case Description: A 51-year-old man was admitted with mild left hemiparesis. CT and MRI showed right hemisphere ischemia. Duplex Scan and MRA showed bilateral severe stenosis of the carotid arteries in the neck. A percutaneous angioplasty with stenting of the...

  16. Carotid Artery Disease

    Science.gov (United States)

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  17. Carotid artery disease

    Science.gov (United States)

    ... you have had a stroke or TIA, a nervous system (neurological) exam will show other problems. You may also have the following tests: Blood cholesterol and triglycerides test Blood sugar (glucose) test Ultrasound of the carotid arteries ( carotid ...

  18. Carotid angioplasty and stenting in the elderly

    International Nuclear Information System (INIS)

    To investigate the technical success rate as well as the procedural and mid-term complication rates of carotid angioplasty and stenting in elderly patients, a group excluded from large randomized endarterectomy trials given their perceived high surgical risk. Of 200 consecutive carotid angioplasty and/or stenting procedures performed between March 1996 and March 2005, 21 procedures were performed without cerebral protection devices in 20 patients over the age of 79 years (mean age: 83 years, 12 men, eight women). These patients' medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and mid-term complication rates were calculated and compared to a previously published cohort of 133 consecutive patients ≤79 years of age who also underwent endovascular treatment at our institution. Carotid stenosis was reduced from a mean of 82% to no significant stenosis in all procedures. The procedural stroke rate was zero of 21 procedures. The procedural transient ischemic attack rate (TIA) was one of 21 procedures (4.8%). Mean follow-up was 24.6 months (range: 1.0-79.5 months) with at least a 30-day follow-up for 20 of the 21 procedures (95.2%). There were no new strokes. There was one recurrent ipsilateral TIA at 1.9 months. In five cases with follow-up carotid ultrasonography, no hemodynamically significant restenosis had occurred. There were three myocardial infarctions (MI) occurring at 0.5, 2.1, and 15.2 months, of which the last MI was fatal. The composite 30-day stroke and death rate was zero of 21 procedures (95% confidence interval: 0-14%). No significant difference was found in the 30-day rate of stroke, TIA, MI, or death between the elderly and younger patients. Carotid angioplasty and stenting in elderly patients can be performed successfully with acceptable procedural and mid-term complication rates comparable to younger patients. (orig.)

  19. Carotid artery stenting

    International Nuclear Information System (INIS)

    An ipsilateral stenosis of the internal carotid artery is found in 10 - 15 % of all ischemic strokes and indicates an increased risk of a second stroke. Carotid artery stenting (CAS) is a therapy that is established for many years. CAS reveals complication rates and long-term efficacy comparable to carotid endarterectomy (TEA). Especially younger patients seem to benefit from CAS. Abilities and experiences of the therapist and the choice of the techniques used are critical for patient safety. The efficacy of CAS for treatment of asymptomatic carotid stenosis is probable but still unproven in prospective-randomized trial. (orig.)

  20. Carotid artery stenting; Karotisangioplastie

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    Fiehler, Jens [Universitaetsklinikum Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neuroradiologische Diagnostik und Intervention, Diagnostikzentrum

    2009-09-15

    An ipsilateral stenosis of the internal carotid artery is found in 10 - 15 % of all ischemic strokes and indicates an increased risk of a second stroke. Carotid artery stenting (CAS) is a therapy that is established for many years. CAS reveals complication rates and long-term efficacy comparable to carotid endarterectomy (TEA). Especially younger patients seem to benefit from CAS. Abilities and experiences of the therapist and the choice of the techniques used are critical for patient safety. The efficacy of CAS for treatment of asymptomatic carotid stenosis is probable but still unproven in prospective-randomized trial. (orig.)

  1. Hyperperfusion syndrome after carotid stent angioplasty

    International Nuclear Information System (INIS)

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  2. Hyperperfusion syndrome after carotid stent angioplasty

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    Grunwald, I.Q.; Politi, M.; Reith, W.; Krick, C.; Karp, K.; Zimmer, A.; Struffert, T.; Kuehn, A.L.; Papanagiotou, P. [University of the Saarland, Department for Interventional and Diagnostic Neuroradiology, Homburg (Germany); Roth, C.; Haass, A. [University of the Saarland, Clinic for Neurology, Homburg (Germany)

    2009-03-15

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  3. Surgical treatment of internal carotid artery restenosis following eversion endarterectomy

    OpenAIRE

    Radak Đorđe; Tanasković Slobodan; Vukotić Miloje; Babić Srđan; Aleksić Nikola; Kolar Jovo; Popov Petar; Nenezić Dragoslav; Vučurević Goran; Gajin Predrag; Ilijevski Nenad

    2012-01-01

    Introduction. Carotid angioplasty and internal carotid artery stenting is the therapeutic method of choice in the treatment of carotid restenosis, but when it is not technically feasible (expressed tortuosity of supraaortic branches, calcifications, presence of pathological elongation of very long lesions) a redo surgery is indicated. Objective. The aim of our study was to examine the benefits and risks of redo surgery in patients with symptomatic and asymptomatic significant internal c...

  4. Carotid endarterectomy for atherosclerotic carotid artery stenosis

    International Nuclear Information System (INIS)

    Several randomized controlled trials (RCTs) have demonstrated carotid endarterectomy (CEA) to be more beneficial for the prevention of recurrent or first-ever ischemic stroke than treatment with antiplatelet agents in patients with moderate-severe stenosis of the cervical internal carotid artery. CEA is the standard treatment for such lesions; however, other RCTs have demonstrated carotid artery stenting (CAS) with a protective device to be comparable to CEA in patients with or without radiological or medical high-risks for CEA, although the selection criteria among these treatments have not yet been established in clinical practice. This review compares the results of RCTs valuating the superiority of CEA over medical treatment or CAS, preoperative examination, procedures of CEA, perioperative management and complications, long-term results, and indications for CEA based on the currently available evidence-based publications. A preoperative evaluation of the patients' medical condition, including atherosclerosis, is therefore important to minimize the perioperative complications of CEA, because myocardial infarction during the perioperative period is frequently observed in patients undergoing CEA. A through radiological examination such as plaque imaging is essential for selecting appropriate treatment strategies involving revascularization or medical treatment for atherosclerotic carotid artery stenosis. In addition, the surgical indications, particularly for asymptomatic lesions, should be carefully considered in light of the recent improvements in medical treatments including antihypertensive agents and statins. (author)

  5. Carotid angioplasty and stent placement for restenosis after endarterectomy

    International Nuclear Information System (INIS)

    Recurrent carotid stenosis following endarterectomy is a common complication, and reoperation may be associated with increased morbidity. The goal of this study was to determine the procedural safety and long-term complication rates of carotid angioplasty and stenting for recurrent stenosis. Of 248 consecutive carotid angioplasty and/or stenting procedures performed at our institution between March 1996 and November 2005, 83 procedures for recurrent stenosis following endarterectomy were performed in 75 patients (mean age 68 years; 43 men, 32 women) without cerebral protection devices. The patients' medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and long-term complication rates were calculated. Recurrent stenosis was reduced from a mean of 80.6% to no significant stenosis in 82 of 83 procedures. The procedural stroke rate was 3 out of 83 procedures (3.6%). The procedural transient ischemic attack (TIA) rate was 2 out of 83 procedures (2.4%). Mean follow-up was 22.4 months (range 0.1 to 86.7 months) with at least 6 months follow-up for 54 of 83 procedures (65%). There were five TIAs and no strokes on follow-up (new TIAs at 25.5 and 43.4 months; recurrent TIAs at 1, 11.1, and 12 months, all with normal angiograms). The composite 30-day stroke, myocardial infarction, or death rate was 5 of 83 procedures (6.0%). In this series, angioplasty and stenting were effective in relieving stenosis secondary to recurrent carotid disease after endarterectomy, and have low rates of ischemic complications. (orig.)

  6. Frequency and predictors for angiographically improved inflow of contrast medium after carotid angioplasty and stenting

    International Nuclear Information System (INIS)

    Percutaneous transluminal carotid angioplasty and stenting (PTAS) can result in immediate improvement in cerebral blood flow (CBF) evident through faster transit of contrast medium on angiography. To evaluate frequency and predictors of changes in inflow of contrast medium before and after PTAS, we reviewed 86 patients (mean age 68.6 ± 9.1 years) treated for symptomatic or asymptomatic carotid stenosis. Clinical data and lesion characteristics were extracted from charts and digital angiograms, respectively. Perfusion change was assessed qualitatively by comparing pre- and poststenting images matched for projection and time from injection. Improved inflow was defined on the basis of spatial or temporal distribution of contrast medium: grade -1: fewer vessels visible after stenting; 0: no change; 1: more distal small arteries visible; 2: time-matched poststenting image showing a capillary blush; 3: time-matched poststenting image showing small veins, 4 time-matched poststenting image showing large veins and sinuses. Faster inflow of contrast medium was observed in 74 % of patients (grades 1: 34 %,and 4: 4.7 %). In linear regression analysis, higher degrees of ipsilateral stenosis were associated with greater changes in inflow of contrast medium (P < 0.05). Right internal carotid lesions were associated with greater change in inflow than left-sided lesions (P < 0.01). In 31 patients (36 %) we initially showed contralateral anterior cerebral artery (ACA) filling, and in 39 % of these, normal filling was restored after stenting. Lesser contralateral carotid stenosis was associated with crossed ACA filling and with restoration of normal filling pattern after stenting. Faster appearance of a contrast-medium blush is seen in most cases of carotid angioplasty and stenting and depends on the degree of hemodynamic inflow obstruction relieved by stenting. (orig.)

  7. Análise morfométrica da carótida de suínos submetidos a angioplastia com ou sem implante de stent de cromo-cobalto Morphometric analysis of swine carotid artery angioplasty with or without cobalt-chromium stent implantation

    Directory of Open Access Journals (Sweden)

    João Luiz de Lara Elesbão

    2010-06-01

    Full Text Available Contexto: A hiperplasia intimal é a reação tardia mais comum decorrente da angioplastia. O uso de stents de cromo-cobalto é bem estudado na circulação coronariana, porém não há muitos estudos que abordem o uso desses stents nas circulações carotídea e periférica. Objetivo: Analisar mediante morfometria a reação intimal presente na artéria carótida de suínos submetidos a angioplastia isoladamente e a angioplastia seguida de implante de stent de cromo-cobalto. Materiais e métodos: Em oito suínos, foi realizada angioplastia da artéria carótida comum direita e angioplastia seguida de implante de um stent de cromo-cobalto na artéria carótida comum esquerda. Após 4 semanas, os animais foram submetidos a eutanásia para a retirada de amostras de tecido arterial e preparo de lâminas histológicas. As imagens das lâminas foram digitalizadas e analisadas por programa de morfometria digital. A análise estatística foi realizada através da média e desvio padrão das áreas em cada grupo, utilizando-se o Teste t de Student. O valor de p Background: Intimal hyperplasia is the most common delayed response to angioplasty. The use of cobalt-chromium stents is well studied in the coronary circulation; however, there are few studies on their use in the carotid and peripheral circulation. Objective: To analyze the intimal reaction in a swine carotid artery undergoing simple angioplasty and angioplasty followed by implantation of cobalt-chromium stent. Materials and methods: We carried out angioplasty in the right common carotid artery and angioplasty with cobalt-chromium stent in the left common carotid artery in eight swine. Four weeks later, all animals were sacrificed for arterial tissue sampling and preparation of histological slides. Slide images were scanned and analyzed using a digital morphometry program. Statistical analysis was performed by mean values and standard deviations of the areas in each group, using the Student's t

  8. Carotid Artery Disease

    Science.gov (United States)

    ... org Diagnosis Proteins in the wall of the aorta, called elastin and collagen The diagnosis of carotid ... a higher risk after age 75) • Smoking • Hypertension • Diabetes • High cholesterol, and especially high amounts of “low ...

  9. Renal artery stent angioplasty for renovascular hypertension

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic results of expandable stent for treatment of atherosclerotic renovascular obstructive disease. Methods: 15 patients (10 men and 5 women, 41-75 years old; mean age, 52 years) with renal arterial hypertension underwent renal stent angioplasty including renal arterial stenosis 89%(n=13) and fully obstruction without function in 2, of which 2 patients had bilateral involvement. The stenotic range of all arterial segments showed 60% to 90% width of the normal arterial diameter. 16 stents were implanted under the guidance of fluoroscopy. The most of stents implanted were Palmaz (n=12, 75%) with regular clinical and angiographic follow up. Results: Technical success (residual stenosis <30%) was achieved in all patients without serious complication. During the follow-up (6-15 months; mean, 8 ± 4 months), hypertension was improved in 9 patients and cured in 4 patients with a total benefit of 86% and no efficacy in 2(13%). The average systolic blood pressure decreased from 27.12 ± 3.09 kPa to 18.62 ± 3.12 kPa and the average diastolic blood pressure decreased from 17.73 ± 1.92 kPa to 11.12 ± 2.43 kPa after stent treatment (P<0.05). Serum creatinine remained stable in 60% (n=9) patients with improvement in 33% (n=5) and worsened in 6% (n=1) patients. Follow-up angiography was performed in all patients with 1 case of a restenosis. 6 months after expanding through stent by using balloon, the two follow up angiographies showed a stable restenosis about 20%. Conclusions: Percutaneous transluminal stent placement is highly beneficial for patients who had renal arterial obstructive disease. The success of stent angioplasty of complete obstructive renal arteries reveals wide prospects for interventional method. (authors)

  10. Surgical treatment of internal carotid artery restenosis following eversion endarterectomy

    Directory of Open Access Journals (Sweden)

    Radak Đorđe

    2012-01-01

    Full Text Available Introduction. Carotid angioplasty and internal carotid artery stenting is the therapeutic method of choice in the treatment of carotid restenosis, but when it is not technically feasible (expressed tortuosity of supraaortic branches, calcifications, presence of pathological elongation of very long lesions a redo surgery is indicated. Objective. The aim of our study was to examine the benefits and risks of redo surgery in patients with symptomatic and asymptomatic significant internal carotid artery restenosis and its impact on early and late morbidity and mortality. Methods. The study included 45 patients who were surgically treated for a hemodynamically significant internal carotid artery restenosis from January 2000 to December 2009. Surgical techniques included redo endarterectomy with direct suture, redo anderectomy with a patch plastic and resection with Dacron tubular graft interposition. The patients were followed for postoperative neurological ischemic events (transient ischemic attack (TIA, stroke, local surgical complications and lethal outcome after one month, six months, one year and after two years. Results. In the early postoperative period (up to 30 days there were no lethal outcomes. TIA was diagnosed in four patients (8.8%, minor stroke in one patient (2.2% and one patient (2.2% also had cranial nerve injury. After two years two patients died (4.4% due to fatal myocardial infarction, three patients (6.5% had ipsilateral stroke and one patient developed graft occlusion (2%. Conclusion. In the case of symptomatic and asymptomatic carotid restenosis that cannot be treated by carotid percutaneous angioplasty, redo surgical treatment is therapeutic option with an acceptable rate of early and late postoperative complications.

  11. Computer simulation of the carotid artery

    OpenAIRE

    Santos, A.; Sousa, L. de; Tavares, J.; Santos, R.; Castro, P.; Azevedo, E.

    2012-01-01

    Background: Disturbed flow conditions at the bifurcation of common carotid artery and proximal internal carotid artery plays an important role in the development of local atherosclerotic plaques, which are important causes of stroke. Being able to build 3D models based on ultrasound imaging can improve diagnostic assessment and support interventions like endarterectomy or carotid stenting. Our aim was to describe a carotid segmentation algorithm to build these 3D models.Methods: We developed ...

  12. Short-term outcome of stent-assisted angioplasty for extracranial carotid stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and short-term outcome of stent-assisted angioplasty for extracranial carotid stenosis. Methods: From October 2000 to September 2002, 93 cases of extracranial carotid stenosis, including 86 cases of carotid bifurcation stenosis, 4 of extracranial internal carotid stenosis, 2 of common carotid stenosis and 1 of functional external carotid stenosis, were treated by self-expandable stent placement and angioplasty. Results: Stent placement and angioplasty were successfully administered in all the 93 patients. The average stenosis rate was reduced from (79.5 ± 14.6)% before treatment to (11.2 ± 7.8)% after stent-assisted angioplasty. There were only 1 case of TIA (1.1%) and 1 case of minor stroke (1.1%) during the operation, without mortality or major stroke. No cerebral ischemic attach occurred in the 91 patients during clinical follow up for a period of 3-25 months with an average of 7.9 months. twenty-nine patients were angiographically followed up 6 months after treatment with only one asymptomatic restenosis (3.4%). Conclusions: Endovascular stent-assisted angioplasty for extracranial stenosis is safe and effective with considerable good short-term outcome

  13. Anomalous external carotid artery-internal carotid artery anastomosis in two patients with proximal internal carotid arterial remnants

    International Nuclear Information System (INIS)

    Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other

  14. Anomalous external carotid artery-internal carotid artery anastomosis in two patients with proximal internal carotid arterial remnants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Hun [Dept. of Neurology, Stroke Center, Myongji Hospital, Goyang (Korea, Republic of); Cho, Young Dae; Kang, Hyun Seung; Kim, Jeong Eun; Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Seung Chai [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Ahn, Jun Hyong [Dept. of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2015-08-15

    Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.

  15. Angioplasty and stent placement - carotid artery - discharge

    Science.gov (United States)

    ... Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society ...

  16. Surgical management for retained distal embolic protection device and fractured guidewire after carotid artery stenting.

    Science.gov (United States)

    Li, Tongxun; Zha, Yuanting; Bo, Liyang; Wirthlin, Douglas J; Zhang, Qinyi

    2016-01-01

    Entrapment and fracture of carotid angioplasty and stenting hardware is a rare complication of percutaneous stenting procedures. We describe a case of a retained distal filter embolic protection device and guidewire in a 57-year-old male in Beijing, China. After unsuccessful attempts at removal via interventional methods, a second stent was deployed to secure the original hardware in situ, and the patient was discharged. He later experienced guidewire fragmentation in the carotid artery and aortic arch, with subsequent thrombus formation. We report partial removal of the guidewire and stent via carotid artery cutdown and open thoracotomy without complication. When efforts to retrieve stenting hardware are unsuccessful, it is never a suitable choice to leave them within the artery. We advocate for early surgical management of retained materials after unsuccessful carotid artery stenting. Furthermore, improved quality monitoring and assurance programs are needed to prevent such complications in the future. PMID:27316621

  17. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    Science.gov (United States)

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort.

  18. Shape optimization of the carotid artery bifurcation

    OpenAIRE

    Bressloff, N. W.; Forrester, A.I.J.; Banks, J.; Bhaskar, K.V.

    2004-01-01

    A parametric CAD model of the human carotid artery bifurcation is employed in an initial exploration of the response of shear stress to the variation of the angle of the internal carotid artery and the width of the sinus bulb. Design of experiment and response surface technologies are harnessed for the first time in such an application with the aim of developing a better understanding of the relationship between geometry (anatomy) and sites of arterial disease.

  19. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery

    DEFF Research Database (Denmark)

    Tønnesen, K H; Sager, P; Karle, A; Henriksen, L; Jørgensen, B

    1988-01-01

    We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually of ...

  20. Internal carotid artery rupture caused by carotid shunt insertion

    OpenAIRE

    Giulio Illuminati; Caliò, Francesco G.; Giulia Pizzardi; Francesco Vietri

    2015-01-01

    Introduction: Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. Presentation of case: A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arteria...

  1. Internal carotid artery dissection following rigid esophagoscopy

    OpenAIRE

    Ricchetti, Alma Paola; Becker, Minerva; Dulguerov, Pavel

    1999-01-01

    A case of internal carotid artery dissection that developed after rigid esophagoscopy is described. The diagnosis was suggested by the clinical presentation and confirmed by the findings of radiological examinations. Internal carotid artery dissection is a rare condition of controversial etiology. Most frequently, the cause is unknown and the condition is termed idiopathic. A few cases have occurred after forceful cervical extensions and manipulations. The pathogenesis in our case is uncertai...

  2. Transcutaneous angioplasty of vertebral artery atheromatous ostial stricture

    International Nuclear Information System (INIS)

    The authors report experience of intravascular angioplasty of atheromatous ostial strictures of the vertebral artery in 24 patients. After reviewing the technique, they authive the indications provided through Doppler velocimetric data. The results seem to be encouraging as symptoms disappeared completely in 21 patients. (orig.)

  3. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study) : an interim analysis of a randomised controlled trial

    NARCIS (Netherlands)

    Ederle, Joerg; Dobson, Joanna; Featherstone, Roland L.; Bonati, Leo H.; van der Worp, H. Bart; de Borst, Gert J.; Lo, T. Hauw; Gaines, Peter; Dorman, Paul J.; Macdonald, Sumaira; Lyrer, Philippe A.; Hendriks, Johanna M.; McCollum, Charles; Nederkoorn, Paul J.; Brown, Martin M.; Algra, A.; Bamford, J.; Beard, J.; Bland, M.; Bradbury, A. W.; Brown, M. M.; Clifton, A.; Gaines, P.; Hacke, W.; Halliday, A.; Malik, I.; Mas, J. L.; McGuire, A. J.; Sidhu, P.; Venables, G.; Bradbury, A.; Brown, M. M.; Clifton, A.; Gaines, P.; Collins, R.; Molynewc, A.; Naylor, R.; Warlow, C.; Ferro, J. M.; Thomas, D.; Bonati, L. H.; Coward, L.; Dobson, J.; Ederle, J.; Featherstone, R. F.; Tindall, H.; McCabe, D. J. H.; Wallis, A.; Brooks, M.; Chambers, B.; Chan, A.; Chu, P.; Clark, D.; Dewey, H.; Donnan, G.; Fell, G.; Hoare, M.; Molan, M.; Roberts, A.; Roberts, N.; Beiles, B.; Bladin, C.; Clifford, C.; Fell, G.; Grigg, M.; New, G.; Bell, R.; Bower, S.; Chong, W.; Holt, M.; Saunder, A.; Than, P. G.; Gett, S.; Leggett, D.; McGahan, T.; Quinn, J.; Ray, M.; Wong, A.; Woodruff, P.; Foreman, R.; Schultz, D.; Scroop, R.; Stanley, B.; Allard, B.; Atkinson, N.; Cambell, W.; Davies, S.; Field, P.; Milne, P.; Mitchell, P.; Tress, B.; Yan, B.; Beasley, A.; Dunbabin, D.; Stary, D.; Walker, S.; Cras, P.; d'Archambeau, O.; Hendriks, J. M. H.; Van Schil, P.; Bosiers, M.; Deloose, K.; van Buggenhout, E.; De Letter, J.; Devos, V.; Ghekiere, J.; Vanhooren, G.; Astarci, P.; Hammer, F.; Lacroix, V.; Peeters, A.; Verhelst, R.; DeJaegher, L.; Peeters, A.; Verbist, J.; Blair, J-F; Caron, J. L.; Daneault, N.; Giroux, M-F; Guilbert, F.; Lanthier, S.; Lebrun, L-H; Oliva, V.; Raymond, J.; Roy, D.; Soulez, G.; Weill, A.; Hill, M.; Hu, W.; Hudion, M.; Morrish, W.; Sutherland, G.; Wong, J.; Alback, A.; Harno, H.; Ijas, P.; Kaste, M.; Lepantalo, M.; Mustanoja, S.; Paananen, T.; Porras, M.; Putaala, J.; Railo, M.; Sairanen, T.; Soinne, L.; Vehmas, A.; Vikatmaa, P.; Goertler, M.; Halloul, Z.; Skalej, M.; Brennan, P.; Kelly, C.; Leahy, A.; Moroney, J.; Thornton, J.; Koelemay, M. J. W.; Nederkoorn, P. J.; Reekers, J. A. A.; Roos, Y. B. W. E. M.; Hendriks, J. M.; Koudstaal, P. J.; Pattynama, P. M. T.; van der Lugt, A.; van Dijk, L. C.; van Sambeek, M. R. H. M.; van Urk, H.; Verhagen, H. J. M.; Bruininckx, C. M. A.; de Bruijn, S. F.; Keunen, R.; Knippenberg, B.; Mosch, A.; Treurniet, F.; van Dijk, L.; van Overhagen, H.; Wever, J.; de Beer, F. C.; van den Berg, J. S. P.; van Hasselt, B. A. A. M.; Zeilstra, D. J.; Boiten, J.; van Otterloo, J. C. A. de Mol; de Vries, A. C.; Nieholt, G. J. Lycklama A.; van der Kallen, B. F. W.; Blankensteijn, J. D.; De Leeuw, F. E.; Kool, L. J. Schultze; van der Vliet, J. A.; de Borst, G. J.; de Kort, G. A. P.; Kapelle, L. J.; Lo, T. H.; Mali, W. P. Th M.; Moll, F.; van der Worp, H. Bart; Verhagen, H.; Barber, P. A.; Bourchier, R.; Hill, A.; Holden, A.; Stewart, J.; Bakke, S. J.; Krohg-Sorensen, K.; Skjelland, M.; Tennoe, B.; Bialek, P.; Biejat, Z.; Czepiel, W.; Czlonkowska, A.; Dowzenko, A.; Jedrzejewska, J.; Kobayashi, A.; Lelek, M.; Polanski, J.; Kirbis, J.; Milosevic, Z.; Zvan, B.; Blasco, J.; Chamorro, A.; Macho, J.; Obach, V.; Riambau, V.; San Roman, L.; Branera, J.; Canovas, D.; Estela, Jordi; Gimenez Gaibar, A.; Perendreu, J.; Bjorses, K.; Gottsater, A.; Ivancev, K.; Maetzsch, T.; Sonesson, B.; Berg, B.; Delle, M.; Formgren, J.; Gillgren, P.; Kall, T-B; Konrad, P.; Nyman, N.; Takolander, R.; Andersson, T.; Malmstedt, J.; Soderman, M.; Wahlgren, C.; Wahlgren, N.; Binaghi, S.; Hirt, L.; Michel, P.; Ruchat, P.; Bonati, L. H.; Engelter, S. T.; Fluri, F.; Guerke, L.; Jacob, A. L.; Kirsch, E.; Lyrer, P. A.; Radue, E-W; Stierli, P.; Wasner, M.; Wetzel, S.; Bonvin, C.; Kalangos, A.; Lovblad, K.; Murith, N.; Ruefenacht, D.; Sztajzel, R.; Higgins, N.; Kirkpatrick, P. J.; Martin, P.; Adam, D.; Bell, J.; Bradbury, A. W.; Crowe, P.; Gannon, M.; Henderson, M. J.; Sandler, D.; Shinton, R. A.; Scriven, J. M.; Wilmink, T.; D'Souza, S.; Egun, A.; Guta, R.; Punekar, S.; Seriki, D. M.; Thomson, G.; Brennan, A.; Enevoldson, T. P.; Gilling-Smith, G.; Gould, D. A.; Harris, P. L.; McWilliams, R. G.; Nasser, H-C; White, R.; Prakash, K. G.; Serracino-Inglott, F.; Subramanian, G.; Symth, J. V.; Walker, M. G.; Clarke, M.; Davis, M.; Dixit, S. A.; Dolman, P.; Dyker, A.; Ford, G.; Golkar, A.; Jackson, R.; Jayakrishnan, V.; Lambert, D.; Lees, T.; Louw, S.; Macdonald, S.; Mendelow, A. D.; Rodgers, H.; Rose, J.; Stansby, G.; Wyatt, M.; Baker, T.; Baldwin, N.; Jones, L.; Mitchell, D.; Munro, E.; Thornton, M.; Baker, D.; Davis, N.; Hamilton, G.; McCabe, D.; Platts, A.; Tibballs, J.; Beard, J.; Cleveland, T.; Dodd, D.; Gaines, P.; Lonsdale, R.; Nair, R.; Nassef, A.; Nawaz, S.; Venables, G.; Belli, A.; Clifton, A.; Cloud, G.; Halliday, A.; Markus, H.; McFarland, R.; Morgan, R.; Pereira, A.; Thompson, A.; Chataway, J.; Cheshire, N.; Gibbs, R.; Hammady, M.; Jenkins, M.; Malik, I.; Wolfe, J.; Adiseshiah, M.; Bishop, C.; Brew, S.; Brookes, J.; Brown, M. M.; Jaeger, R.; Kitchen, N.; Ashleigh, R.; Butterfield, S.; Gamble, G. E.; McCollum, C.; Nasim, A.; O'Neill, P.; Wong, J.; Edwards, R. D.; Lees, K. R.; MacKay, A. J.; Moss, J.; Rogers, P.

    2010-01-01

    Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid

  4. Efficiency of ultrasonography and CT angiography in follow-up studies of carotid stent and percutaneous transluminal angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Lee, Byung Hee; Chung, Bong Sub; Ahn, Jung Yong; Heo, Kyung; Kho, Young Sik [Pundang CHA General Hospital, Pochon CHA Univ. College of Medicine, Pochon (Korea, Republic of)

    1999-12-01

    The aim of this study was to determine a more appropriate method for follow-up of carotid stenting by comparing the efficiency of US and CT angiography. Eleven carotid arteries of seven patients(men:5, women:2, mean age:56.4years) who underwent stent placement and percutaneous transluminal angioplasty(PTA) because of carotid stenosis were studied. The follow-up periods ranged from three to eleven (mean, five) months, and US and CT angiography were performed in one day. Color duplex sonography was performed with a 10 MHz linear array transducer. After spiral CT scan were obtained, MPR images were reconstructed on a workstation. Retrospective imaging analysis specifically focused on [1] stent configuration, [2] the accuracy of internal diameter measurement, [3] the detection of blood flow and the measurement of blood flow velocity, [4] the presence of atheroma and intraluminal thrombi, [5] the measurement of stent location, and [6] artifacts. US was more accurate than CT angiography for measuring internal diameter. In all cases, US and CT angiography were able to detect the blood flow at carotid artery, and utilizing the Doppler spectrum, flow velocity was measured. US showed atheromas in all cases but CT angiography demonstrated calcified atheromas in three cases only. In six cases, US failed to determine stent location, though in this respect CT angiography was successful in all cases. Artifacts of US were small reverberation artifact(11/11) of the stent and a defective color Doppler signal caused by acoustic shadowing of atheroma calcification(3/11). Artifacts of CT angiogrpahy were hardbeam artifact of the stent(11/11) and motion artifact(3/11). US was superior to CT angiography in accuracy of measuring stent diameter, hemodynamic assessment, high-resolution views of the luminal state of the stent and minimal artifacts for the non-invasive follow-up studies of carotid stenting.

  5. Efficiency of ultrasonography and CT angiography in follow-up studies of carotid stent and percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    The aim of this study was to determine a more appropriate method for follow-up of carotid stenting by comparing the efficiency of US and CT angiography. Eleven carotid arteries of seven patients(men:5, women:2, mean age:56.4years) who underwent stent placement and percutaneous transluminal angioplasty(PTA) because of carotid stenosis were studied. The follow-up periods ranged from three to eleven (mean, five) months, and US and CT angiography were performed in one day. Color duplex sonography was performed with a 10 MHz linear array transducer. After spiral CT scan were obtained, MPR images were reconstructed on a workstation. Retrospective imaging analysis specifically focused on [1] stent configuration, [2] the accuracy of internal diameter measurement, [3] the detection of blood flow and the measurement of blood flow velocity, [4] the presence of atheroma and intraluminal thrombi, [5] the measurement of stent location, and [6] artifacts. US was more accurate than CT angiography for measuring internal diameter. In all cases, US and CT angiography were able to detect the blood flow at carotid artery, and utilizing the Doppler spectrum, flow velocity was measured. US showed atheromas in all cases but CT angiography demonstrated calcified atheromas in three cases only. In six cases, US failed to determine stent location, though in this respect CT angiography was successful in all cases. Artifacts of US were small reverberation artifact(11/11) of the stent and a defective color Doppler signal caused by acoustic shadowing of atheroma calcification(3/11). Artifacts of CT angiogrpahy were hardbeam artifact of the stent(11/11) and motion artifact(3/11). US was superior to CT angiography in accuracy of measuring stent diameter, hemodynamic assessment, high-resolution views of the luminal state of the stent and minimal artifacts for the non-invasive follow-up studies of carotid stenting

  6. Radiation-induced carotid artery atherosclerosis

    International Nuclear Information System (INIS)

    Purpose: Carotid arteries frequently receive significant doses of radiation as collateral structures in the treatment of malignant diseases. Vascular injury following treatment may result in carotid artery stenosis (CAS) and increased risk of stroke and transient ischaemic attack (TIA). This systematic review examines the effect of radiotherapy (RT) on the carotid arteries, looking at the incidence of stroke in patients receiving neck radiotherapy. In addition, we consider possible surrogate endpoints such as CAS and carotid intima-medial thickness (CIMT) and summarise the evidence for radiation-induced carotid atherosclerosis. Materials and methods: From 853 references, 34 articles met the criteria for inclusion in this systematic review. These papers described 9 studies investigating the incidence of stroke/TIA in irradiated patients, 11 looking at CAS, and 14 examining CIMT. Results: The majority of studies utilised suboptimally-matched controls for each endpoint. The relative risk of stroke in irradiated patients ranged from 1.12 in patients with breast cancer to 5.6 in patients treated for head and neck cancer. The prevalence of CAS was increased by 16–55%, with the more modest increase seen in a study using matched controls. CIMT was increased in irradiated carotid arteries by 18–40%. Only two matched-control studies demonstrated a significant increase in CIMT of 36% and 22% (p = 0.003 and <0.001, respectively). Early prospective data demonstrated a significant increase in CIMT in irradiated arteries at 1 and 2 years after RT (p < 0.001 and <0.01, respectively). Conclusions: The incidence of stroke was significantly increased in patients receiving RT to the neck. There was a consistent difference in CAS and CIMT between irradiated and unirradiated carotid arteries. Future studies should optimise control groups

  7. Retropharyngeal internal carotid artery: case report

    Directory of Open Access Journals (Sweden)

    Figueiredo, Ricardo Rodrigues

    2009-03-01

    Full Text Available Introduction: Variations to the course of carotid arteries may lead to abnormal pharyngeal protrusions, to which the otorhinolaryngologist should always attentive. Objective: To report a case of abnormal pharyngeal protrusion due to vascular anomaly in the course of the internal carotid artery, with literature review. Case Report: A 73- year-old woman complained of globus pharyngeus and intermittent dysphonia. A pulsating convexity was observed at the right part of the oropharynx, associated to laryngoscopic signals of pharyngo-laryngeal reflux. The pharyngeal computed tomography scan showed an abnormal tortuous internal carotid in the retropharyngeal space. The patient was sent to the vascular surgeon, who, after a normal blood flow finding at the Doppler, opted for an expectation conduct. The pharyngeal symptoms improved with the antireflux treatment. Final Comments: Internal carotid vascular anomalies must always be recalled in the pharyngeal wall convexity differential diagnosis.

  8. Carotid artery disease : plaque features and vulnerability

    OpenAIRE

    Jashari, Fisnik

    2015-01-01

    Background: Atherosclerosis is an important cause of stroke. Ultrasound offers the convenience of real-time and detailed assessment of carotid plaque features as well as arterial wall thickening and composition. Evaluation of these features is important for determining patients’ risk of suffering vascular events and also contributes to selecting the best treatment strategy. Methods: Using ultrasound data analysis we have determined plaque features in the bifurcation and internal carotid arter...

  9. Angioplasty and stent placement - heart

    Science.gov (United States)

    ... angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation ... to carefully guide the catheter up into your heart and arteries. Dye will be injected into your ...

  10. Innovations in Stroke Prevention: An Update on Carotid Stenting

    Medline Plus

    Full Text Available ... could be a loss of speech or the ability to name objects, especially the -- in the left ... an external carotid artery does not negate your ability to do carotid stent angioplasty. 00:37:59 ...

  11. Innovations in Stroke Prevention: An Update on Carotid Stenting

    Medline Plus

    Full Text Available ... a minimally invasive approach in which we will access from the groin and treat the carotid artery ... carotid stent angioplasty is multifactorial. First is the access is generally done, performed, from a groin access, ...

  12. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  13. Oxygen transfer in human carotid artery bifurcation

    Institute of Scientific and Technical Information of China (English)

    Z.G.Zhang; Y.B.Fan; X.Y.Deng

    2007-01-01

    Arterial bifurcations are places where blood flow may be disturbed and slow recirculation flow may occur.To reveal the correlation between local oxygen transfer and atherogenesis, a finite element method was employed to simulate the blood flow and the oxygen transfer in the human carotid artery bifurcation. Under steady-state flow conditions, the numerical simulation demonstrated a variation in local oxygen transfer at the bifurcation, showing that the convective condition in the disturbed flow region may produce uneven local oxygen transfer at the blood/wall interface.The disturbed blood flow with formation of slow eddies in the carotid sinus resulted in a depression in oxygen supply to the arterial wall at the entry of the sinus, which in turn may lead to an atherogenic response of the arterial wall, and contribute to the development of atherosclerotic stenosis there.

  14. Haemodynamic evaluation of carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T

    Cerebral ischaemia in the region of an internal carotid artery (ICA) stenosis may be caused by embolism or cerebral hypoperfusion. A severe ICA stenosis may be well compensated by collateral blood supply, however, in some patients the capacity of the collateral blood supply is insufficient. Studies...

  15. Long-term results of brachiocephalic artery percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    This paper establishes the ling-term and angiographic sequelae of percutaneous transluminal angioplasty (PTA) of stenoses of the origins of the brachycephalic arteries. From November of the proximal segments of the brachycephalic arteries. Clinical follow-up after PTA was 45 months. Two patients had recurrence of vertigo, after 16 and 75 months. There was no evidence of restenosis in the patient whose recurrence was after 16 months, but considerable restenosis was noted in the patient whose symptoms recurred after 75 months. That patient underwent successful repeated PTA

  16. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    Directory of Open Access Journals (Sweden)

    Jeng JS

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  17. Stenosis of calcified carotid artery detected on Panoramic Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, So Yang; Oh, Won Mann; Yoon, Suk Ja; Yoon, Woong; Lee, Jae Seo; Kang, Byung Cheol [School of Dentistry, Chonnam National University, Seoul (Korea, Republic of); Palomo, Juan M. [Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland (United States)

    2009-09-15

    This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20 carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.

  18. Stenosis of calcified carotid artery detected on Panoramic Radiography

    International Nuclear Information System (INIS)

    This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20 carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.

  19. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2010-03-20

    Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy.

  20. Internal Carotid Artery Aneurysm Mimicking Peritonsillar Abscess

    Directory of Open Access Journals (Sweden)

    Jacek Brzost

    2015-01-01

    Full Text Available The extracranial internal carotid artery aneurysm (EICAA is an uncommon arterial lesion. Patients typically present with neurologic symptoms resulting from impaired cerebral perfusion and compression symptoms of cranial nerves. Often EICAA presents as a pulsatile neck mass, which is otherwise asymptomatic. We present a case of an 84-year-old female, who was initially referred to the Emergency Department for Otolaryngology with suspected peritonsillar abscess. The patient had a history of recent upper airway infection and cardiovascular comorbidities, including hypertension and ischaemic stroke complicated by extensive neurologic deficits. Physical examination revealed a compact, nonpulsatile mass in the lateral parapharyngeal space and local erythema of the mucosa. Duplex Doppler Ultrasonography and Computed Tomography revealed an atherosclerotic aneurysm of the right internal carotid artery, measuring 63×55×88 mm, stretching from the skull base to the angle of the mandible.

  1. Radiation-induced carotid artery disease

    International Nuclear Information System (INIS)

    Nine patients with atherosclerotic carotid artery disease associated with neck radiation were compared to 40 control patients. The data suggest that significant differences in age, incidence of coronary and peripheral vascular disease, elevated lipids and serum cholesterol, and the angiographic incidence of disseminated atherosclerosis justify the description of radiation-induced carotid disease as a clinical entity. Elevated serum cholesterol and hyperlipidemia may contribute to the development of radiation-induced vascular disease. Successful surgical reconstruction does not appear to be influenced by the prior radiotherapy, although periarterial fibrosis and increased difficulty in separating the plaques from the vascular media was encountered

  2. Automated carotid artery intima layer regional segmentation

    International Nuclear Information System (INIS)

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge(TM) systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 ± 0.186 mm while FOAM showed -0.016 ± 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  3. Automated carotid artery intima layer regional segmentation

    Science.gov (United States)

    Meiburger, Kristen M.; Molinari, Filippo; Rajendra Acharya, U.; Saba, Luca; Rodrigues, Paulo; Liboni, William; Nicolaides, Andrew; Suri, Jasjit S.

    2011-07-01

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge™ systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 ± 0.186 mm while FOAM showed -0.016 ± 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  4. Automated carotid artery intima layer regional segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Meiburger, Kristen M; Molinari, Filippo [Biolab, Department of Electronics, Politecnico di Torino, Torino (Italy); Acharya, U Rajendra [Department of ECE, Ngee Ann Polytechnic (Singapore); Saba, Luca [Department of Radiology, A.O.U. di Cagliari, Cagliari (Italy); Rodrigues, Paulo [Department of Computer Science, Centro Universitario da FEI, Sao Paulo (Brazil); Liboni, William [Neurology Division, Gradenigo Hospital, Torino (Italy); Nicolaides, Andrew [Vascular Screening and Diagnostic Centre, London (United Kingdom); Suri, Jasjit S, E-mail: filippo.molinari@polito.it [Fellow AIMBE, CTO, Global Biomedical Technologies Inc., CA (United States)

    2011-07-07

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge(TM) systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 {+-} 0.186 mm while FOAM showed -0.016 {+-} 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  5. Angioplasty and stent placement in chronic occlusion of the superficial femoral artery: technique and results.

    OpenAIRE

    Conroy, RM; Gordon, IL; Tobis, JM; Hiro, T; Kasaoka, S; Stemmer, EA; Wilson, SE

    2000-01-01

    PURPOSE: To improve the patency rate for angioplasty in chronic occlusion of the superficial femoral artery by deploying stents after angioplasty. MATERIALS AND METHODS: Angioplasty and stent placement were performed in 61 arteries in 48 male patients. The mean occlusion length was 13.5 cm and the mean stent length was 30 cm. Patency rates were analyzed at 6 months and at 1, 2, 3, and 4 years. The predictors of restenosis were analyzed by univariate and multiple logistic regression. RESULTS: ...

  6. Carotid artery rupture and cervicofacial actinomycosis.

    Science.gov (United States)

    Kummer, Anne; Lhermitte, Benoît; Ödman, Micaela; Grabherr, Silke; Mangin, Patrice; Palmiere, Cristian

    2012-11-01

    Cervicofacial actinomycosis is an uncommon, progressive infection caused by bacilli of the Actinomyces genus. Actinomyces are common commensal saprophytes in the oral cavity which may have medical importance as facultative pathogens. Subsequent to local injuries to the oral mucosa, they may penetrate the deep tissues and be responsible for suppurative or granulomatous infections. We herein report a case of a 65-year-old man who underwent surgery followed by chemotherapy and radiotherapy for a tonsillar carcinoma. An ulcerous lesion in the base of the tongue developed and spread to the carotid artery wall. The man died of a massive hemorrhage due to left carotid artery rupture. Postmortem computed tomography angiography performed prior to autopsy allowed the precise localization of the source of bleeding to be detected. Postmortem biochemical investigations confirmed the presence of inflammation associated with local bacterial infection. Histological investigations revealed the rupture of the left carotid artery surrounded by numerous colonies of Actinomyces. Acute and chronic inflammation with tissue necrosis as well as post-actinic, fibrotic changes were also found in the tissues surrounding the ruptured artery wall. PMID:22819527

  7. Molecular mediators linking stroke and carotid artery disease

    OpenAIRE

    Nuotio, Krista

    2007-01-01

    Carotid artery disease is the most prevalent etiologic precursor of ischemic stroke, which is a major health hazard and the second most common cause of death in the world. If a patient presents with a symptomatic high-grade (>70%) stenosis in the internal carotid artery, the treatment of choice is carotid endarterectomy. However, the natural course of radiologically equivalent carotid lesions may be clinically quite diverse, and the reason for that is unknown. It would be of utmost importance...

  8. Calcium deposits in the common carotid artery

    International Nuclear Information System (INIS)

    Complete text of publication follows. Arterial calcification consists mainly of calcium apatite and takes place at two sites in the vessel wall: the intima and the media. Intimal calcification occurs exclusively within atherosclerotic plaques, while medial calcification may develop independently [1]. Ultrasound examination of the carotid arteries is performed routinely to assess pathological alterations. Large calcified plaques in the carotid arteries can be detected by B-mode ultrasonography easily as high frequency ultrasound does not penetrate calcium and have been investigated extensively. In this study our aim was to determine the calcium distribution in the vessel wall itself, excluding large plaques, and to make the first step towards investigating the relationship between the calcium distributional maps and the respective ultrasonic images. The carotid arteries of five elderly (age 71±9 years) and one young (age 27 years) deceased patients were excised at autopsy and were investigated with a medical ultrasound equipment in a tank containing saline solution. Scan sequences were videotaped and images of previously marked cross-sections were transferred to a computer. Small pieces of the arteries were cut and quench frozen. Sections of 60μm from the middle of the scanned segments (30mm proximal to the bifurcation) were cut in a cryostat. The cryosections were transferred to microprobe target holders. The elemental distribution of the samples were determined by particle induced X-ray emission (PIXE) at the Debrecen microprobe [2]. True elemental maps and absolute concentration values were evaluated with a new software (True Pixe Imaging) [3]. The average calcium content of the scanned areas varied between 1000 and 9000μg/g in the slices of the common carotid arteries of the elderly patients. In contrast, scanned areas in the slices from the young subject contained only 600-800μg/g calcium. The concentration of calcium could reach even 3.75% along the wide

  9. Haemodynamic evaluation of carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T

    1989-01-01

    Cerebral ischaemia in the region of an internal carotid artery (ICA) stenosis may be caused by embolism or cerebral hypoperfusion. A severe ICA stenosis may be well compensated by collateral blood supply, however, in some patients the capacity of the collateral blood supply is insufficient. Studi...... orthograde flow any severe pressure reduction may be ruled out. In cases of inverted flow, analysis of distal ICA waveforms may identify patients with severe reduction in ICA perfusion pressure....

  10. Carotid Endarterectomy in the Face of a Persistent Hypoglossal Artery.

    Science.gov (United States)

    Koleilat, Issam; Hanover, Tod

    2015-11-01

    A 68-year-old woman presented with signs and symptoms suggestive of a cerebrovascular accident. Her work-up revealed left internal carotid artery stenosis consistent with her presentation of a left middle cerebral artery distribution stroke. Imaging also incidentally revealed a persistent hypoglossal artery. She underwent carotid endarterectomy. Our intraoperative strategy for management of this persistent fetal anomaly is reviewed. PMID:26303270

  11. Obesity and carotid artery remodeling

    DEFF Research Database (Denmark)

    Kozakova, M; Palombo, C; Morizzo, C;

    2015-01-01

    BACKGROUND/OBJECTIVE: The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions...... and CCA LD (266 healthy subjects with wide range of body weight (24-159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese...... subjects without CV complications and 88 non-obese subjects matched for gender and age). RESULTS: CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile was...

  12. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  13. Successful Reconstruction of Asymptomatic Bilateral External Carotid Artery Aneurysms.

    Science.gov (United States)

    Loja, Melissa N; Pevec, William C

    2016-04-01

    True aneurysms of the external carotid artery (ECA) are extremely rare with an unknown incidence and natural history. We present the successful operative management of an asymptomatic 65-year-old man found to have bilateral internal carotid artery stenosis and bilateral ECA aneurysms. His bilateral carotid arteries were reconstructed with bifurcated interposition grafts in a staged fashion. The patient recovered without sequelae and continues to be asymptomatic 1 year after reconstruction. We present the operative management of this rare case. PMID:26802292

  14. Ischemic stroke: carotid and vertebral artery disease.

    Science.gov (United States)

    Vilela, P; Goulão, A

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. PMID:15657789

  15. Ischemic stroke: carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  16. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  17. Endovascular therapeutic occlusion following bilateral carotid artery bypass for radiation-induced carotid artery blowout. Case report

    International Nuclear Information System (INIS)

    A patients with breast cancer received radiation therapy to the upper chest wall. Twenty-two years later, she presented with repeated severe bleeding through a left lower neck ulcer. She was taken to surgery for hemostasis, which was not successful because the carotid artery was surgically inaccessible. To manage for explosive carotid blowout, we performed common carotid artery ligation and endovascular coil embolization after contralateral-external-carotid to ipsilateral-common-carotid artery bypass with a polytetrafluoroethylene (PTFE) graft. The patients has experienced no ischemic events or bleeding since this treatment. (author)

  18. File list: His.CDV.20.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.CDV.20.AllAg.Carotid_Arteries hg19 Histone Cardiovascular Carotid Arteries http...://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.CDV.20.AllAg.Carotid_Arteries.bed ...

  19. File list: Unc.CDV.05.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.CDV.05.AllAg.Carotid_Arteries hg19 Unclassified Cardiovascular Carotid Arteries... http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.CDV.05.AllAg.Carotid_Arteries.bed ...

  20. File list: His.CDV.50.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.CDV.50.AllAg.Carotid_Arteries hg19 Histone Cardiovascular Carotid Arteries http...://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.CDV.50.AllAg.Carotid_Arteries.bed ...

  1. File list: Unc.CDV.50.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.CDV.50.AllAg.Carotid_Arteries hg19 Unclassified Cardiovascular Carotid Arteries... http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.CDV.50.AllAg.Carotid_Arteries.bed ...

  2. File list: Unc.CDV.20.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.CDV.20.AllAg.Carotid_Arteries hg19 Unclassified Cardiovascular Carotid Arteries... http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.CDV.20.AllAg.Carotid_Arteries.bed ...

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    Lifescience Database Archive (English)

    Full Text Available His.CDV.10.AllAg.Carotid_Arteries hg19 Histone Cardiovascular Carotid Arteries http...://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.CDV.10.AllAg.Carotid_Arteries.bed ...

  4. File list: His.CDV.05.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.CDV.05.AllAg.Carotid_Arteries hg19 Histone Cardiovascular Carotid Arteries http...://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.CDV.05.AllAg.Carotid_Arteries.bed ...

  5. File list: Unc.CDV.10.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.CDV.10.AllAg.Carotid_Arteries hg19 Unclassified Cardiovascular Carotid Arteries... http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.CDV.10.AllAg.Carotid_Arteries.bed ...

  6. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)

    1997-06-01

    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  7. Cutting Balloon-Assisted Angioplasty of an Anastomotic Carotid-Brachial Bypass Graft Stenosis: A Case Report

    International Nuclear Information System (INIS)

    Neointimal hyperplasia leads to anastomotic stenosis in bypass grafts. These stenoses are often resistant to conventional balloon dilatation. We present a case of a carotid-brachial bypass graft stenosis, which was treated by a 5-mm cutting balloon angioplasty with a good angiographic and clinical result

  8. Novel A20-gene-eluting stent inhibits carotid artery restenosis in a porcine model

    Science.gov (United States)

    Zhou, Zhen-hua; Peng, Jing; Meng, Zhao-you; Chen, Lin; Huang, Jia-Lu; Huang, He-qing; Li, Li; Zeng, Wen; Wei, Yong; Zhu, Chu-Hong; Chen, Kang-Ning

    2016-01-01

    Background Carotid artery stenosis is a major risk factor for ischemic stroke. Although carotid angioplasty and stenting using an embolic protection device has been introduced as a less invasive carotid revascularization approach, in-stent restenosis limits its long-term efficacy and safety. The objective of this study was to test the anti-restenosis effects of local stent-mediated delivery of the A20 gene in a porcine carotid artery model. Materials and methods The pCDNA3.1EHA20 was firmly attached onto stents that had been collagen coated and treated with N-succinimidyl-3-(2-pyridyldithiol)propionate solution and anti-DNA immunoglobulin fixation. Anti-restenosis effects of modified vs control (the bare-metal stent and pCDNA3.1 void vector) stents were assessed by Western blot and scanning electron microscopy, as well as by morphological and inflammatory reaction analyses. Results Stent-delivered A20 gene was locally expressed in porcine carotids in association with significantly greater extent of re-endothelialization at day 14 and of neointimal hyperplasia inhibition at 3 months than stenting without A20 gene expression. Conclusion The A20-gene-eluting stent inhibits neointimal hyperplasia while promoting re-endothelialization and therefore constitutes a novel potential alternative to prevent restenosis while minimizing complications. PMID:27540277

  9. A gene-centric study of common carotid artery remodelling

    NARCIS (Netherlands)

    Harrison, Seamus C.; Zabaneh, Delilah; Asselbergs, Folkert W.; Drenos, Fotios; Jones, Gregory T.; Shah, Sonia; Gertow, Karl; Sennblad, Bengt; Strawbridge, Rona J.; Gigante, Bruna; Holewijn, Suzanne; De Graaf, Jacqueline; Vermeulen, Sita; Folkersen, Lasse; van Rij, Andre M.; Baldassarre, Damiano; Veglia, Fabrizio; Talmud, Philippa J.; Deanfield, John E.; Agu, Obi; Kivimaki, Mika; Kumari, Meena; Bown, Matthew J.; Nyyssonen, Kristiina; Rauramaa, Rainer; Smit, Andries J.; Franco-Cereceda, Anders; Giral, Philippe; Mannarino, Elmo; Silveira, Angela; Syvanen, Ann-Christine; de Borst, Gert J.; van der Graaf, Yolanda; de Faire, Ulf; Baas, Annette F.; Blankensteijn, Jan D.; Wareham, Nicholas J.; Fowkes, Gerry; Tzoulaki, Ionna; Price, Jacqueline F.; Tremoli, Elena; Hingorani, Aroon D.; Eriksson, Per; Hamsten, Anders; Humphries, Steve E.

    2013-01-01

    Background: Expansive remodelling is the process of compensatory arterial enlargement in response to atherosclerotic stimuli. The genetic determinants of this process are poorly characterized. Methods: Genetic association analyses of inter-adventitial common carotid artery diameter (ICCAD) in the IM

  10. [An integrated segmentation method for 3D ultrasound carotid artery].

    Science.gov (United States)

    Yang, Xin; Wu, Huihui; Liu, Yang; Xu, Hongwei; Liang, Huageng; Cai, Wenjuan; Fang, Mengjie; Wang, Yujie

    2013-07-01

    An integrated segmentation method for 3D ultrasound carotid artery was proposed. 3D ultrasound image was sliced into transverse, coronal and sagittal 2D images on the carotid bifurcation point. Then, the three images were processed respectively, and the carotid artery contours and thickness were obtained finally. This paper tries to overcome the disadvantages of current computer aided diagnosis method, such as high computational complexity, easily introduced subjective errors et al. The proposed method could get the carotid artery overall information rapidly, accurately and completely. It could be transplanted into clinical usage for atherosclerosis diagnosis and prevention. PMID:24195385

  11. Carotid artery revascularization : Surgical and endovascular developments

    OpenAIRE

    de Borst, G. J.

    2007-01-01

    Carotid artery revascularization. Surgical and endovascular developments. Stroke is among the most disabling chronic diseases and the third major cause of death in the Western world. In the Netherlands around 12 per 1000 inhabitants suffers a stroke, and in 2005 over 10.000 people died as a result of stroke representing 7.6% of all deaths. In 10-20% of patients stroke is heralded by transient cerebral deficit. These harbingers of stroke allow a certain amount of time to search for the cause o...

  12. Pulse Wave Velocity in the Carotid Artery

    DEFF Research Database (Denmark)

    Sørensen, Gertrud Laura; Jensen, Julie Brinck; Udesen, Jesper; Holfort, Iben Kraglund; Jensen, Jørgen Arendt

    The pulse wave velocity (PWV) in the carotid artery (CA) has been estimated based on ultrasound data collected by the experimental scanner RASMUS at DTU. Data is collected from one test subject using a frame rate (FR) of 4000 Hz. The influence of FRs is also investigated. The PWV is calculated from...... distension wave forms (DWF) estimated using cross-correlation. The obtained velocities give results in the area between 3-4 m/s, and the deviations between estimated PWV from two beats of a pulse are around 10%. The results indicate that the method presented is applicable for detecting the local PWV...

  13. Congenital Absence of the Internal Carotid Artery

    International Nuclear Information System (INIS)

    We report three cases of congenital absence of an internal carotid artery (ICA), diagnosed incidentally by digital subtraction angiography. The analysis of the cases is based on the classification of segmental ICA agenesis proposed by Lasjaunias and Berenstein. Usually the patients with this rare vascular anomaly are asymptomatic; some may have symptoms related to cerebrovascular insufficiency, compression by enlarged intracranial collateral vessels, or complications associated with cerebral aneurysms. Diagnosis of congenital absence of ICA is made by skull base computed tomography (CT) scan, CT and magnetic resonance angiography, and conventional or digital subtraction angiography

  14. Common Carotid Artery Occlusion: A Case Series

    OpenAIRE

    Zoltán Bajkó; Rodica Bălaşa; Anca Moţăţăianu; Smaranda Maier; Octavia Claudia Chebuţ; Szabolcs Szatmári

    2013-01-01

    Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Paten...

  15. Syncope in Patient with Bilateral Severe Internal Carotid Arteries Stenosis/Near Occlusion: A Case Report and Literature Review

    Science.gov (United States)

    Miran, Muhammad Shah; Suri, M. Fareed K.; Qureshi, Mushtaq H.; Ahmad, Aamir; Suri, Mariam K.; Basreen, Rabia; Qureshi, Adnan I.

    2016-01-01

    Background Syncope is commonly worked up for carotid stenosis, but only rarely attributed to it. Considering paucity of such cases in literature, we report a case and discuss the pathophysiology. Design/methods We report a patient with high-grade bilateral severe internal carotid artery (ICA) stenosis who presented with syncopal episodes in the absence of stroke, orthostatic hypotension, significant cardiovascular disease, or vasovagal etiology. We reviewed all literature pertaining to syncope secondary to carotid stenosis and other cerebrovascular disease. Results A 67-year-old man presented with two brief syncopal episodes. History and physical examination was not suggestive of seizure or vasovagal syncope. Other workup was negative for any stroke or syncope secondary to cardiac or vasovagal etiology. Magnetic resonance angiography (MRA) revealed bilateral ICA severe stenosis. This was confirmed by transfemoral carotid vessels angiography. Internal carotid angioplasty and stenting was performed on one side. After this, the patient remained asymptomatic. After one month, carotid endarterectomy (CEA) of contralateral side was performed. Patient remained symptom free after that. On review of literature, we identified only 12 cases of syncope attributable to carotid stenosis and reviewed 24 cases attributable to other cerebrovascular disease. Conclusion Syncope secondary to carotid stenosis, especially in the absence of any focal ischemic events is rare. It can only be expected in those patients who have bilateral hemodynamically significant carotid disease, which is unlikely in the absence of any focal ischemic events. PMID:27403223

  16. Recent concepts in the management of extracranial carotid stenosis: Carotid endarterectomy versus carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Jeyaraj D Pandian

    2011-01-01

    Full Text Available Carotid stenosis is seen in 10% of patients with ischemic stroke, and carotid endarterectomy (CEA and carotid artery stenting (CAS are the two invasive treatments options available. Pooled analysis of the three largest randomized trials of CEA involving more than 3000 symptomatic patients estimated 30-day stroke and death rate at 7.1% after CEA. Some subgroups among the symptomatic patients appeared to have more benefit from CEA. These include patients aged 75 years or more, patients with ulcerated plaques, and patients with recent transient ischemic attacks within 2 weeks of randomization. Selection of asymptomatic patients for carotid revascularization should be guided by an assessment of comorbid conditions, life expectancy, and other individual factors, and should include a thorough discussion of the risks and benefits of the procedure with an understanding of patient preferences. The recent trials comparing CEA with CAS has not established its superiority over CEA. The carotid revascularization endarterectomy versus stenting (CREST study showed that CAS is still associated with a higher periprocedural risk of stroke or death than CEA. In patients over 70 years of age, CEA is clearly superior to CAS. The increased risk of nonfatal myocardial infarction in the CREST group subjected to CEA clearly suggests that patients being considered for CEA or CAS require a careful preliminary cardiac evaluation. CAS can be justified for patients whose medical comorbidities or cervical anatomy make them questionable candidates for CEA. The benefit of revascularization by either method versus modern aggressive medical therapy has not been established for patients with asymptomatic carotid stenosis.

  17. Carotid Artery Sonography Findings in 291 Patients Undergoing Cabg

    Directory of Open Access Journals (Sweden)

    HR Dehghan

    2006-07-01

    Full Text Available Introduction: Doppler ultrasonography (DUS is the most preferable method for screening of carotid artery disease in patients undergoing CABG. The purpose of this study was to investigate the frequency of carotid artery disease and determine the relation between known risk factors of atherosclerosis and rate of carotid artery narrowing in order to identify high-risk groups among patients scheduled for isolated elective coronary artery bypass grafting (CABG procedures. Methods: Two-hundred ninety-one patients (222 males and 69 females undergoing isolated coronary artery bypass grafting were preoperatively evaluated by carotid artery Doppler ultrasomography and the morphology of carotid artery was determined. Age, sex, cervical bruit, diabetes mellitus (DM, hypertension, hyperlipidemia, smoking, history of cerebrovascular event (CVE and coronary angiographic findings were investigated to define the high-risk group for carotid artery disease. Data were analyzed by SPSS software and P60 years (P=0.84, female sex (P=0.730, and left main coronary disease (P=0.390 were not identified as high-risk factors for carotid artery stenosis greater than 50%. But positive MI history (P=0.025, and cervical bruit (P=0.002, were significantly related to 50% carotid artery stenosis. Conclusion: Based on the results of this study, we can not suggest DUS as a routine screening method in all patients undergoing CABG, except for patients with history of MI and cervical bruit. Another important finding was that 56.4% of patients posted for CABG had different degrees of carotid artery stenosis which requires a long term CVA prophylaxis program.

  18. High Resolution Contrast-enhanced MRA in the Evaluation of Rabbit Carotid Artery

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Introduction:Accurate lumen definition of carotid artery is crucial for determining patient treatment, because a 70% or greater stenosis of a carotid artery will benefit from carotid endarterectomy to reduce the incidence of stroke[1].

  19. The Use of Carotid Artery Ultrasonography in Different Clinical Conditions

    OpenAIRE

    Gasparyan, Armen Yuri

    2009-01-01

    B-mode ultrasonography of the carotid artery is a non-invasive, informative and reproducible technique used for the assessment of prevalence and course of atherosclerosis in a variety of clinical conditions. Visualization of intima-media complex, atherosclerotic plaques, rough arterial wall and calcifications of the carotid artery may be useful for the assessment of atherosclerotic burden. The latter was confirmed in a recent consensus statement of the American Society of Echocardiography. De...

  20. Internal carotid-cerebellar artery anastomosis. So-called persistent trigeminal artery variant

    Energy Technology Data Exchange (ETDEWEB)

    Tanohata, Kazunori; Maehara, Tadayuki; Noda, Masanobu; Katoh, Hiromi

    1987-09-01

    Five cases of internal carotid-cerebellar artery anastomosis are presented. These anomalous vessels are identical to the so-called persistent trigeminal artery variant (PTAV). In our cases, two superior cerebellar arteries (SCAs), two anterior inferior cerebellar arteries (AICAs) and one posterior inferior cerebellar artery (PICA) arose from the precavernous segment of the internal carotid artery. We discuss the embryolgical and neuroradiological aspects of this anomaly.

  1. Surgery efficacy assessment at carotid artery stenosis using ultrasound duplex scanning

    International Nuclear Information System (INIS)

    Sixty-two patients aged 43-84 with high-grade carotid stenosis who in 2003-2011 were performed carotid angioplasty and stent grafting (CAS), of them in 5 with carotid endarterectomy, were investigated. According to the protocol, ultrasound investigation was performed one week before the surgery, during week 1 after CAS and 6-8 months later

  2. Standardization of the reports for carotid artery stenting

    International Nuclear Information System (INIS)

    Objective: Stroke is one of the leading causes of death. Carotid occlusive disease is responsible for 25% of the ischemic strokes. Surgical carotid endarterectomy has been accepted as the best management for the extracranial caroid occlusive disease. However, in recent years, with the development of the endovascular technology, carotid artery stenting becomes more and more popular accompanied by increase of articles in this field correspondingly. The practical difficulty exists in comparison between the carotid stenting and endarterectomy through randomized controlled trials. Standardized report including trial design, patient selection, outcomes, statistical disposition thus become extremely necessary. This article gives a detailed description concerning about the patient selection, pretreatment evaluation, treatment description, curative effect evaluation and complications of carotid artery stenting. The purpose of this article is to standardize the reports of carotid stenting so that the descriptive and statistical data from different authors and agents can be compared. (authors)

  3. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  4. Angiotensin Ⅱ type 2 receptor gene mediated by the tetracycline-regulatable system inhibits neointimal hyperplasia in rat carotid arteries after balloon angioplasty%血管紧张素Ⅱ2型受体在体可调控表达对大鼠颈动脉新生内膜增生的影响

    Institute of Scientific and Technical Information of China (English)

    苗莉; 罗先润; 景涛; 张辉; 刘安丰; 娄云霄; 何国祥

    2011-01-01

    Objective Transducing the angiotensin Ⅱ type 2 receptor (AT2R) gene into rat balloon injury carotid arteries can attenuate neointimal hyperplasia, but how to regulate the expression of the AT2.R gene according to our need is very important in utilizing transgenie technology. The purpose of the current study is to investigate the effects of the AT2R gene medicated by the tetracy-cline regulatable system on neointimal hyperplasia in rat carotid arteries after balloon angioplasty. Methods After establishment of the rat model of carotid balloon injury restenosis, we locally perfused into the rat carotid arteries PBS (the control group), mesenchy-mal stem cells (the MSC group) or MSC/AT2R (the MSC/AT2R group) with AT2R medicated by the tetracycline regulatable system, the latter again subdivided into a doxycycline administration (Dox) and non-doxycycline Dox administration (non-Dox) group. At 14 and 28 days after the operation, we evaluated the expression of AT2R by immunohistochemistry and RT-PCR and measured the neointi-ma/media (I/M) area ratio was by morphometric analysis. Results In the MSC/AT2R + Dox group, the expressions of AT2R mRNA and protein in the neointima were significantly up-regulated from day 14 to 28 after injury (P <0.01), and the I/M ratio significantly reduced (P<0.01). The transplanted MSC showed no obvious effect on the neointimal hyperplasia. Conclusion The expression of the AT2R gene can be regulated efficiently in vivo by local delivery of MSC with dual-stable expression of the AT2R gene, and thus inhibit neointimal hyperplasia.%目的 血管紧张素Ⅱ2型受体(angiotensinⅡtype 2 receptor,AT2R)基因转染可减轻血管损伤后新生内膜的过度增生,但如何主动调控转入体内基因的表达有着重要的临床意义.文中以四环素可调控系统下的AT2R基因转染的骨髓间充质干细胞(mesenchymal stem cell,MSC)为载体,探讨AT2R在体可调控表达及对大鼠颈动脉新生内膜的影响.方法 大鼠

  5. Angiographic features of unilateral nonbifurcating cervical carotid artery: A case report

    International Nuclear Information System (INIS)

    Nonbifurcating cervical carotid artery is a rare anomaly of the common carotid artery (CCA), in which the branches of the external carotid artery (ECA) arise directly from the CCA or proximal internal carotid artery without bifurcation, and therefore there is no proximal main trunk of the ECA. We report a unilateral nonbifurcating cervical carotid artery of a 67-year-old woman, incidentally found during cerebral aneurismal treatment

  6. Angiographic features of unilateral nonbifurcating cervical carotid artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    En, Na Lae [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Seung Koo [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Nonbifurcating cervical carotid artery is a rare anomaly of the common carotid artery (CCA), in which the branches of the external carotid artery (ECA) arise directly from the CCA or proximal internal carotid artery without bifurcation, and therefore there is no proximal main trunk of the ECA. We report a unilateral nonbifurcating cervical carotid artery of a 67-year-old woman, incidentally found during cerebral aneurismal treatment.

  7. Cognitive changes after carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Struffert, T.; Krick, C.; Backens, M. [University of the Saarland, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Supprian, T.; Falkai, P.; Reith, W. [University of the Saarland, Clinic for Psychiatry and Psychotherapy, Homburg (Germany)

    2006-05-15

    We aimed to test changes in cognitive performance after carotid artery stenting (CAS). Ten patients were neuropsychologically tested at least 24 h before and 48 h after CAS. To diminish thromboembolic events, we used a proximal protection device. The following neuropsychological tests were selected: The Mini Mental State Examination (MMSE), symbol digit test and subtests of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery (verbal fluency, constructional practice, word list memory and delayed recall). Affective state was determined by the Beck Depression Score (BDS). No patient suffered from depression (BDS <1) or dementia (MMSE 29.9{+-}1.5). Nine of the ten patients (P=0.12) showed increased speed in the Number Connection Test (NCT) (corresponding to trail making test). Most patients showed better or similar results concerning delayed recall (P=0.31). No change was observed in the symbol digit test, word list memory, verbal fluency or constructional practice. Better results concerning NCT and delayed recall after carotid stenting might be due to improved brain perfusion. After CAS, cognitive and memory performance seem to improve. Further studies with different time intervals and more refined testing, as well as perfusion-weighted imaging, are needed. (orig.)

  8. Cognitive changes after carotid artery stenting

    International Nuclear Information System (INIS)

    We aimed to test changes in cognitive performance after carotid artery stenting (CAS). Ten patients were neuropsychologically tested at least 24 h before and 48 h after CAS. To diminish thromboembolic events, we used a proximal protection device. The following neuropsychological tests were selected: The Mini Mental State Examination (MMSE), symbol digit test and subtests of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery (verbal fluency, constructional practice, word list memory and delayed recall). Affective state was determined by the Beck Depression Score (BDS). No patient suffered from depression (BDS <1) or dementia (MMSE 29.9±1.5). Nine of the ten patients (P=0.12) showed increased speed in the Number Connection Test (NCT) (corresponding to trail making test). Most patients showed better or similar results concerning delayed recall (P=0.31). No change was observed in the symbol digit test, word list memory, verbal fluency or constructional practice. Better results concerning NCT and delayed recall after carotid stenting might be due to improved brain perfusion. After CAS, cognitive and memory performance seem to improve. Further studies with different time intervals and more refined testing, as well as perfusion-weighted imaging, are needed. (orig.)

  9. Common carotid artery intima-media thickness, carotid plaques, and walking speed.

    OpenAIRE

    Elbaz, Alexis; Ripert, Mahaut; Tavernier, Béatrice; Février, Benoît; Zureik, Mahmoud; Gariépy, Jérôme; Alpérovitch, Annick; Tzourio, Christophe

    2005-01-01

    BACKGROUND AND PURPOSE: Gait dysfunction is an important cause of disability among the elderly and may be, in part, of vascular origin. We studied the association between carotid ultrasound parameters and measures of gait and balance in subjects 65 to 85 years of age who participated in the baseline phase of the Three-City Study in the Dijon center. METHODS: The study population comprised 2572 noninstitutionalized individuals. Carotid plaques and common carotid artery intima-media thickness (...

  10. Surgical technique of carotid endarterectomy for patients with high cervical internal carotid artery stenosis

    International Nuclear Information System (INIS)

    We retrospectively examined both the incidence of newly detected hyperintense areas using diffusion-weighted MR images (DWI-HIA) and postoperative complications after carotid endarterectomy (CEA) for patients with high cervical internal carotid artery (ICA) stenosis. Among 39 patients who underwent CEA between January 2001 and October 2006, 10 showed high cervical ICA stenosis on the preoperative carotid angiogram. CEA was successfully performed on 9 patients with oral intubation and 1 patient with nasal intubation under general anesthesia. Transient hypoglossal nerve palsy was seen in 1 patient and wound hematoma in 1 patient. Mortality and morbidity were zero at 1 month after CEA. In 3 of 10 patients (30%), asymptomatic small DWI-HIAs were detected postoperatively. Gentle manipulation of the internal carotid artery is essential for high cervical carotid artery stenosis to prevent embolic complication after CEA. (author)

  11. Ultrasound Common Carotid Artery Segmentation Based on Active Shape Model

    OpenAIRE

    Xin Yang; Jiaoying Jin; Mengling Xu; Huihui Wu; Wanji He; Ming Yuchi; Mingyue Ding

    2013-01-01

    Carotid atherosclerosis is a major reason of stroke, a leading cause of death and disability. In this paper, a segmentation method based on Active Shape Model (ASM) is developed and evaluated to outline common carotid artery (CCA) for carotid atherosclerosis computer-aided evaluation and diagnosis. The proposed method is used to segment both media-adventitia-boundary (MAB) and lumen-intima-boundary (LIB) on transverse views slices from three-dimensional ultrasound (3D US) images. The data set...

  12. Helical CT evaluation of internal carotid artery stenoses

    International Nuclear Information System (INIS)

    To determine the utility of helical CT angiography in the evaluation of carotid artery stenoses, helical CT images (reconstructed three-dimensional images, reconstructed multiplanar images, and two-dimensional axial images) obtained from 60 patients were compared with images obtained using conventional angiography. Based on conventional angiographic criteria, 22 arteries had no stenosis, 26 had mild stenosis. 69 had severe stenosis, and 3 were occluded. All carotid bifurcations were clearly identified on helical CT scanning and there were no complications. There were no motion artifacts due to the short examination time. In normal arteries, reconstructed three-dimensional images provided accurate anatomic depiction of the carotid bifurcation. Calcification was present at the stenotic lesion in 52 arteries. In 43 arteries in which the stenotic lesion was free of calcification, the degree of carotid stenosis determined using reconstructed three-dimensional images correlated with that determined using conventional angiography. In 19 of 52 arteries with calcification at the stenotic lesion, the calcification was focal and did not obscure the vessel lumen significantly when viewed from multiple angles. In the other 33 arteries, the calcification was dense and/or circumferential, making it difficult to evaluate the axial images allowed evaluation of the vessel lumen in the area of calcification, and the degree of stenosis was similar to that determined by conventional angiography. In 3 arteries, occlusion of the internal carotid artery was seen in reconstructed three-dimensional images and was confirmed by conventional angiography. (K.H.)

  13. Helical CT evaluation of internal carotid artery stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Akiyama, Yoshinori; Imakita, Satoshi; Suzuki, Susumu; Yamamoto, Satoshi; Tsukahara, Tetsuya; Hashimoto, Nobuo [National Cardiovascular Center, Suita, Osaka (Japan)

    1997-06-01

    To determine the utility of helical CT angiography in the evaluation of carotid artery stenoses, helical CT images (reconstructed three-dimensional images, reconstructed multiplanar images, and two-dimensional axial images) obtained from 60 patients were compared with images obtained using conventional angiography. Based on conventional angiographic criteria, 22 arteries had no stenosis, 26 had mild stenosis. 69 had severe stenosis, and 3 were occluded. All carotid bifurcations were clearly identified on helical CT scanning and there were no complications. There were no motion artifacts due to the short examination time. In normal arteries, reconstructed three-dimensional images provided accurate anatomic depiction of the carotid bifurcation. Calcification was present at the stenotic lesion in 52 arteries. In 43 arteries in which the stenotic lesion was free of calcification, the degree of carotid stenosis determined using reconstructed three-dimensional images correlated with that determined using conventional angiography. In 19 of 52 arteries with calcification at the stenotic lesion, the calcification was focal and did not obscure the vessel lumen significantly when viewed from multiple angles. In the other 33 arteries, the calcification was dense and/or circumferential, making it difficult to evaluate the axial images allowed evaluation of the vessel lumen in the area of calcification, and the degree of stenosis was similar to that determined by conventional angiography. In 3 arteries, occlusion of the internal carotid artery was seen in reconstructed three-dimensional images and was confirmed by conventional angiography. (K.H.)

  14. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  15. Occlusion of Internal Carotid Artery in Kimura's Disease

    OpenAIRE

    Node Yoji; Tomonori Tamaki

    2010-01-01

    We describe a unique case of Kimura's disease in which cerebral infarction was caused by occlusion of the right internal carotid artery. A 25-year-old man with Kimura's disease was admitted to our hospital because of left hemiparesis. Computed tomography and magnetic resonance imaging of the head showed infarction in the right frontal and temporal lobes. Cerebral angiography demonstrated right internal carotid artery occlusion affecting the C1 segment, with moyamoya-like collateral vessels ar...

  16. Evaluation of Computer-Assisted Quantification of Carotid Artery Stenosis

    OpenAIRE

    Biermann, Christina; Tsiflikas, Ilias; Thomas, Christoph; Kasperek, Bernadette; Heuschmid, Martin; Claussen, Claus D

    2011-01-01

    The purpose of this study was to evaluate the influence of advanced software assistance on the assessment of carotid artery stenosis; particularly, the inter-observer variability of readers with different level of experience is to be investigated. Forty patients with suspected carotid artery stenosis received head and neck dual-energy CT angiography as part of their pre-interventional workup. Four blinded readers with different levels of experience performed standard imaging interpretation. A...

  17. Is Acute Carotid Artery Stent Thrombosis an Avoidable Complication?

    Science.gov (United States)

    Köklü, Erkan; Yüksel, İsa Öner; Bayar, Nermin; Arslan, Şakir

    2015-10-01

    The most serious complication of carotid artery stenting (CAS) is acute carotid artery stent thrombosis (ACAST). ACAST is a very rare complication, but it may lead to dramatic and catastrophic consequences. The most important cause is inadequate or ineffective antiaggregant therapy. It is very important to identify, before CAS, those patients who might be candidates for ACAST and to start antiplatelet therapy for them. Testing patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may prevent this complication. PMID:26303788

  18. Mycotic pseudo-aneurysm of the extracranial carotid artery.

    Science.gov (United States)

    Desimpelaere, J; Seynaeve, P; Kockx, M; Appel, B; Gyselinck, J; Mortelmans, L

    1997-08-01

    A rare case of mycotic pseudo-aneurysm of the common carotid artery as a complication in an immunosuppressed paediatric patient is presented. Treatment of pseudo-aneurysms of the common carotid artery is generally considered to be an emergency, necessitating quick and accurate diagnosis. In patients with septicemia, angiography has to be avoided. We were able to provide the surgeon with the exact diagnosis and accurate topographical information with helical CT with 3D reformation. PMID:9351308

  19. Diagnosis of carotid artery disease by CT scan. Intravenous CT carotid-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kuriyama, Y.; Sawada, T.; Naito, H.; Karasawa, J. (National Cardiovascular Center, Osaka (Japan))

    1981-09-01

    Non-invasive methods, such as radioisotope angiography, oculoplethsmography, and ultrasonic Doppler flowmetry, are used for the detection of caroid artery lesion. However, these methods are qualitative, and diagnostic accuracies are inferior to arteriography. On the other hand arterography needs catheterization. So we tried to use CT scan and intravenous contrast enhancement for the diagnosis of carotid artery disease. A CT/T scanner (X-2) was used, which enabled to produce computer reconstruction image of the carotid artery by use of the arrange program. 12 sequential axial images of the neck (between heights of C2 and C5) were obtained before and during infusion of contrast material. Analysis of sequential axial images and reformatted images were obtained in patients with cerebrovascular disease. Carotid arteriography were made in 53 arteries, lesions with stenosis and/or occlusion were demonstrated in 26/53 arteries. Intravenous CT carotid-angiography revealed lesions with stenosis and/or occlusion in 25/53 arteries. Results of statistical analysis were as follows; overall diagnostic accuracy 52/53 (98%), diagnostic sensitivity 25/26 (96%) and diagnostic specificity 27/27 (100%), respectively. Moreover, intravenous CT carotid-angiography provided following benefits beyond arteriography. 1) Minimal calcification of the carotid wall and precise localisation of atheromatous plaque could be detected. 2) Patent arterial lumen above the occluded lesion could be found out. 3) CT carotid-angiography would be suitable for the follow-up study after carotid endoarterectomy because of the unneccessity of catheterization. 4) Thrombus formation in the internal jugular vein could be grasped.

  20. Carotid Artery Management in Head and Neck Surgery

    Directory of Open Access Journals (Sweden)

    Murat Haluk Özkul

    2014-06-01

    Full Text Available Prevention and management of intraoperative and postoperative bleeding are of a great importance in performing successful head and neck surgery. Since the carotid artery is the major source of cerebral vascular supply, the management of carotid artery diseases including replacement, when needed, necessitates special knowledge and skill as well as experience. Delayed postoperative hemorrhage usually comes from carotid artery due to increasing frequency of radiotherapy treatment of head and neck cancers nowadays. This is the most catastrophic complication of the head and neck surgery. Carotid resection can be planned as part of surgical treatment or salvage. Carotid resection is performed mostly to salvage patients when radiotherapy and chemotherapy are ineffective and less for carotid invasion caused by either direct extension of a malign tumor originating from the nasopharynx and oropharynx or extracapsular invasion of advanced jugular node metastasis. The purpose of this presentation was to enlighten the readers about carotid artery problems and management emphasizing the importance of preoperative evaluation. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 71-4

  1. Carotid artery stenting versus endarterectomy: a systematic review.

    Science.gov (United States)

    Gahremanpour, Amir; Perin, Emerson C; Silva, Guilherme

    2012-01-01

    For about 2 decades, investigators have been comparing carotid endarterectomy with carotid artery stenting in regard to their effectiveness and safety in treating carotid artery stenosis. We conducted a systematic review to summarize and appraise the available evidence provided by randomized trials, meta-analyses, and registries comparing the clinical outcomes of the 2 procedures. We searched the MEDLINE, SciVerse Scopus, and Cochrane databases and the bibliographies of pertinent textbooks and articles to identify these studies. The results of clinical trials and, consequently, the meta-analyses of those trials produced conflicting results regarding the comparative effectiveness and safety of carotid endarterectomy and carotid stenting. These conflicting results arose because of differences in patient population, trial design, outcome measures, and variability among centers in the endovascular devices used and in operator skills. Careful appraisal of the trials and meta-analyses, particularly the most recent and largest National Institutes of Health-sponsored trial (the Carotid Revascularization Endarterectomy vs Stenting Trial [CREST]), showed that carotid stenting and endarterectomy were associated with similar rates of death and disabling stroke. Within the 30-day periprocedural period, carotid stenting was associated with higher risks of stroke, especially for patients aged >70 years, whereas carotid endarterectomy was associated with a higher risk of myocardial infarction. The slightly higher cost of stenting compared with endarterectomy was within an acceptable range by cost-effectiveness standards. We conclude that carotid artery stenting is an equivalent alternative to carotid endarterectomy when patient age and anatomy, surgical risk, and operator experience are considered in the choice of treatment approach. PMID:22949763

  2. Carotid artery stenosis. Current state of therapy; Karotisstenose. Aktueller Stand der Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, K.I.; Papanagiotou, P.; Zimmer, A.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Schaefers, H.J. [Universitaetsklinikum des Saarlandes, Klinik fuer Thorax- und Herz-Gefaess-Chirurgie, Homburg/Saar (Germany)

    2010-07-15

    Ipsilateral occlusive or embolizing carotid artery stenoses are found in 20-30% of all cases of ischemic stroke. Several randomized studies revealed endarterectomy to be the gold standard in the therapy of severe symptomatic (NASCET, ESCT) and to some extent of asymptomatic carotid stenoses (ACAS, ACST). Stent angioplasty has been established as an alternative therapeutic option although non-inferiority of this procedure has not yet been proven. We provide an overview of both procedures as well of the state of current trials. (orig.) [German] Okkludierende oder embolisierende Stenosen der A. carotis interna sind in 20-30% der Faelle fuer einen ipsilateralen ischaemischen Schlaganfall verantwortlich. Nach Abschluss mehrerer randomisierter Studien erscheint die Karotisendarteriektomie als Therapie der Wahl bei hochgradigen symptomatischen (NASCET, ESCT) und z. T. auch asymptomatischen Stenosen (ACAS, ACST). Seit einigen Jahren hat sich die (Stent-)Angioplastie zunehmend als Therapiealternative etabliert, auch wenn die bislang veroeffentlichten Studien die Gleichwertigkeit beider Verfahren noch nicht zeigen konnten. Wir geben einen Ueberblick ueber beide Verfahren sowie ueber die derzeitige Studienlage. (orig.)

  3. Deep arterial injury during experimental angioplasty: relation to a positive indium-111-labeled platelet scintigram, quantitative platelet deposition and mural thrombosis

    International Nuclear Information System (INIS)

    Although it is not clear why coronary occlusion and restenosis occur after successful coronary angioplasty, factors related to the procedure may influence early and late results. The possible adverse effects of a medial tear documented histologically and produced during balloon angioplasty of the common carotid arteries were studied in 30 fully heparinized (100 U/kg body weight) normal pigs. Scanning electron microscopy showed endothelial denudation and extensive platelet deposition in all dilated arterial segments. Visible macroscopic mural thrombus was present within an hour of the procedure in 29 (91%) of the 32 arteries that had a medial tear documented by histologic study; the tear produced an indium-111-labeled platelet deposition of 116.4 +/- 26.5 X 10(6)/cm2 (mean +/- SE) and total thrombotic occlusion in 2 arteries (4%). None of the 24 arteries without a medial tear had a thrombus, and the mean platelet deposition in that group was 7.0 +/- 0.5 X 10(6)/cm2 (p less than 0.0008). In 12 pigs scanned with a gamma camera, visible thrombus was associated with platelet deposition in excess of 20 X 10(6)/cm2 in 12 arteries, 9 of which had a positive indium-111-labeled platelet scintigram. Thus, arterial angioplasty causes deep arterial injury, which appears to be a major cause of mural thrombosis, heavy platelet deposition, a positive indium-111-labeled platelet scintigram and acute arterial occlusion. A positive indium-111-labeled platelet scintigram was always associated with macroscopic thrombus of at least 20 > 10(6) platelets/cm2 and underlying deep arterial injury

  4. Innovations in Stroke Prevention: An Update on Carotid Stenting

    Medline Plus

    Full Text Available ... incision in the neck and many times general anesthesia. Carotid stent angioplasty is the topic of tonight, ... significant coronary artery disease. Again, many times general anesthesia is required, though we can do it under ...

  5. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Raul G. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurosurgery, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Neurocritical Care and Vascular Neurology Section, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States); Schwamm, Lee H.; Buonanno, Ferdinando S.; Koroshetz, Walter J. [Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Neurocritical Care and Vascular Neurology Section, Boston, MA (United States); Yoo, Albert J.; Rabinov, James D.; Pryor, Johnny C.; Hirsch, Joshua A. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurosurgery, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States)

    2008-04-15

    The use of coronary balloons in the cerebral vasculature is limited due to their poor trackability and increased risk of vessel injury. We report our experience using more compliant elastomer balloons for thrombus resistant to intraarterial (IA) pharmacological and mechanical thrombolysis in acute stroke. We retrospectively analyzed 12 consecutive patients with an occluded intracranial artery treated with angioplasty using a low-pressure elastomer balloon. Angiograms were graded according to the Thrombolysis in Cerebral Infarction (TICI) and Qureshi grading systems. Outcomes were categorized as independent (modified Rankin scale, mRS, score {<=}2), dependent (mRS score 3-5), or dead (mRS score 6). Included in the study were 12 patients (mean age 66{+-}17 years, range 31-88 years; mean baseline National Institutes of Health stroke scale score 17{+-}3, range 12-23). The occlusion sites were: internal carotid artery (ICA) terminus (five patients, including two concomitant cervical ICA occlusions), M1 segment (two patients), and basilar artery (two patients). Pharmacological treatment included intravenous (IV) t-PA only (two patients), IA urokinase only (nine patients), both IV t-PA and IA urokinase (one patient), and IV and/or IA eptifibatide (eight patients). Mean time to treatment was 5.9{+-}3.9 h (anterior circulation) and 11.0{+-}7.2 h (posterior circulation). Overall recanalization rate (TICI grade 2/3) was 91.6%. Procedure-related morbidity occurred in one patient (distal posterior inferior cerebellar artery embolus). There were no symptomatic hemorrhages. Outcomes at 90 days were independent (five patients), dependent (three patients) and dead (four patients, all due to progression of stroke with withdrawal of care). Angioplasty of acutely occluded intracranial arteries with low-pressure elastomer balloons results in high recanalization rates with an acceptable degree of safety. Prior use of thrombolytics may increase the chances of recanalization, and

  6. Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    Ze-Zhou; Song; Yan-Ming; Zhang

    2015-01-01

    The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

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    Lifescience Database Archive (English)

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  1. File list: Oth.CDV.50.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. Internal carotid artery bifurcation aneurysms. Surgical experience

    International Nuclear Information System (INIS)

    Internal carotid artery (ICA) bifurcation aneurysms are relatively uncommon and frequently rupture at a younger age compared to other intracranial aneurysms. We have treated a total of 999 patients for intracranial aneurysms, of whom 89 (8.9%) had ICA bifurcation aneurysms, and 42 of the 89 patients were 30 years of age or younger. The present study analyzed the clinical records of 70 patients with ICA bifurcation aneurysms treated from mid 1997 to mid 2003. Multiple aneurysms were present in 15 patients. Digital subtraction angiography films were studied in 55 patients to identify vasospasm and aneurysm projection. The aneurysm projected superiorly in most of these patients (37/55, 67.3%). We preferred to minimize frontal lobe retraction, so widely opened the sylvian fissure to approach the ICA bifurcation and aneurysm neck. Elective temporary clipping was employed before the final dissection and permanent clip application. Vasospasm was present in 24 (43.6%) of 55 patients. Forty-eight (68.6%) of the 70 patients had good outcome, 14 (20%) had poor outcome, and eight (11.4%) died. Patients with ICA bifurcation aneurysms tend to bleed at a much younger age compared to those with other intracranial aneurysms. Wide opening of the sylvian fissure and elective temporary clipping of the ICA reduces the risk of intraoperative rupture and perforator injury. Mortality was mainly due to poor clinical grade and intraoperative premature aneurysm rupture. (author)

  3. Diagnosis of carotid artery disease by CT scan

    International Nuclear Information System (INIS)

    Non-invasive methods, such as radioisotope angiography, oculoplethsmography, and ultrasonic Doppler flowmetry, are used for the detection of caroid artery lesion. However, these methods are qualitative, and diagnostic accuracies are inferior to arteriography. On the other hand arterography needs catheterization. So we tried to use CT scan and intravenous contrast enhancement for the diagnosis of carotid artery disease. A CT/T scanner (X-2) was used, which enabled to produce computer reconstruction image of the carotid artery by use of the arrange program. 12 sequential axial images of the neck (between heights of C2 and C5) were obtained before and during infusion of contrast material. Analysis of sequential axial images and reformatted images were obtaned in patients with cerebrovascular disease. Carotid arteriography were made in 53 arteries, lesions with stenosis and/or occlusion were demonstrated in 26/53 arteries. Intravenous CT cartid-angiography revealed lesions with stenosis and/or occlusion in 25/53 arteries. Results of statistical analysis were as follows; overall diagnostic accuracy 52/53 (98%), diag nostic sensitivity 25/26 (96%) and diagnostic specificity 27/27 (100%), respectively. Moreover, intravenous CT carotid-angiography provided following benefits beyond arteriography. 1) Minimal calcification of the carotid wall and precise localisation of atheromatous plaque could be detected. 2) Patent arterial lumen above the occluded lesion could be found out. 3) CT carotid-angiography would be suitable for the follow-up study after carotid endoarterectomy because of the unneccessity of catheterization. 4) Thrombus formation in the internal jugular vein could be grasped. (author)

  4. Persistent primitive trigeminal artery with cavernous carotid aneurysm

    International Nuclear Information System (INIS)

    A case of a 61 years old woman with persistent trigeminal artery associated with a giant carotid aneurysm is reported. It was studied with magnetic resonance and angiographic magnetic resonance. The angiographic and anatomic Saltzman classification and the frequent association of persistent trigeminal artery and vascular malformations were reviewed. (author)

  5. Low level termination of external carotid artery and its clinical significance: A case report

    Directory of Open Access Journals (Sweden)

    Surekha Devadasa Shetty

    2015-09-01

    Full Text Available The external carotid arterial system is a complex vascular system providing nourishment to the territorial areas of the head and neck. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries during carotid endarterectomy. Knowledge of anatomical variation of the external carotid artery is important in head and neck surgeries. Variations in the branching pattern of the external carotid artery are well known and documented. We report a rare case of low-level termination of the external carotid artery. It terminated by dividing into maxillary and superficial temporal arteries deep into the posterior belly of the digastric muscle, one inch below the angle of the mandible. The occipital and posterior auricular arteries arose from a common trunk given off by the external carotid artery. [Arch Clin Exp Surg 2015; 4(3.000: 160-163

  6. Determination of site-specific carotid-intima media thickness: common –carotid artery and carotid bifurcation in hypercholesterolemia patients

    OpenAIRE

    Perwaiz Khan, Samia; Gul, Pashmina; Khemani, Saleem; Yaqub, Zia

    2013-01-01

    Objective: To determine site specific carotid intima-media thickness: common–carotid artery and carotid bifurcation in hypercholesterolemia patients as a marker for atherosclerosis. Methods: Fifty patients with hypercholesterolemia and twenty controls were selected after getting informed consent regarding the investigation of carotid- intima media thickness by B-mode ultrasound. All the patients of hypercholesterolemia with LDL-C > 160mg/dL had family history of coronary artery diseases. This...

  7. Cardioembolic occlusion of the internal carotid artery presented with infarction in the posterior cerebral artery territory

    Institute of Scientific and Technical Information of China (English)

    XUE Su-fang; JIA Jian-ping

    2010-01-01

    @@ Posterior circulation stroke may rarely be associated with occlusive disease in the anterior circulation, such as in the context of a direct (fetal) origin of the posterior cerebral artery (PCA) from the internal carotid artery (ICA), or in the presence of a persistent trigeminal artery (PTA) or persistent hypoglossal artery (PHA).1,2

  8. Clinical observation of intraluminal stent angioplasty in the treatment of renal arterial stenoses

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical application of intraluminal stent angioplasty (PTRAS) in the treatment of renal arterial stenoses. Methods: A retrospective study was done in 28 patients with renal arterial stenoses. Primary renal artery stenting was performed in 28 consecutive patients (36 renal arteries). Blood pressure, serum creating, the number of anti-hypertensive medications were recorded at 1, 6, 12 month post stent angioplasty respectively. Arterial angiography was also taken 1 year later to evaluate the incidence of restenosis. Results: Technical success rate was 100% achieving in all patients without serious complications. Primary successful patently rate reached 82% (renal artery 86%), secondary successful rate was 89% (renal artery 90%). Systolic and diastolic blood pressure were reduced significantly (P<0.01) at 1,6,12 month after stent angioplasty comparing with baseline and clinical improvement (cured + improved) of hypertension reached 100%, 92.9%, 89.3% respectively. There were no significant differences between serum creatine level and the number of anti-hypertensive medications before and after stent angioplasty. One year later, 14.3% of all patients showed improvement of renal function, 64.3% remained in stabilization and 21.4% fell into deterioration. Angiographic restenosis was found in 3 cases one year after stent angioplasty. Complications included 1 hematoma at puncture site and 3 transient azotaemia. Conclusions: PTRAS can be performed safely with high technical success and beneficial to the majority of patients with hypertension or renal insufficiency and therefore it should be the first choice in treating renal arterial stenoses

  9. Decreased hyperintense vessels on FLAIR images after endovascular recanalization of symptomatic internal carotid artery occlusion

    International Nuclear Information System (INIS)

    Background and purpose: Hyperintense vessels (HV) on fluid-attenuated inversion recovery (FLAIR) images were assumed to be explained by slow antegrade or retrograde leptomeningeal collateral flow related to extracranial or intracranial artery steno-occlusion. The aim of this study was to investigate the effect of recanalization after endovascular therapy of symptomatic internal carotid artery (ICA) occlusion on the presence of HV. Methods: Eleven patients with symptomatic ICA occlusion were retrospectively enrolled. Changes in the HV on FLAIR images were examined in affected hemisphere of each patient after successful treatment with endovascular recanalization (angioplasty, n = 3; stent-assisted angioplasty, n = 8). The relationship between postoperative changes in the HV and Thrombolysis In Cerebral Ischemia (TICI) scale (I-III) was assessed. Results: After operation, HV of the 11 affected hemispheres were showed to be decreased (n = 3) or disappeared (n = 8) in treated side. The median interval between pre- and postoperative MRI examinations was 97.0 h (range, from 69. to 48.7 h). Of the 8 patients with disappeared HV, 7 achieved high TICI grade flow (III) and 1 had relatively low TICI grade flow (IIc) in treated side. However, all the 3 patients with decreased HV were found to be relatively low TICI grade flow (IIc). Conclusion: Our data indicate that endovascular recanalization of ICA occlusion was effective for decreasing HV. Postoperative decrease in HV can be considered as a marker for hemodynamic improvement.

  10. Carotid endarterectomy in patients with occlusion of the contralateral carotid artery. Perioperative risk and late results

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Rasmussen, L;

    1987-01-01

    . Compared with a complication rate of about 5% previously reported from this institution, this clearly indicates contralateral carotid occlusion as a major risk factor in carotid surgery. Though not statistically significant, patients with severely reduced cerebral perfusion pressure (CPP) had suffered more...... severe strokes when compared to patients with only minor reduction in CPP. In addition, the internal carotid artery blood flow following endarterectomy was significantly higher in the low pressure group (P less than 0.02). No patients were lost during follow-up, for a mean of 34 months. The cumulative...

  11. Adjuvant revascularization of intracranial artery occlusion with angioplasty and/or stenting

    International Nuclear Information System (INIS)

    In conjunction with intravenous and/or intra-arterial thrombolysis, adjuvant revascularization of intracranial artery occlusion by angioplasty vs. stenting remains controversial. We evaluated outcome in patients with intracranial occlusion after angioplasty and/or stenting. Thirty-three patients who underwent angioplasty or stenting (17 stenting and 16 angioplasty) for intracranial arterial occlusion during the past 5 years were enrolled from prospective neurointerventional database. We compared recanalization rate [defined as thrombolysis in myocardial infarction (TIMI) grade II/III flow], adverse events, and clinical outcome [modified Rankin scale (mRS) at 1 and 6 months]. We also tried to determine independent variables associated with clinical outcome. Median initial National Institutes of Health Stroke Scale (NIHSS) was 13 and median time to treatment was 12 h from symptom onset. The successful recanalization rate was mean 79%. Symptomatic hemorrhage occurred in 15% (5/33). Events (27%, 9/33) at 1 month included four deaths, four major, and one minor stroke. Good outcome (mRS ≤ 2) was achieved in 17 patients (52%) at 6 months and was significantly related to age, initial NIHSS, TIMI flow, and stenting on bivariate analysis. On multivariable analysis, stenting was the only variable significantly associated with a 6-month, good clinical outcome (OR, 14.48; 95% CI, 1.76 to 118.93; p = 0.013) Intracranial revascularization with angioplasty and/or stenting may improve the clinical outcome in selected patients with intracranial occlusion. Multiple factors are related to favorable clinical outcome. (orig.)

  12. Subintimal angioplasty for the treatment of long segment occlusion of superficial femoral artery: the midterm results

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical value of subintimal angioplasty in treating long segment occlusion of superficial femoral artery and to observe its midterm results. Methods: Subintimal angioplasty was performed in 45 patients with long segment occlusion of superficial femoral artery, whose clinical presentation was intermittent claudication or critical limb ischemia. The primary patency, limb salvage and factors influencing long-term patency were observed, and the clinical data were analyzed. Results: Of the total 45 cases, the subintimal angioplasty was successfully accomplished in 43. The success rate of antegrade approach technique via the superficial femoral artery was 80% (n=36), the occlusion was recanalized by using retrograde approach technique via ipsilateral popliteal artery in 7 case. The total technical success rate was 95.6%. The primary patency in 43 successful cases at 6, 12, 24 and 36 months was 85.7%, 69.0% 57.3% and 50.9%, respectively. No statistically significant difference in primary patency existed between the group of intermittent claudication and the group of critical limb ischemia (P>0.05). Statistically significant prediction factors for primary patency included the number of the run off vessels below the knee and the length of the occlusion (P<0.05). Conclusion: Subintimal angioplasty is an effective procedure for the treatment of long segment occlusions of superficial femoral artery with satisfactory mid-term results. (authors)

  13. An experimental study on the changes of the doppler patterns in the common carotid artery after clamping of the internal carotid artery

    International Nuclear Information System (INIS)

    Recently, duplex sonography has been used as a screening test for the evaluation of carotid arterial disease. If an occlusion of atherosclerosis is located at the bifurcation of the common carotid artery or the lower portion of the internal carotid artery, the luminal change may be directly visualized on high-resolution B-mode sonography or color-Doppler images. But when the lesion is located at the high cervical, petrous or cavernous protion of the internal carotid artery, it is difficult to directly visualize the lesion with the sonography. The purpose of this paper is to evaluate the indirect changes on the Doppler patterns of both common carotid arteries with clamping of an internal carotid artery. Thirty common carotid arteries in fifteen normal rabbits were examined with duplex ultrasonography using high-resolution real-time imaging and 7.5MHz pulsed-wave Doppler flow measurements with velocity waveform analysis. Systolic velocity (SV) was 45.4 ± 8.4cm/sec, end-diastolic velocity (EDV) 15.3 ± 4.9cm/sec and resistative index (RI) 0.66 ± 0.08 in the common carotid artery before clamping of the internal carotid artery. SV was 26.3 ± 7.8cm/sec, EDV 6.0 ± 5.2cm/sec and RI 0.78 ± 0.18 in the ipsilateral common carotid artery and SV was 56.6 ± 13.0cm/sec, EDV 22.3 ± 8.2cm/sec and RI 0.61 ± 0.10 in the contralateral common carotid artery after clamping of the internal carotid artery. During clamping of the internal carotid artery, the difference between SV of bilateral common carotid arteries was 30.3 ± 13.8cm/sec and EDV 16.3 ± 9.2cm/sec. There was no difference of the velocity patterns of the common carotid artery between preclamping and declamping of the internal carotid artery. In conclusion, lower SV and EDV in a common carotid artery than that in contralateral side on Doppler patterns strongly suggests an occlusion of ipsilateral internal carotid artery

  14. Persistent trigeminal artery arising from the arterial ring/fenestration of the cavernous segment of the internal carotid artery.

    Science.gov (United States)

    Uchino, Akira; Saito, Naoko; Kurita, Hiroki; Ishihara, Shoichiro

    2012-09-01

    A persistent trigeminal artery (PTA) is the most common carotid-vertebrobasilar anastomosis, usually arising from the cavernous or precavernous segment of the internal carotid artery (ICA) and connecting to the distal basilar artery. There are two types of PTA, lateral and medial. We present the first case of a lateral-type PTA arising from the large arterial ring/fenestration of the cavernous segment of the left ICA with findings from both magnetic resonance angiography and selective catheter angiography. PMID:22215430

  15. AN INVESTIGATION OF RELATIONSHIP BETWEEN TONSILLOLITH AND CAROTID ARTERY CALCIFICATION ON PANORAMIC RADIOGRAPHY

    OpenAIRE

    Cakur, Binali; Yıldırım, Eren; Demirtaş, Ömer

    2015-01-01

    Aim: Carotid artery calcification can results in important vascular obstruction. It is reported that the combination of risk factors such as periodontitis, pulp stones contribute to carotid artery calcification. However in the literature, no study has yet investigated carotid artery calcification with respect to tonsillolith. The objective of this study was to investigate whether carotid artery calcification correlate with tonsillolith using dental panoramic radiography.Material and method: P...

  16. Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Yamei Cai; Xiaoming Wang; Xin Liu; Liting Cao

    2008-01-01

    BACKGROUND: Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease.OBJECTIVE: To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging.DESIGN, TIME AND SETTING: The present concurrent, non-randomized, controlled experiment was performed at the Departments of Neurology and Ultrasound, Affiliated Hospital of North Sichuan Medical College between November 2006 and August 2007.PARTICIPANTS: Fifty-five patients with cerebral infarction, consisting of 35 males and 20 females, aged 50-82 years, were admitted to the hospital between November 2006 and August 2007 and recruited for this study, An additional 30 subjects consisting of 18 males and 12 females, aged 47-78 years, that concurrently received a health examination at the same hospital, were also included as normal controls.METHODS: Intima-media thickness (IMT), plaque shape, size, and echo intensity of all subjects were detected by color Doppler flow imaging. Assessment criteria: IMT > 1.0 mm was considered to be intimal thickening, and IMT > 1.2 mm was determined to be formed atherosclerotic plaques. In the position of the largest plaque, the degree of carotid artery stenosis was determined by the following formula:(1-cross-sectional area of residual vascular luminal area/vascular cross-sectional area) x 100%. Less than 30% exhibited mild stenosis, 30%-40% moderate stenosis, and > 50% severe stenosis.MAIN OUTCOME MEASURES: IMT and the degree of carotid artery stenosis were evaluated by color Doppler flow imaging. The Mini-Mental State Examination (MMSE), as well as the clinical memory scale,was compared between patients with cerebral infarction and normal controls.RESULTS: In the cerebral

  17. MR-angiography of the carotid and vertebral artery

    International Nuclear Information System (INIS)

    Magnetic Resonance Angiography (MRA) is a new, noninvasive modality for evaluation of carotid and vertebral artery disease. At a field strength of 1.5 T subtraction of flowrephased and dephased images, to eliminate signal from stationary tissue, offers no significant advantage over computerized postprocessing of rephased images. In a protocol of 3D-gradient-echo-sequenzes, using gradient motion refocussing (GMR), 27 patients with evidence of carotid or vertebral artery disease have been examined by MRA in comparison to ultrasound. MRA displays the carotid and vertebral arteries up to the cricle of Willis. Within short examination times, the method is sensitive in the detection of disturbed hemodynamics, secondary to vessel disease. The specific, at that time is limited. MRA has great potential in the diagnoses of cerebrovascular disease. (orig.)

  18. Common carotid arterial thrombosis associated with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Hitoshi Nogami; Tsuneo Iiai; Satoshi Maruyama; Tatsuo Tani; Katsuyoshi Hatakeyama

    2007-01-01

    A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient's bowel disease.

  19. Associations between bicycling and carotid arterial stiffness in adolescents

    DEFF Research Database (Denmark)

    Ried-Larsen, M; Grøntved, A; Østergaard, Lars;

    2015-01-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European...... Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys...... using their bicycle every day of the week displayed a higher carotid arterial compliance {standard beta 0.47 [95% confidence interval (CI) 0.07-0.87]} and distension [standard beta 0.38 (95% CI -0.04 to 0.81)]. Boys using their bicycle every day of the week furthermore displayed a lower Young's elastic...

  20. File list: DNS.CDV.10.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available DNS.CDV.10.AllAg.Carotid_Arteries hg19 DNase-seq Cardiovascular Carotid Arteries ht...tp://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.CDV.10.AllAg.Carotid_Arteries.bed ...

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  4. File list: ALL.CDV.20.AllAg.Carotid_Arteries [Chip-atlas[Archive

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  5. File list: ALL.CDV.50.AllAg.Carotid_Arteries [Chip-atlas[Archive

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  6. File list: ALL.CDV.05.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  7. File list: DNS.CDV.50.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  8. Iliac artery myointimal hyperplasia in rabbits submitted to angioplasty and treated with Moringa oleifera

    Directory of Open Access Journals (Sweden)

    Jânio Cipriano Rolim

    2016-02-01

    Full Text Available Objective: to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. Methods : we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10 - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10 - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. Results : there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. Conclusion : there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.

  9. Measurement of carotid artery stenosis: correlation analysis between B-mode ultrasonography and contrast arteriography

    OpenAIRE

    Lee, Kyo Won; Park, Yang Jin; Rho, Young-Nam; Kim, Dong-Ik; Kim, Young-Wook

    2011-01-01

    Purpose To evaluate the efficacy of B-mode ultrasonography (US) in measurement of carotid stenosis% (CS%). Methods One hundred and thirth-three carotid arteries in 96 patients who underwent both carotid US and carotid arteriography (CA) were included in this retrospective study. To measure CS% on US, a cross sectional view of the most stenotic segment of the internal carotid artery was captured and residual diameter and original diameter of that segment were measured with electronic caliper o...

  10. Carotid Artery Doppler Assessment In Patients Accussed Of Strokes

    Directory of Open Access Journals (Sweden)

    H. Mazaher

    2005-08-01

    Full Text Available Carotid Doppler ultrasound assessment mostly indicated in patients accussed of TIAs or in younger patients with nonpersistant neurologic deficits. This assessment should be consisted of gray scale sonography, color Doppler Sonography, spectral Doppler sonography and power Doppler sonography. By gray scale sonography atherosclerotic plaques assessed from the point of Homogenousity, degree of echogenicity, surface regularity, calcification, length, Thichkness and sites of involvement. In color Doppler sonography hypoechoic Plaques which could not be identified in gray scale sonogarphy, arterial tortusity, Better and faster detection of Dis-turbed flow for flow spectrum analysis are assessed. Flow spectrum analysis and degree of stenosis in carotid arteries are assessed by Spectral Doppler sonography. Finally the main indication of carotid power Doppler sonography is differentiation Of high grade stenosis from occlusion.

  11. Improved circulation in ocular ischemic syndrome after carotid artery stenting

    Institute of Scientific and Technical Information of China (English)

    WANG Yan-ling; ZHAO Lu; LI Ming-ming

    2011-01-01

    Ocular ischemic syndrome is a chronic ischemic eye disease including a series of ischemic ocular and brain syndromes caused by carotid artery occlusion or stenosis.Because of the different degrees of ischemia,clinical manifestations of ocular ischemic syndrome are diverse,and it is difficult to diagnose in the initial stage.The main strategy to treat ocular ischemic syndrome is elimination of carotid stenosis.We presented a patient who recovered dramatically after carotid artery stenting.The pre-stenting arm-retinal circulation time of the patient's left eye was prolonged,and a large amount of microaneurysm appeared at the posterior polar and mid-peripheral aspects of the left retina.The post-stenting arm-retinal circulation time of the left eye decreased to 16.3 seconds,and the microaneurysm almost disappeared.

  12. Carotid artery reconstruction following resection during radical neck dissection

    OpenAIRE

    Soulier, Christian Jacques Gérard; Dulguerov, Pavel; Maurice, Jean Pierre; Allal, Abdelkarim Said; Faidutti, Bernard; Lehmann, Willy

    1998-01-01

    From 1972 to 1991, 7 patients with advanced cancer of the head and neck and nodal metastasis with capsular rupture underwent radical neck dissection and sacrifice of the carotid artery. Vascular reconstruction was performed with either an autologous venous (8 cases) or arterial (1 case) graft. In all patients, the postoperative course was uneventful without neurologic complications. One patient is alive 4 years after the procedure. Six patients expired after a mean survival of 20 months. The ...

  13. Assessment of carotid arteri calcification using 3D-CT angiography

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate carotid arteri calcifications using 3D-CT angiography. We performed a retrospective review of 181 patients referred for 64-slice multi-detector row computed tomography. Using curved multiplanar reformation (curved MPR) images of ZIOSOFT M900 QUADRA, we evaluated the distribution of calcifications around the carotid bifurcation. Among the 181 patients, 66 patients (36%) had arterial calcifications. The present study found that almost arterial calcifications localized at the carotid bifurcation. Furthermore, in the group with carotid arterial stenosis, we found arterial calcifications localized not only at the carotid bifurcation, but also at the distal side of internal carotid artery. Curved MPR imaging using 3D-CT angiography is a helpful tool for evaluating calcification of carotid arteries. (author)

  14. Estimation of Carotid Artery Pulse Wave Velocity by Doppler Ultrasonography

    Directory of Open Access Journals (Sweden)

    Mehdi Maerefat

    2009-06-01

    Full Text Available Background: Pulse wave velocity (PWV is widely used for estimating the stiffness of an artery. Various invasive and non-invasive methods have been developed to determine PWV over the years. In the present research, the non-invasive estimation of the PWV of large arteries was used as an index for arterial stiffness. Methods: A dynamic model based on the Navier-Stokes equations coupled to elasticity equations was introduced for the PWV in arteries with elastic walls. This system of equations was completed by clinical information obtained from the Doppler ultrasound images of the carotid artery of 40 healthy male volunteers. For this purpose, the Doppler ultrasound images were recorded and saved in a computer; and subsequently center-line blood velocity, arterial wall thickness, and arterial radius were measured by offline processing. Results: The results from the analytic solution of the completed equations showed that the mean value of PWV for the group of healthy volunteers was 2.35 m/s when the mean arterial radius was used as the neutral radius and 5.00 m/s when the end-diastole radius was used as the neutral radius. It is noteworthy that the latter value closely complies with that reported by other researchers. Conclusion: By applying this method, a non-invasive clinical and local evaluation of the common carotid artery stiffness via a Doppler ultrasound measurement will be possible.

  15. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

    Institute of Scientific and Technical Information of China (English)

    LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen

    2010-01-01

    Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.

  16. Carotid artery phantom designment and simulation using field II

    Science.gov (United States)

    Lin, Yuan; Yang, Xin; Ding, Mingyue

    2013-10-01

    Carotid atherosclerosis is the major cause of ischemic stroke, a leading cause of mortality and disability. Morphology and structure features of carotid plaques are the keys to identify plaques and monitoring the disease. Manually segmentation on the ultrasonic images to get the best-fitted actual size of the carotid plaques based on physicians personal experience, namely "gold standard", is a important step in the study of plaque size. However, it is difficult to qualitatively measure the segmentation error caused by the operator's subjective factors. In order to reduce the subjective factors, and the uncertainty factors of quantification, the experiments in this paper were carried out. In this study, we firstly designed a carotid artery phantom, and then use three different beam-forming algorithms of medical ultrasound to simulate the phantom. Finally obtained plaques areas were analyzed through manual segmentation on simulation images. We could (1) directly evaluate the different beam-forming algorithms for the ultrasound imaging simulation on the effect of carotid artery; (2) also analyze the sensitivity of detection on different size of plaques; (3) indirectly reflect the accuracy of the manual segmentation base on segmentation results the evaluation.

  17. Emergency revascularization of acute internal carotid artery occlusion: Follow the spike, it guides you.

    Science.gov (United States)

    Cohen, José E; Gomori, John M; Leker, Ronen R; Eichel, Roni; Itshayek, Eyal

    2016-07-01

    The present study sought to examine the incidence of the angiographic "spike sign" and to assess its predictive significance for achieving carotid revascularization in 54 patients with acute internal carotid artery (ICA) occlusions that required urgent endovascular revascularization. Clinical and imaging files of consecutive patients with ICA occlusion who were treated in a tertiary care academic medical center from 2011-2015 were retrospectively examined under Institutional Review Board approval with a waiver of the requirement for informed consent. All proximal ICA occlusions were treated by stent-assisted carotid angioplasty, and all distal embolic occlusions were managed with stent-assisted mechanical thrombectomy. The study included 24 patients with acute ICA occlusion (group 1) and 30 patients with tandem ICA-intracranial occlusions (group 2). The spike sign was seen in 16/24 patients in group 1 (67%), and successful ICA revascularization was achieved in 14/16 (88%). The sign was seen in 26/30 patients in group 2 (87%), and ICA revascularization was successful in all 26 (100%). The remaining 12 patients had no spike sign, and ICA revascularization was successful in only 7/12 (58%). The spike sign is a transient finding that represents the proximal patent remnant of the stenotic corridor in fresh clot. Acute ICA occlusion frequently leaves the spike sign as a marker of the recent thrombotic event. The spike vertex points to the "path of least resistance" for the guidewire to cross the occlusion and engage the true arterial lumen, a critical step during ICA endovascular revascularization. PMID:26935747

  18. Sequential CT findings on giant aneurysms of the intracranial internal carotid artery after carotid ligation

    International Nuclear Information System (INIS)

    Twenty one patients with giant aneurysms of the intracranial carotid artery were experienced from 1961 to the end of 1980. Three out of 21 were given no treatment and the remaining 18 were treated by indirect surgery. At follow-up, 15 cases were living useful lives; nine of these cases were treated by carotid ligation, five by carotid ligation with STA-MCA anastomosis and one had no surgical treatment. Fourteen out of 15 living cases were examined by CT scan. Sequential CT findings of the giant aneurysm were as follows. The cavity of the giant aneurysm was filled with clots within one week after ligation. Most of the cavity was thrombosed and a small residual cavity was visualized within 2 to 3 weeks after surgery. A thick mural thrombus was organized gradually between 4 and 6 weeks but a narrowed residual aneurysmal cavity still existed. Further organization and calcification of the thrombus and aneurysmal wall progressed for several years. More than 5 years following carotid ligation, a small residual cavity was thrombosed and the aneurysm could not be detected by CT scan. CT findings which prove the effectiveness of indirect surgical treatment were observed in 11 out of 13 patients (84.6%). However, complications after carotid ligation cannot be neglected. Therefore, combined therapy consisting of neck internal carotid ligation and STA-MCA anastomosis is recommended to prevent complications due to carotid ligation. Sequential CT scans are very useful for observation of the fate of the giant aneurysm after carotid ligation and the effectiveness of therapy, and for evolution of the prognosis of patients. (J.P.N.)

  19. Sequential CT findings on giant aneurysms of the intracranial internal carotid artery after carotid ligation

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, S.; Kodama, N.; Suzuki, J. (Tohoku Univ., Sendai (Japan). School of Medicine)

    1982-04-01

    Twenty one patients with giant aneurysms of the intracranial carotid artery were experienced from 1961 to the end of 1980. Three out of 21 were given no treatment and the remaining 18 were treated by indirect surgery. At follow-up, 15 cases were living useful lives; nine of these cases were treated by carotid ligation, five by carotid ligation with STA-MCA anastomosis and one had no surgical treatment. Fourteen out of 15 living cases were examined by CT scan. Sequential CT findings of the giant aneurysm were as follows. The cavity of the giant aneurysm was filled with clots within one week after ligation. Most of the cavity was thrombosed and a small residual cavity was visualized within 2 to 3 weeks after surgery. A thick mural thrombus was organized gradually between 4 and 6 weeks but a narrowed residual aneurysmal cavity still existed. Further organization and calcification of the thrombus and aneurysmal wall progressed for several years. More than 5 years following carotid ligation, a small residual cavity was thrombosed and the aneurysm could not be detected by CT scan. CT findings which prove the effectiveness of indirect surgical treatment were observed in 11 out of 13 patients (84.6%). However, complications after carotid ligation cannot be neglected. Therefore, combined therapy consisting of neck internal carotid ligation and STA-MCA anastomosis is recommended to prevent complications due to carotid ligation. Sequential CT scans are very useful for observation of the fate of the giant aneurysm after carotid ligation and the effectiveness of therapy, and for evolution of the prognosis of patients.

  20. Difference in carotid artery elasticity in subjects with different brachial artery kinetic of vasodilatation.

    Science.gov (United States)

    Tripolino, C; Gnasso, A; Carallo, C; Scavelli, F B; Irace, C

    2016-08-01

    Increased carotid stiffness and impaired brachial artery flow-mediated dilatation (FMD) associate with cardiovascular events. We have previously reported three FMD patterns based on the time of maximal dilatation. The aim of the present study was to verify whether different FMD patterns associate with carotid artery stiffness. In all, 133 subjects were enrolled. All participants underwent complete clinical examination, blood sampling and ultrasound study. FMD was used as a measure of endothelial function. Based on the maximal brachial artery FMD, subjects were divided into Early dilators (peak FMD at 50 s), Late dilators (peak FMD over 50 s) and No dilators. Echo-Doppler evaluation of carotid arteries was performed in order to calculate elastic indexes (strain, β-stiffness index and distensibility). In all, 64 subjects were classified as Early FMD, 36 as Late FMD and 33 as No dilators. Age, gender and cardiovascular risk factors were comparable among three groups. Early FMD had higher values of strain compared with both Late and no Dilators (PFMD and No Dilators were detected. Our results demonstrate that common carotid artery elasticity indexes significantly differ among Early, Late and No dilators. Subjects with delayed or absent brachial artery dilatation have stiffer common carotid arteries compared with subjects with early dilatation. In conclusion, our research suggests that the assessment of the kinetics of FMD in a clinical setting might represent a useful screening tool to improve the cardiovascular risk stratification. PMID:26467820

  1. MRI of the carotid artery at 7 Tesla: Quantitative comparison with 3 Tesla

    NARCIS (Netherlands)

    Koning, Wouter; De Rotte, Alexandra A J; Bluemink, Johanna J.; Van Der Velden, Tijl A.; Luijten, Peter R.; Klomp, DWJ; Zwanenburg, Jaco J M

    2015-01-01

    Purpose: To evaluate the 7 Tesla (T) MRI of the carotid arteries, as quantitatively compared with 3T. Materials and Methods: The 7T MRI of the carotid arteries was performed in six healthy subjects and in two patients with carotid stenosis. The healthy group was scanned at 3T and at 7T, using curren

  2. CrossFit-related cervical internal carotid artery dissection.

    Science.gov (United States)

    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients. PMID:25917634

  3. Comprehensive evaluation of carotid artery disease with MR imaging

    International Nuclear Information System (INIS)

    The authors have combined conventional MR imaging, three-dimensional MR angiographic examinations of the extracranial and intracranial arterial systems, and quantitative blood flow measurements in the carotid arteries, using the RACE (real-time acquisition and evaluation) technique in a single patient examination. RACE is a projective phase technique with a high degree of temporal resolution; thus, it requires no electrocardiographic synchronization and allows the real-time display of flow data. The projectional nature of the data from RACE measurements lends itself to the derivation of actual average volumetric flow rates (in milliliters per minute) by integration of the flow curves for the data columns corresponding to a vessel. The combination of the three techniques can result in a comprehensive noninvasive evaluation of cerebrovascular disorders due to carotid artery disease

  4. Unusual looping of the internal carotid artery in relation to an enlarged lymph node

    Directory of Open Access Journals (Sweden)

    Nayak SB

    2010-06-01

    Full Text Available Knowledge of variations of internal carotid artery is important to surgeons doing head and neck surgery as well as to radiologists doing imaging and invasive techniques. In the current case, the right internal carotid artery showed a characteristic loop at its beginning. An abnormal, enlarged lymph node was found at the carotid bifurcation, which was projecting into the loop. The left internal carotid artery was normal. The unusual looping of internal carotid artery at its beginning might result in altered blood flow to the brain and may lead to confusions in surgical, imaging and invasive techniques.

  5. Duplex scanning of carotid artery following thrombo-endarteriectomy and plastic dilation

    International Nuclear Information System (INIS)

    40 carotid arteries were studied in 32 patients following thrombo-endarteriectomy with plastic patching, with 27 cases having additional digital angiography findings available for control. Both the communal carotid arteries and the carotid bifurcations were sufficiently assessable in the B-image in 95%. Safe image diagnosis of the internal carotid arteries was possible in 82% only. Proximal formation of steps (40%) and stenoses of the external carotid artery (43%) were found most frequently. Only 4 cases revealed discrepancies to DSA findings. Duplex scanning should not be performed until a fortnight after operation due to soft tissue swellings. (orig.)

  6. [Revascularization of the carotid and vertebral arteries in the elderly].

    Science.gov (United States)

    Illuminati, G; Bezzi, M; D'Urso, A; Giacobbi, D; Ceccanei, G; Vietri, F

    2004-01-01

    From January 1994 to July 2004, 323 patients underwent 348 revascularization of carotid bifurcation for atherosclerotic stenoses. Eighty eight patients (group A) were 75 year-old or older, whereas 235 (group B) were younger than 75 years. Postoperative mortality/neurologic morbidity rate was 1% in group A, and 1.4% in group B. At 5 years, patency and freedom from symptoms/stroke were, respectively, 91% and 92% in group A, and 89% and 91% in group B. None of these differences was statistically significant. In the same time period, 26 internal carotid arteries were revascularized in 24 patients, 75 or more aged, for a symptomatic kinking. Postoperative mortality/morbidity rate was absent, whereas, at 5 years, patency and freedom from symptoms/stroke were, respectively, 88% and 92%. Twelve vertebral arteries were revascularized in 12 patients, 75 or more aged, for invalidating symptoms of vertebrobasilar insufficiency. Postoperative mortality/neurologic morbidity rate was absent. In one case postoperative recurrence of symptoms occurred, despite a patent revascularization. Patency and freedom from symptoms/stroke were 84% and 75%, at 5 years. Revascularization of carotid and vertebral arteries in the elderly can be accomplished with good results, superposable to those of standard revascularization of carotid bifurcation in a younger patients' population. PMID:15803810

  7. Urgent stenting for patients with acute stroke due to atherosclerotic occlusive lesions of the cervical internal carotid artery

    International Nuclear Information System (INIS)

    Acute symptomatic occlusion of the cervical internal carotid artery (ICA) can be treated by intravenous administration of tissue plasminogen activator, percutaneous transluminal angioplasty, and carotid endarterectomy. Carotid artery stenting (CAS) is now indicated for cervical ICA stenosis, but the safety and the efficacy of urgent CAS have not been established. We retrospectively reviewed 10 patients treated by urgent CAS for atherosclerotic occlusive lesions of cervical ICA with acute stroke. Five patients had complete occlusions and five had near total occlusions. Five of the 10 patients had intracranial tandem occlusions. Indication for urgent CAS was determined by mismatch of diffusion-weighted and perfusion-weighted magnetic resonance imaging findings. Stents were successfully deployed in all lesions. Three of five patients with concomitant intracranial tandem occlusions were treated by additional intraarterial fibrinolysis after the CAS. Intracranial artery occlusions were completely recanalized in one patient, and partially recanalized in two by fibrinolysis. Hyperperfusion syndrome did not occur in any of the patients. A favorable outcome (modified Rankin Scale ≤1) was obtained in all of the five patients with isolated cervical ICA occlusion and one of the five patients with intracranial tandem occlusions. Urgent CAS is a safe and effective treatment in patients with isolated cervical ICA occlusion. Treatment of intracranial tandem occlusions is an issue that must be resolved. (author)

  8. A suggested training programme for carotid artery stenting (CAS)

    International Nuclear Information System (INIS)

    Carotid artery stenting as an alternative to traditional carotid endartrectomy is becoming increasingly important in the treatment of transient ischemic attack and stroke. Physicians from several different medical disciplines are interested in treating appropriate patients by this method. Patients are entitled to know what training and experience the surgeon or clinician has before giving consent. This should involve endovascular experience in all systems and experience and knowledge of cerebral angiography and intervention. A multidisciplinary approach and reporting of adverse events is vital for patient safety

  9. Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

    OpenAIRE

    Vilson Lacerda Brasileiro Junior; Aníbal Henrique Barbosa Luna; Marcelo Augusto Oliveira de Sales; Tânia Lemos Coelho Rodrigues; Priscilla Lopes da Fonseca Abrantes Sarmento; Carlos Fernando Mello Junior

    2014-01-01

    Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcific...

  10. Agenesis of the internal carotid artery with a large hemangioma of the tongue

    International Nuclear Information System (INIS)

    Total developmental absence of the internal carotid artery is relatively rare, with only 54 cases previously reported. Most, being without neurological symptoms, were found by chance. For this patient with cavernous hemangiomas in the facial, oral and cervical regions, conventional treatment would be embolization of the feeding vessels, combined with ligation of the external carotid artery. Angiography, however, revealed agenesis of the left internal carotid artery, abnormal origin of the aortic arch and azygos anterior cerebral artery. (orig./MG)

  11. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions

    International Nuclear Information System (INIS)

    The use of coronary balloons in the cerebral vasculature is limited due to their poor trackability and increased risk of vessel injury. We report our experience using more compliant elastomer balloons for thrombus resistant to intraarterial (IA) pharmacological and mechanical thrombolysis in acute stroke. We retrospectively analyzed 12 consecutive patients with an occluded intracranial artery treated with angioplasty using a low-pressure elastomer balloon. Angiograms were graded according to the Thrombolysis in Cerebral Infarction (TICI) and Qureshi grading systems. Outcomes were categorized as independent (modified Rankin scale, mRS, score ≤2), dependent (mRS score 3-5), or dead (mRS score 6). Included in the study were 12 patients (mean age 66±17 years, range 31-88 years; mean baseline National Institutes of Health stroke scale score 17±3, range 12-23). The occlusion sites were: internal carotid artery (ICA) terminus (five patients, including two concomitant cervical ICA occlusions), M1 segment (two patients), and basilar artery (two patients). Pharmacological treatment included intravenous (IV) t-PA only (two patients), IA urokinase only (nine patients), both IV t-PA and IA urokinase (one patient), and IV and/or IA eptifibatide (eight patients). Mean time to treatment was 5.9±3.9 h (anterior circulation) and 11.0±7.2 h (posterior circulation). Overall recanalization rate (TICI grade 2/3) was 91.6%. Procedure-related morbidity occurred in one patient (distal posterior inferior cerebellar artery embolus). There were no symptomatic hemorrhages. Outcomes at 90 days were independent (five patients), dependent (three patients) and dead (four patients, all due to progression of stroke with withdrawal of care). Angioplasty of acutely occluded intracranial arteries with low-pressure elastomer balloons results in high recanalization rates with an acceptable degree of safety. Prior use of thrombolytics may increase the chances of recanalization, and glycoprotein IIb

  12. Percutaneous trans-ulnar artery approach for coronary angiography and angioplasty; A case series study

    Science.gov (United States)

    Roghani-Dehkordi, Farshad; Hadizadeh, Mahmood; Hadizadeh, Fatemeh

    2015-01-01

    BACKGROUND Coronary angiography is the gold standard method for diagnosis of coronary heart disease and usually performed by femoral approach that has several complications. To reduce these complications, upper extremity approach is increasingly used and is becoming preferred access site by many interventionists. Although radial approach is relatively well studied, safety, feasibility and risk of applying ulnar approach in not clearly known yet. METHODS We followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18) who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 months and recorded their outcomes. RESULTS In 97 patients out of 105 ones (92.38%), procedure through ulnar access were successfully done. Unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet (2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. In 94 patients (89.52%), the angiography and angioplasty was done without any complications. Five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolved with painkiller. No infection, amputation or need for surgery was reported. CONCLUSION This study demonstrated that ulnar access in our patients was a safe and practical approach for coronary angiography or angioplasty, without any major complication. Bearing in mind its high success rate, it can be utilized when a radial artery is not useful for the catheterization and in cases such as prior harvesting of the radial artery (in prior coronary artery bypass grafting). PMID:26715936

  13. Surgical techniques and curative effect of carotid endarterectomy for carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Min HAN

    2014-02-01

    Full Text Available Objective To investigate the surgical techniques of carotid endarterectomy (CEA for treating carotid artery stenosis, in order to improve the surgical efficacy and reduce intraoperative adverse events and complications after operation. Methods Retrospective analysis was carried out on surgical data of 53 cases who were performed CEA from October 2010 to October 2013 in Department of Neurosurgery in Tianjin Huanhu Hospital. There were 39 males and 14 females, aged from 40 to 78 years old and mean age (60.34 ± 8.92 years old; the course of disease was from 2 d to 4 years. Twenty-six cases were diagnosed as right carotid stenosis, 15 cases left carotid stenosis and 12 cases double-sided carotid stenosis. Among all of those cases, 35 cases were diagnosed as moderate stenosis (30%-69%, 16 cases severe stenosis (70%-99% , and 2 cases complete occlusion. Results Among 53 patients, 50 patients underwent CEA; 2 cases underwent CEA and aneurysm clipping; one case underwent stent removal surgery and CEA because restenosis was found after carotid artery stenting (CAS. Postoperative neck CTA and fMRI showed good morphology of carotid artery, fluent blood flow and improved cerebral perfusion after operation. All of those patients were followed up for 3 to 24 months. One case died of myocardial infarction; 2 cases appeared skin numbness on the operating side of the neck, and the symptom disappeared 3 months later; one case appeared hoarseness after operation; 3 cases experienced mild transient ischemic attack (TIA and the symptom disappeared 2 months later. No case of stroke was found. Conclusions CEA is a safe and effective surgical approach to treat carotid stenosis. Correct and reasonable choices of the surgical indications and skilled surgical technique are the key to ensure the success of operation and to improve efficacy of the therapy. doi:10.3969/j.issn.1672-6731.2014.02.006Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v14n2a6

  14. A CT study of the prevalence of carotid artery calcification in dental patients

    International Nuclear Information System (INIS)

    Stroke is one of the leading causes of death in Korea. Atherosclerotic disease in the carotid artery bifurcation is the most common cause of stroke. The carotid artery calcification is easily appreciated by CT(Computed tomography). CT is often taken in a dental hospital for the diagnosis of inflammation. injury, cyst or tumor on maxillofacial region. However, there was no report of carotid artery calcification on CT in dental patients. The presence of carotid artery calcification was evaluated by an experienced radiologist on CT scans of 287 patients (166 males, 121 females, average age 42, range 6 to 86 years) and the medical history of the patient and the interpretation of CT were reviewed. Carotid artery calcification was detected on CT scans of 57 patients (19.8%; 35 males, 22 females). All the male patients with carotid artery calcification were older than 50, and all the female patients with carotid artery calcification were older than 60. Among the 57 patients, 10 had Diabetes mellitus, 20 had cardiovascular disease, 3 had history of stroke and 3 underwent radiation therapy for head and neck cancer. Carotid artery calcification was not included in the interpretation of CT of dental patients except one patient. The prevalence of carotid artery calcification on CT of dental patients was about 20% in this study. Carotid artery calcification should be included in the interpretation of CT of dental patients

  15. A CT study of the prevalence of carotid artery calcification in dental patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Suk Ja; Lee, Jae Seo; Yoon, Woong [Chonnam National Univ. Medical School, Gwangju (Korea, Republic of)

    2006-09-15

    Stroke is one of the leading causes of death in Korea. Atherosclerotic disease in the carotid artery bifurcation is the most common cause of stroke. The carotid artery calcification is easily appreciated by CT(Computed tomography). CT is often taken in a dental hospital for the diagnosis of inflammation. injury, cyst or tumor on maxillofacial region. However, there was no report of carotid artery calcification on CT in dental patients. The presence of carotid artery calcification was evaluated by an experienced radiologist on CT scans of 287 patients (166 males, 121 females, average age 42, range 6 to 86 years) and the medical history of the patient and the interpretation of CT were reviewed. Carotid artery calcification was detected on CT scans of 57 patients (19.8%; 35 males, 22 females). All the male patients with carotid artery calcification were older than 50, and all the female patients with carotid artery calcification were older than 60. Among the 57 patients, 10 had Diabetes mellitus, 20 had cardiovascular disease, 3 had history of stroke and 3 underwent radiation therapy for head and neck cancer. Carotid artery calcification was not included in the interpretation of CT of dental patients except one patient. The prevalence of carotid artery calcification on CT of dental patients was about 20% in this study. Carotid artery calcification should be included in the interpretation of CT of dental patients.

  16. Carotid bifurcation calcium and correlation with percent stenosis of the internal carotid artery on CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, Alexander M.; Casey, Sean O.; Teksam, Mehmet; Truwit, Charles L.; Kieffer, Stephen [University of Minnesota Medical School, Departments of Radiology, Minneapolis, MN (United States); Lucato, Leandro T. [Clinics Hospital, University of Sao Paulo, Sao Paulo (Brazil); Smith, Maurice [Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States)

    2005-01-01

    The aim of this paper was to determine the correlation between calcium burden (expressed as a volume) and extent of stenosis of the origin of the internal carotid artery (ICA) by CT angiography (CTA). Previous studies have shown that calcification in the coronary arteries correlates with significant vessel stenosis, and severe calcification (measured by CT) in the carotid siphon correlates with significant (greater than 50% stenosis) as determined angiographically. Sixty-one patients (age range 50-85 years) underwent CT of the neck with intravenous administration of iodinated contrast for a variety of conditions. Images were obtained with a helical multidetector array CT scanner and reviewed on a three-dimensional workstation. A single observer manipulated window and level to segment calcified plaque from vascular enhancement in order to quantify vascular calcium volume (cc) in the region of the bifurcation of the common carotid artery/ICA origin, and to measure the extent of ICA stenosis near the origin. A total of 117 common carotid artery bifurcations were reviewed. A ''significant'' stenosis was defined arbitrarily as >40% (to detect lesions before they become hemodynamically significant) of luminal diameter on CTA using NASCET-like criteria. All ''significant'' stenoses (21 out of 117 carotid bifurcations) had measurable calcium. We found a relatively strong correlation between percent stenosis and the calcium volume (Pearson's r= 0.65, P<0.0001). We also found that there was an even stronger correlation between the square root of the calcium volume and the percent stenosis as measured by CTA (r= 0.77, P<0.0001). Calcium volumes of 0.01, 0.03, 0.06, 0.09 and 0.12 cc were used as thresholds to evaluate for a ''significant'' stenosis. A receiver operating characteristic (ROC) curve demonstrated that thresholds of 0.06 cc (sensitivity 88%, specificity 87%) and 0.03 cc (sensitivity 94%, specificity

  17. Carotid bifurcation calcium and correlation with percent stenosis of the internal carotid artery on CT angiography

    International Nuclear Information System (INIS)

    The aim of this paper was to determine the correlation between calcium burden (expressed as a volume) and extent of stenosis of the origin of the internal carotid artery (ICA) by CT angiography (CTA). Previous studies have shown that calcification in the coronary arteries correlates with significant vessel stenosis, and severe calcification (measured by CT) in the carotid siphon correlates with significant (greater than 50% stenosis) as determined angiographically. Sixty-one patients (age range 50-85 years) underwent CT of the neck with intravenous administration of iodinated contrast for a variety of conditions. Images were obtained with a helical multidetector array CT scanner and reviewed on a three-dimensional workstation. A single observer manipulated window and level to segment calcified plaque from vascular enhancement in order to quantify vascular calcium volume (cc) in the region of the bifurcation of the common carotid artery/ICA origin, and to measure the extent of ICA stenosis near the origin. A total of 117 common carotid artery bifurcations were reviewed. A ''significant'' stenosis was defined arbitrarily as >40% (to detect lesions before they become hemodynamically significant) of luminal diameter on CTA using NASCET-like criteria. All ''significant'' stenoses (21 out of 117 carotid bifurcations) had measurable calcium. We found a relatively strong correlation between percent stenosis and the calcium volume (Pearson's r= 0.65, P<0.0001). We also found that there was an even stronger correlation between the square root of the calcium volume and the percent stenosis as measured by CTA (r= 0.77, P<0.0001). Calcium volumes of 0.01, 0.03, 0.06, 0.09 and 0.12 cc were used as thresholds to evaluate for a ''significant'' stenosis. A receiver operating characteristic (ROC) curve demonstrated that thresholds of 0.06 cc (sensitivity 88%, specificity 87%) and 0.03 cc (sensitivity 94%, specificity 76%) generated the best combinations of sensitivity and

  18. Ultrasound common carotid artery segmentation based on active shape model.

    Science.gov (United States)

    Yang, Xin; Jin, Jiaoying; Xu, Mengling; Wu, Huihui; He, Wanji; Yuchi, Ming; Ding, Mingyue

    2013-01-01

    Carotid atherosclerosis is a major reason of stroke, a leading cause of death and disability. In this paper, a segmentation method based on Active Shape Model (ASM) is developed and evaluated to outline common carotid artery (CCA) for carotid atherosclerosis computer-aided evaluation and diagnosis. The proposed method is used to segment both media-adventitia-boundary (MAB) and lumen-intima-boundary (LIB) on transverse views slices from three-dimensional ultrasound (3D US) images. The data set consists of sixty-eight, 17 × 2 × 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80 mg atorvastatin and nine with placebo), who had carotid stenosis of 60% or more, at baseline and after three months of treatment. Manually outlined boundaries by expert are adopted as the ground truth for evaluation. For the MAB and LIB segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC) of 94.4% ± 3.2% and 92.8% ± 3.3%, mean absolute distances (MAD) of 0.26 ± 0.18 mm and 0.33 ± 0.21 mm, and maximum absolute distances (MAXD) of 0.75 ± 0.46 mm and 0.84 ± 0.39 mm. It took 4.3 ± 0.5 mins to segment single 3D US images, while it took 11.7 ± 1.2 mins for manual segmentation. The method would promote the translation of carotid 3D US to clinical care for the monitoring of the atherosclerotic disease progression and regression. PMID:23533535

  19. Endovascular stenting for high risk patients with high grade internal carotid stenosis combined with occlusion of the contralateral carotid artery

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy and safety of endovascular therapy for high risk patients with high grade internal carotid artery stenosis combined with occlusion of the contralateral internal carotid artery. Methods: From October, 2000 to December, 2001, 8 patients with high grade stenosis of one internal carotid artery combined with occlusion of the other whose conditions were not suitable for carotid endarterectomy, were treated through endovascular approach. The stenotic degree of the lesions before procedures was (85.2±9.4)% (70%-98%). NIHSS was used to evaluate the neurological function before and after endovascular stenting, and modified Rakin scale was used before and 3 months after endovascular stenting. Carotid arterial ultrasound and transcranial Doppler (TCD) examinations were used before and 2 days, 3 months, 6 months, 12 months after procedure. The averaged follow-up duration was 9 months (6 - 14 months). Results: Predilation was made in 3 patients in whom the stenotic degree of the lesions was more than 90 %. Five Smart self-expanding stents and 3 Wallstent were applied in the 8 patients. All the procedures were technologically successful, and the residual stenosis after procedures were (5.3±2.2)% (5% - 9%). The carotid stenosis after procedure was improved significantly compared with that of preoperation (t = 4.79, P 0.05). Results of carotid ultrasound and TCD examinations showed that the stenotic arteries in which stents were placed were patent, the velocity of blood flow after procedures was markedly improved, and the blood perfusion improved not only at the procedure side but also at the carotid occlusive side in some patients. Neither new stroke nor TIA happened during the follow-up period. Conclusion: Endovascular stenting is an effective and safe method for the treatment of high risk internal carotid stenosis combined with occlusion of the contralateral internal carotid artery which is not suitable for carotid endarterectomy

  20. Popliteal artery thrombosis in a patient with Cogan syndrome: Treatment with thrombolysis and percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    A 31-year-old woman with Cogan syndrome (a rare form of systemic vasculitis) was evaluated for a cold, painful left foot with diminished pulses. Arteriography demonstrated thrombosis of the left popliteal artery with evidence of vasculitis. Thrombolytic therapy was begun with initial success but eventual rethrombosis. After reinitiating thrombolytic therapy combined with intraarterial vasodilator therapy, successful angioplasty was performed with sustained results, at 6-month follow-up

  1. Acute occlusion of the coronary artery after transluminal balloon coronary angioplasty

    International Nuclear Information System (INIS)

    The research was aimed at elucidation of the relationship of the clinical and angiographic factors, on the one hand, and development of acute occlusion following transluminal balloon coronary angioplasty TBCA, on the other. TBCA was carried out in 162 patients. Eight (4.9 %) patients developed acute occlusion of the coronary artery, which was complicated by acute myocardial infarction in 50 % cases. 35 refs.; 4 tabs

  2. Intercavernous portion of internal carotid artery occlusion resulting from snowboarding

    Directory of Open Access Journals (Sweden)

    Sudiptamohan Mukhopadhyay

    2010-04-01

    Full Text Available Sudiptamohan Mukhopadhyay1, Awen Iorwerth21Department of Orthopaedics, University Hospital of Wales, Cardiff, UK; 2Department of Orthopaedics, Royal Glamorgan Hospital, Wales, UKAbstract: A 33-year-old gentleman who was otherwise fit and healthy suffered repetitive low impact head injuries while snowboarding in Austria over a period of one week. During the fall he had several hyperextension injuries and presented with headache, nausea, vomiting, drowsiness (felt ‘drunk’ on Friday night despite not being drunk, diplopia, abnormal pupillary signs. A Horner’s syndrome was diagnosed and on investigation, the left intercavernous portion of internal carotid artery (ICA was found to be thrombosed. The symptoms gradually settled after conservative treatment for a month. Blunt head trauma is a recognized cause of carotid dissection and thrombosis and many neuromechanics studies have attempted to calculate the wall shear stress involved. Physicians treating snowboarders should be aware of the condition and should look for Horner’s syndrome and consider the possibility of carotid occlusion. With a thorough PubMed, Ovid, EMBASE search using ‘snowboarding’, ‘carotid dissection’, ‘Horner’s syndrome’ no such case was found to be reported. Proper training for such sport activities is essential to avoid serious consequences.Keywords: snowboarding, carotid dissection, Horner’s syndrome

  3. Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance

    International Nuclear Information System (INIS)

    Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95 % stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication

  4. Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance

    Energy Technology Data Exchange (ETDEWEB)

    Köklü, Erkan, E-mail: drerkankoklu@gmail.com; Arslan, Şakir; Yüksel, İsa Öner; Bayar, Nermin [Antalya Education and Research Hospital, Clinic of Cardiology (Turkey); Koç, Pınar [Antalya Education and Research Hospital, Clinic of Radiology (Turkey)

    2015-08-15

    Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95 % stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication.

  5. MR imaging in carotid artery atherosclerosis plaque characterization

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the potential role of carotid artery atherosclerosis plaque magnetic resonance (MR) microimaging as magnetic resonance imaging (MRI) marker, ex vivo MR images were acquired at optimized parameters on 9.4T Bruker animal imager for occluded tissue resected by carotid endarterectomy (CEA) and corresponding histopathological analysis was made. For imaging, CEA tissues of size 2-6 cm long and 0.5-1.5 cm wide, were transferred to 15 ml co-polymer laboratory culture tubes containing either 10% formalin in phosphate buffered saline (PBS) or in 50% glycerol in PBS. Imaging protocol was set at echo time (TE)=30 ms, repetition time (TR)=1.5 s, matrix size=265 x 512, number of excitations (NEX)=128, slice thickness=1 mm and in-plane resolution=0.1 mm for total sample size 2.5 cm. Soon after imaging done, carotid artery tissues were cut into 5-mm segments and processed for histological section for successive 5-micrometer slices. To compare morphology of 5 μm thin CEA section with that of 1 mm MR slices, registration was obtained between histologic sections and MR slices. Contrast and magnetic resonance relaxation characteristics were analyzed. Total carotid artery area computed by MR imaging was correlated with areas determined from histologic sections (r2=0.989, p=0.0001). For the lumen area, the correlation between MR images and histologic area was (r2 0.942, p=0.0001). Relaxation times and T2 parametric images of different plaque components were determinant for contrast resolution. Scan parameters were optimized for fibrous cap and atheroma. Scan parameters were characteristic for comparison at 1.5T and 9.4T MR imagers. The observed correlation validated MR microimaging to assess morphological features of carotid artery plaques and contrast resolution highlighted the potential of in vivo MR imaging as non-invasive MRI marker to monitor carotid artery plaque morphometry and plaque composition. (author)

  6. Long-term outcomes of internal carotid artery disease treated using radial artery graft

    International Nuclear Information System (INIS)

    Complex internal carotid artery disease presents a surgical challenge because limitations and difficulty are encountered with either clipping or endovascular treatment. Our review of previous reports suggests that no current vascular assessment can accurately predict occurrence of ischemic complications after internal carotid artery ligation. The present study concerns long-term clinical outcome of radial artery grafting followed by parent artery trapping or proximal occlusion for management of these difficult lesions. Between September 1997 and October 2007, we performed radial artery grafting followed immediately by parent artery occlusion in 20 sides of 19 patients with complex internal carotid arteries disease with follow-up for more than 36 months (5 men, 14 women; mean follow-up duration, 62 months). All patients underwent postoperative MRI and MR angiography (MRA) every year to assess graft patency, ischemic complications, and de novo aneurysm. Another 20 carotid aneurysms with visual disturbance were assessed concerning outcome. Among 13 patients with cranial nerve (III and VI) disturbances, all dysfunctions were improved in cases treated within 8 months of onset to operation. On the other hand, patients with second cranial nerve disturbances were not improved in cases treated after 4 months of onset. No long-term complications were discovered with MRI and MRA. With appropriate attention to surgical technique, radial artery grafting followed by acute parent artery occlusion is a safe treatment for complex internal carotid artery aneurysms. Long-term safety is satisfactory, with no delayed complications such as graft stenosis, ischemic complications or de novo aneurysm formations in follow-up periods of more than 3 years. Good clinical outcome of cranial nerve palsy was achieved in patients treated within 8 months of onset for cranial nerve (CN) III and VI, and 4 of CN II palsy. (author)

  7. Stent angioplasty of iliac artery stenoses under MR-control: initial clinical results

    International Nuclear Information System (INIS)

    Purpose: To investigate the feasibility of MR-guided stent angioplasty of iliac artery stenozls under passive visualization. Material and methods: Three patients with short, concentric stenoses of the iliac arteries were enrolled. The vascular interventions were performed on a 1.5 T MR scanner (Magnetom Symphony, Siemens, Erlangen, Germany). Stents, guidewires, and balloon catheters were visualized on the basis of susceptibility artifacts. Contrast-enhanced MR angiography (ceMRA) was used to localized the stenosis prior to stent deployment. Nitinol stents were placed under MR-guidance using a fast 2D gradient echo technique. Balloon dilatiation was performed with an angioplasty catheter inflated with diluted gadolinium-DTPA. Postinterventional results were evaluated by ceMRA, DSA, and Doppler indices. Results: Position of the stent, stent deployment, and balloon dilatation were depicted by MR. All stents were correctly placed within the stenosis. Stent positions as monitored by MRI were identical to those seen on DSA images. All patients were treated successfully by the MR-guided intervention. Conclusion: An MR-guided stent angioplasty of simple iliac artery stenoses is feasible under passive visualization. (orig.)

  8. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

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    Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

    2013-11-01

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

  9. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure

  10. Bilateral Carotid Artery Dissection after High Impact Road Traffic Accident

    Directory of Open Access Journals (Sweden)

    Michael Kelly

    2008-11-01

    Full Text Available A 58 year old man was involved in a high impact road traffic incident and was admitted for observation. Asymptomatic for the first 24 hours, he collapsed with symptoms and signs consistent with a cerebrovascular accident. Computed tomography angiogram (CTA and Magnetic resonance angiogram (MRA demonstrated bilateral internal carotid artery dissections and a left middle cerebral artery infarct. It was not considered appropriate to attempt stenting or other revascularistation. The patient was treated with heparin prior to starting warfarin. He made a partial recovery and was discharged to a rehabilitation facility. This case is a reminder of carotid dissection as an uncommon but serious complication of high speed motor vehicle accident, which may be silent initially. Literature Review suggests risk stratification before relevant radiological screening at risk patients. Significant advances in CTA have made it the diagnostic tool of choice, but ultrasound is an important screening tool.

  11. Breast arterial calcification on mammogram: correlation with carotid arterial atherosclerosis on ultrasonogram

    International Nuclear Information System (INIS)

    To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic imaging was performed and the findings were compared between the two groups. The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary

  12. Breast arterial calcification on mammogram: correlation with carotid arterial atherosclerosis on ultrasonogram

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Ju; Suh, Jung Ho [School of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Ji Hyung [College of Medicine, KonYang Univ., Nonsan (Korea, Republic of)

    2002-01-01

    To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic imaging was performed and the findings were compared between the two groups. The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary.

  13. Bilateral Internal Carotid Artery Occlusion Associated with the Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Pria Anand

    2014-03-01

    Full Text Available A 39-year-old woman presented with a right-hemispheric stroke 1 year after she had suffered a left-hemispheric stroke. Her diagnostic workup was notable for bilateral occlusions of the internal carotid arteries at their origins and a positive lupus anticoagulant antibody test. There was no evidence of carotid dissection or another identifiable cause for her carotid occlusions. These findings suggest that the antiphospholipid antibody syndrome may be implicated in the pathological changes that resulted in occlusions of the extracranial internal carotid arteries. Young stroke patients who present with unexplained internal carotid artery occlusions may benefit from testing for the presence of antiphospholipid antibodies.

  14. SUTURE NON-SUTSRE CIRCUMFERENTIAL REPAIR OF CAROTID ARTERY

    Directory of Open Access Journals (Sweden)

    Jafar Nader

    1969-01-01

    Full Text Available plastic adhesives, normal butyl cyanoacrylate monomer, isobutyl cyanoacrylate monomer and methyl 2 _ cyaooacrylate monomer, have been utilized in a comparative study with 5-{ silk suture in the repair of transected carotid arteries. Follow _ up arteriog ramS indicate isobutyl cyanoacrylate monomer and normal butyl cyanoacrylate monomer as having the most impressive rerults with only tWO thrombosis each. The silk suture had three thromboses and the adhesive methyl 2 _ cyanoacrylate monomer had nine, one of which a delayed

  15. IEEM Programming Procedure For Detecting Boundary Of Carotid Artery

    OpenAIRE

    V.Savithri; Purushothaman, S.(GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, 64291, Germany)

    2010-01-01

    This paper presents an IEEM programming procedure for use on noisy B-mode ultrasound images of the carotid artery. This programming procedure is based on Image Enhancement, Edge detection and Morphological operations in Boundary detection. This procedure may simplify the job of the practitioner for analyzing accuracy and variability of segmentation results. Possible plaque regions are also highlighted. A thorough evaluation of the method in the clinical environment shows that inter observer v...

  16. Multimodal Image Analysis for Carotid Artery Plaque Characterization

    OpenAIRE

    Engelen, Arna

    2014-01-01

    markdownabstract__Abstract__ Atherosclerosis of the carotid artery is a main cause of ischemic cerebrovascular events. There is evidence that the composition of the vessel wall is more strongly related to plaque vulnerability and subsequent events than luminal stenosis, which is currently used for risk stratification in clinical practice. Noninvasive imaging can characterize the composition of the vessel wall. In order to incorporate measures of plaque composition into clinical practice, accu...

  17. Fully automated segmentation of carotid and vertebral arteries from CTA

    OpenAIRE

    Cuisenaire, Olivier

    2009-01-01

    We propose a method for segmenting and labeling the main head and neck vessels (common, internal, external carotid and vertebral arteries) from a contrast enhanced computed tomography angiography (CTA) volume. First, an initial centerline of each vessel is extracted. Next, the vessels are segmented using 3D active objects initialized using the first step. Finally, the true centerline is identified by smoothly deforming it away from the segmented mask edges using a spline-snake. We focus parti...

  18. Usefulness of Acceleration Time for Internal Carotid Artery Origin Stenosis

    OpenAIRE

    Tamura, Hirokazu; Akaiwa, Yasuhisa; Onda, Kiyoshi

    2013-01-01

    Calcification of the internal carotid artery (ICA) hinders accurate evaluation of the stenosis by conventional ultrasonography due to acoustic shadow. We examined the relationship between acceleration time (AcT) and ICA origin stenosis. One hundred thrity seven samples (266 vessels) that enforced duplex ultrasonography in our hospital were targeted. The results have shown that there is a significant relationship between AcT and stenosis. AcT of more than 110 msec suggests that the stenosis is...

  19. Eagle syndrome presenting with external carotid artery pseudoaneurysm

    OpenAIRE

    Dao, Van Anh; Karnezis, Stellios; Lane, John S.; Fujitani, Roy M.; Saremi, Farhood

    2011-01-01

    Eagle syndrome refers to a clinical syndrome caused by the abnormal elongation of the styloid process with calcification/ossification of the stylohyoid ligament. We present the first reported case of Eagle syndrome resulting in an external carotid artery (ECA) pseudoaneurysm. A patient presented to emergency room with an expanding, painful right-neck mass. CT angiography with three-dimensional volume rendering showed a bilobed 4.0-cm right ECA pseudoaneurysm and bilateral ossification of the ...

  20. High Agatston Calcium Score of Intracranial Carotid Artery

    OpenAIRE

    Kao, Hung-Wen; Liou, Michelle; Chung, Hsiao-Wen; Liu, Hua-Shan; Tsai, Ping-Huei; Chiang, Shih-Wei; Chou, Ming-Chung; Peng, Giia-Sheun; Huang, Guo-Shu; Hsu, Hsian-He; Chen, Cheng-Yu

    2015-01-01

    Abstract The effect of intracranial internal carotid artery (ICA) calcification on cognitive impairment is uncertain. Our objective was to investigate whether intracranial ICA calcification is a significant cognitive predictor for cognitive impairment. Global cognition and degrees of intracranial ICA calcification of 579 subjects were assessed with Mini-Mental State Examination (MMSE) and Agatston calcium scoring method, respectively. Other risk factors for cognitive impairment, including age...

  1. Сharacteristics of flexible elastic properties of the carotid arteries in women with arterial hypertension

    OpenAIRE

    Коval О.A.; Zubko I.M.

    2013-01-01

    The article presents the results of study of the features of the carotid wall structure using ultrasound scanning with differential measurement of intima and media thickness, as well as characteristics of arterial elasticity in women with hypertension without comorbidities. It is shown that in women with hypertension vascular remodeling occurs mainly in the form of thickening of the intima-media due to increase in the media layer and is associated with remodeling of the left heart. Carotid re...

  2. Separate origins of the internal and external carotid arteries depicted on CT angiography: A case report

    International Nuclear Information System (INIS)

    Agenesis of the common carotid artery (CCA) is a rare congenital anomaly. We presented a rare case of unilateral congenital absence of the right CCA with separate origins of the ipsilateral internal and external carotid arteries from the brachiocephalic artery. Further, we reviewed the embryological mechanism and clinical importance of this anomaly

  3. Separate origins of the internal and external carotid arteries depicted on CT angiography: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kwang Ho [Dept. of horacic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of); Beak, Hye Jin; Jung, Hyun Kyung [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2015-08-15

    Agenesis of the common carotid artery (CCA) is a rare congenital anomaly. We presented a rare case of unilateral congenital absence of the right CCA with separate origins of the ipsilateral internal and external carotid arteries from the brachiocephalic artery. Further, we reviewed the embryological mechanism and clinical importance of this anomaly.

  4. Carotid Cavernous Fistula Associated with Persistent Trigeminal Artery

    Science.gov (United States)

    Hurst, Robert W.; Howard, Robert S.; Zager, Eric

    1998-01-01

    Carotid-cavernous fistula (CCF) associated with persistent trigeminal artery (PTA) is a rare but important clinical entity. We present a case treated by microcoil embolization with preservation of internal carotid, PTA, and hasilar artery flow following embolization. A 62-year-old female developed pulsatile tinnitus followed by left eye proptosis and diplopia. Examination revealed a cranial nerve VI palsy and an objective bruit over the left orbit. Angiographic evaluation revealed a carotid cavernous fistula originating from a persistent trigeminal artery. Placement of a detachable balloon across the fistula site while preserving the PTA proved impossible, and the fistula was treated with microcoils following placement of a microcatheter across the fistula into the cavernous sinus. Complete closure of the fistula was followed by resolution of the patient's symptoms. Preservation of all major vessels including the PTA was accomplished through the use of coil embolization. Careful evaluation of the angiogram is necessary to identify PTA associated with a CCF. Previous reports have described treatment of CCF with PTA by surgical or balloon ocolusion, some involving sacrifice of the PTA. Examination of the relevant embryology and anatomy reveals, however, that occlusion of the PTA must be approached with caution due to potential supply to the posterior circulation. ImagesFigure 1 PMID:17171071

  5. Diagnosis of carotid artery atheroma by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Atheroma appears as a very low signal intensity area on 2-dimensional time-of-flight (TOF) magnetic resonance (MR) images, and its components have various signal intensities on spin-echo (SE) images. The present study investigated atheroma of the carotid arteries in 37 subjects with risk factors (63±10 years of age; 19 men) by magnetic resonance imaging (MRI). On 2-dimensional (2D) TOF images, the carotid arteries were clearly demonstrated in all cases and atheroma was detected in 23 patients. The most common location of atheroma was at the origin of the internal carotid artery. There was vascular remodeling in all patients with atheroma. 2D-TOF images showed 97% agreement with ultrasonography. SE images clearly demonstrated atheroma in all 23 patients with atheroma. All patients with atheroma showing high signal intensity on T1-weighted images had hyperlipidemia. These findings indicate that the 2D-TOF imaging method is useful for detecting atheroma and SE-images are useful for its characterization. (author)

  6. Interventional therapy of traumatic pseudoaneurysms in internal carotid artery siphon

    International Nuclear Information System (INIS)

    Objective: To determine the methods and results of treating traumatic pseudoaneurysms in siphon segment of internal carotid artery (ICA)by interventional therapy. Methods: Twelve cases of traumatic pseudoaneurysms in siphon segment of internal carotid artery were treated. The collateral circulation of Willis circle was observed after DSA. Different methods of treatment were applied according to the collateral circulation of Willis circle. Ten cases were treated by occlusion of ICA completely, 1 case was embolized by guglielmi detachable coil (GDC) only. Results: Nine of 12 treated by occlusion of ICA were cured. In the 3 cases who had poor collateral of Willis circle, one was cured by GDC embolization alone; one died 48 hours later after ICA occlusion though his consciousness and the activity of extremities were normal during the temporary balloon test occlusion (BTO) of ICA. One died during the training to improve the collateral of the Willis circle. Conclusion: ICA embolization is feasible for treatment of traumatic pseudoaneurysms in siphon segment of internal carotid artery after evaluating the collateral circulation of Willis circle. (authors)

  7. Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis

    Science.gov (United States)

    Akçay, Betül İlkay Sezgin; Kardeş, Esra; Maçin, Sultan; Ünlü, Cihan; Özgürhan, Engin Bilge; Maçin, Aydın; Bozkurt, Tahir Kansu; Ergin, Ahmet; Surmeli, Reyhan

    2016-01-01

    Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique. Results. The mean age of the patients was 71.9 ± 10.8 years. The mean percentage of ICA stenosis was 74 ± 4.9% in Group 1 and 47.5 ± 7.7% in Group 2. The mean SFCT was 231.9 ± 44.6 μm in Group 1 and 216.2 ± 46.8 μm in Group 2, which was significantly lower (P = 0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r = 0896, P = 0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%. PMID:26989500

  8. Prevalence of significant carotid artery stenosis in Iranian patients with peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Bavil AS

    2011-10-01

    Full Text Available Abolhassan Shakeri Bavil1, Kamyar Ghabili2, Seyed Ebrahim Daneshmand3, Masoud Nemati3, Moslem Shakeri Bavil4, Hossein Namdar5, Sheyda Shaafi61Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran; 4Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran; 5Department of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran; 6Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Generalized screening for carotid artery stenosis with carotid duplex ultrasonography in patients with peripheral arterial disease is controversial.Objectives: The aim of the present study was to determine the prevalence of significant internal carotid artery (ICA stenosis in a group of Iranian patients with peripheral arterial disease.Methods: We prospectively screened 120 patients with a known diagnosis of peripheral vascular disease for carotid artery stenosis. Based on the angiographic assessment of abdominal aorta and arteries of the lower extremities, patients with stenosis greater than 70% in the lower extremity arteries were included. A group of healthy individuals aged ≥50 years was recruited as a control. Risk factors for atherosclerosis including smoking, diabetes mellitus, hyperlipidemia, ischemic heart disease, and cerebrovascular disease were recorded. Common carotid arteries (CCAs and the origins of the internal and external arteries were scanned with B-mode ultrasonogaphy. Significant ICA stenosis, >70% ICA stenosis but less than near occlusion of the ICA, was diagnosed when the ICA/CCA peak systolic velocity ratio was ≥3.5.Results: Ninety-five patients, with a mean age of 58.52 ± 11.04 years, were studied. Twenty-five patients had a history of smoking, six

  9. Automatic Active Contour-Based Segmentation and Classification of Carotid Artery Ultrasound Images

    OpenAIRE

    Chaudhry, Asmatullah; Hassan, Mehdi; Khan, Asifullah; Kim, Jin Young

    2013-01-01

    In this paper, we present automatic image segmentation and classification technique for carotid artery ultrasound images based on active contour approach. For early detection of the plaque in carotid artery to avoid serious brain strokes, active contour-based techniques have been applied successfully to segment out the carotid artery ultrasound images. Further, ultrasound images might be affected due to rotation, scaling, or translational factors during acquisition process. Keeping in view th...

  10. Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis

    Science.gov (United States)

    Yin, Suo; Zhang, Hong T.; Zhang, Dao P.; Zhang, Shu L.

    2015-01-01

    In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings. PMID:25935186

  11. Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis.

    Science.gov (United States)

    Yin, Suo; Zhang, Hong T; Zhang, Dao P; Zhang, Shu L

    2015-05-01

    In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings. PMID:25935186

  12. Dissection of Extracranial Internal Carotid Artery Due to Balloon Guiding Catheter Resulting in Asymptomatic Internal Carotid Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Akpinar

    2016-04-01

    Full Text Available Dissection of the internal carotid artery (ICA is a rare condition that accounts for a significant proportion of ischemic strokes in young adults. Iatrogenic dissection as a complication of neurointerventional procedures is a traumatic dissection which has been reported relatively rare in the literature. In this report, a case of dissection of the ICA is reported that was caused by repetitive movement of the balloon guiding catheter during stent-assisted thrombectomy (SAT, resulting in occlusion of the ICA.

  13. Aberrant internal carotid artery in the middle ear : a case report

    International Nuclear Information System (INIS)

    Aberrant internal carotid artery in the middle ear is a rare disease which, if unrecognized on raiological studies, can lead to serious complications during tissue biopsy. We report the imaging features of a case with aberrant internal carotid artery in the middle ear. A 60-year-old woman visited our hospital because of hearing difficulty on the right side. Temporal bone CT showed a well-defined mass of the right middle ear and lateral bony defect in the carotid canal adjacent to the mass. After arterial phase temporal bone CT with spiral CT and angiography, the mass could be diagnosed as aberrant internal carotid artery in the middle ear

  14. Anatomical Variations in the Arteries and Nerves of the Right Carotid Triangle

    OpenAIRE

    Quadros LS; Pandey AK; D'Souza AS

    2014-01-01

    Variations of the arteries and nerves are of clinical importance to the clinicians and surgeons in performing the surgeries. During the routine dissection for the undergraduates, variation in the branches of external carotid artery was noted in the right carotid triangle. The superior thyroid artery showed an upward loop from its origin and had a highly tortuous course, the lingual and facial arteries arouse from a common linguo-facial trunk and the ascending pharyngeal artery took origin fro...

  15. The prevalence of asymptomatic carotid artery disease in patients with peripheral vascular disease

    International Nuclear Information System (INIS)

    AIM: To determine the prevalence and severity of asymptomatic carotid artery disease in patients with peripheral arterial disease using colour duplex ultrasound, and to determine any relationship to the severity of peripheral arterial disease or other associated atherosclerotic risk factors. METHOD: Two hundred patients with known peripheral arterial disease but no previous cerebrovascular history were prospectively screened for carotid artery disease, and any identified internal carotid artery (ICA) stenosis graded using established duplex ultrasound criteria. A detailed medical questionnaire established the presence or absence of associated risk factors, and the severity of peripheral arterial disease was graded and correlated with these. RESULTS: A total of 50 patients (25%) were found to have an ICA stenosis of > 50%, with 27 (13.5%) of these having > 70% stenosis. Bilateral ICA stenosis (> 50%) was seen in 21 (10.5%) patients, of which 10 (5%) had bilateral stenoses of > 70%. No correlation was found between the severity of peripheral arterial disease and the presence of significant carotid artery disease, or between the latter and individual atherosclerotic risk factors. CONCLUSION: This study demonstrates a relatively high prevalence of significant carotid artery disease in patients with peripheral arterial disease compared to the general population. The significance of this with respect to the future screening of defined populations for asymptomatic carotid artery disease is discussed, with reference to recent studies comparing surgical and medical management of asymptomatic carotid artery disease. Pilcher, J.M., Danaher, J., Khaw, K.-T. (2000)

  16. Vibrational angioplasty in recanalization of chronic femoropopliteal arterial occlusions: Single center experience

    International Nuclear Information System (INIS)

    Purpose: This prospective study aims to present the overall success rate, safety and long-term outcome of vibrational angioplasty technique, in the treatment of chronic total femoropopliteal occlusions in our institute. Methods: Between October 2000 and December 2008, patients with chronic total femoropoliteal arterial occlusions, treated with vibrational angioplasty during the same session after a failed attempt with conventional recanalization technique, were included. Patient's follow up included serial ankle-brachial index measurements and arterial duplex ultrasound examinations at 1, 3, 6, 12, 24, 36 and 48 months. Results: Twenty-seven patients (16 males and 11 females) and twenty-eight lesions were included in our study. Twenty-five lesions (89.3%) were successfully recanalized. Pain relief was noticed in twenty-one cases. From ten lesions with tissue loss (ulcer or gangrene) in successfully recanalized occlusions, six healed without major, or minor amputation. One non-healing amputation stump was healed after recanalization, without further complications. Four limbs underwent amputation (one minor and three major) despite successful recanalization, however all had an excellent healing of the amputation stump without further complications. The Kaplan–Meier test demonstrated 90%, 85% and 70% amputation-free survival rate at 12, 24 and 36 months, respectively. No major or minor complications were encountered. Conclusions: Vibrational angioplasty is a safe, effective and durable endovascular technique for the treatment of chronic total occlusions in patients with limb ischemia that would be difficult to recanalize using conventional intraluminal techniques

  17. Vibrational angioplasty in recanalization of chronic femoropopliteal arterial occlusions: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kapralos, Ioannis, E-mail: jkapgr@yahoo.gr [251 Hellenic Air Force General Hospital, Athens (Greece); Kehagias, Elias, E-mail: eliaskmd@yahoo.gr [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Ioannou, Christos, E-mail: ioannou@med.uoc.g [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Bouloukaki, Izolde, E-mail: izolthi@gmail.com [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Kostas, Theodoros, E-mail: kostasth@mailbox.gr [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Katsamouris, Asterios, E-mail: asterios@med.uoc.gr [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece)

    2014-01-15

    Purpose: This prospective study aims to present the overall success rate, safety and long-term outcome of vibrational angioplasty technique, in the treatment of chronic total femoropopliteal occlusions in our institute. Methods: Between October 2000 and December 2008, patients with chronic total femoropoliteal arterial occlusions, treated with vibrational angioplasty during the same session after a failed attempt with conventional recanalization technique, were included. Patient's follow up included serial ankle-brachial index measurements and arterial duplex ultrasound examinations at 1, 3, 6, 12, 24, 36 and 48 months. Results: Twenty-seven patients (16 males and 11 females) and twenty-eight lesions were included in our study. Twenty-five lesions (89.3%) were successfully recanalized. Pain relief was noticed in twenty-one cases. From ten lesions with tissue loss (ulcer or gangrene) in successfully recanalized occlusions, six healed without major, or minor amputation. One non-healing amputation stump was healed after recanalization, without further complications. Four limbs underwent amputation (one minor and three major) despite successful recanalization, however all had an excellent healing of the amputation stump without further complications. The Kaplan–Meier test demonstrated 90%, 85% and 70% amputation-free survival rate at 12, 24 and 36 months, respectively. No major or minor complications were encountered. Conclusions: Vibrational angioplasty is a safe, effective and durable endovascular technique for the treatment of chronic total occlusions in patients with limb ischemia that would be difficult to recanalize using conventional intraluminal techniques.

  18. Anatomical Variations in the Arteries and Nerves of the Right Carotid Triangle

    Directory of Open Access Journals (Sweden)

    Quadros LS

    2014-08-01

    Full Text Available Variations of the arteries and nerves are of clinical importance to the clinicians and surgeons in performing the surgeries. During the routine dissection for the undergraduates, variation in the branches of external carotid artery was noted in the right carotid triangle. The superior thyroid artery showed an upward loop from its origin and had a highly tortuous course, the lingual and facial arteries arouse from a common linguo-facial trunk and the ascending pharyngeal artery took origin from the Internal carotid artery. The ansa cervicalis showed absence of inferior root. The second and third cervical spinal nerves joined the superior root separately.

  19. Rupture of the Renal Artery After Cutting Balloon Angioplasty in a Young Woman With Fibromuscular Dysplasia

    International Nuclear Information System (INIS)

    A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD

  20. Stent-Graft for the Management of Hepatic Artery Rupture Subsequent to Transcatheter Thrombolysis and Angioplasty in a Liver Transplant Recipient

    International Nuclear Information System (INIS)

    Arterial rupture subsequent to angioplasty occurs in about 5% of cases. Thrombolysis with re-establishment of flow without resolving underlying anatomic defects such as hepatic arterial stenosis leads to re-thrombosis. We present a case of arterial anastomotic rupture after thrombolysis and angioplasty of an underlying anastomotic hepatic arterial stenosis. Both the underlying anatomic defect and the rupture were resolved successfully with placement of a stent-graft, with a resultant patent artery for 1 year after the procedure.

  1. Cone-beam CT of the internal carotid artery

    Science.gov (United States)

    Hyde, Derek E.; Naik, Sandeep; Habets, Damiaan F.; Holdsworth, David W.

    2002-05-01

    The gold standard for NASCET-type stenosis measurements is currently 2D digital subtraction angiography (DSA). In this paper, we evaluate the efficacy of 3D cone-beam, Volumetric Subtraction Angiography (VSA) for assessing internal carotid artery stenosis, by comparison with conventional DSA. VSA perspective maximum intensity projections (MIPs) and DSAs were assessed separately for NASCET-type, minimum stenosis measurements. Although virtually any viewing angle of the VSA was possible, the minimum stenosis grades were not significantly higher than that of the DSAs. Our study of 38 arteries yielded a sensitivity and specificity of 100% (using a clinically relevant 60% stenosis threshold). Measurements from three neuroradiologists provided an average stenosis grade of 75 +/- 6% and 76 +/- 7% for the DSA and VSA respectively. A paired student t-test indicated a 98% confidence of no statistical difference in the means. Thus, VSA provides gold standard 3D information about carotid lumen geometry. While not intended to supplant noninvasive techniques during routine clinical diagnosis, it does provide a 3D reference standard for research investigations. Additionally, cone-beam CT can provide quantification of calcification around the carotid bifurcation.

  2. Emergency embolization in the treatment of intractable epistaxis resulted from carotid arterial disease

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of internal carotid artery occlusion in treatment of intractable epistaxis caused by carotid artery siphon traumatic lesions. Methods: A total of 37 patients with intractable epistaxis caused by traumatic carotid artery siphon pseudoaneurysm or carotid cavernous fistula were retrospectively analyzed. All the patients underwent embolization from October 1998 to June 2010, including 34 men and 3 women with the age ranged from 25 to 65 years and a average of 40 years. Only lesions were occluded in 12 cases without involving the internal carotid artery, while occlusions of internal carotid artery were performed in the rest 25 cases. Results: Thirty-six patients were cured without recurrent hemorrhage after embolization. Only 1 patient with carotid artery occlusion died 48 hours after operation. Conclusion: For patients with carotid arterial intractable epistaxis, if the elimination of the lesions is not applicable and the collateral circulation of Willis ring has a good compensation, the use of detachable balloon or coil occlusion of ipsilateral internal carotid artery is a quick and easy method to save patients' lives. (authors)

  3. A clinical study on perforator stroke resulting from Wingspan stent angioplasty for symptomatic intracranial artery stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the incidence, potential hazards and effective countermeasure for perforator stroke (PS) resulting from stent angioplasty of symptomatic intracranial artery stenosis. Methods: Peri-operation PS complications of 258 patients receiving Gateway balloon-Wingspan stenting for severe symptomatic intracranial stenosis were analyzed. The incidence, clinical course, and prognosis of PS resulting from stenting were recorded. Special attention was given to the anatomical features, clinical manifestation and video materials of patients with PS. χ2 test was used for statistics. Results: Two hundred and fifty-five patients received stent angioplasty successfully and 7 patients had PS (incidence rate 2.7%). The patients with basilar artery stenosis had a higher incidence of PS resulting from intracranial stenting (6.1%, 4/66) than patients with middle cerebral artery stenosis (2.5%, 3/118) (χ2=2.320, P= 0.025). The potential hazards for PS included preoperative perforator stroke adjacent to the stenotic segment and prominent dissection during operation. Six patients presented symptoms after awake from general anaesthesia and one had symptoms 3 hours after stenting. One deteriorated gradually and the others reached the maximum deficit almost at once. At the follow-up of 3 months, 3 patients were disabled and scored one, two, two by mRS respectively. Conclusion: The incidence of PS resulting from intracranial stenting was low and the prognosis was not disastrous. Stenosis at basilar artery and preoperative perforator stroke adjacent to the stenotic segment were potential risk factors for PS complication. Proper maneuver of angioplasty may decrease the incidence of PS and improve the prognosis. (authors)

  4. The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation

    International Nuclear Information System (INIS)

    Purpose: In the current series of experiments we have characterized cell proliferation leading to vascular lesion formation in a porcine model for post-angioplasty restenosis and examined the mechanism of action of intravascular beta irradiation in the prevention of lesion formation in this model. Methods and Materials: Juvenile male pigs were subjected to balloon overstretch injury of the left anterior descending and circumflex coronary arteries using clinical angioplasty catheters. Proliferating cells were labelled by injections of 50 mg/kg of bromo-deoxyuridine (BrDU) 24, 16 and 8 hrs prior to sacrifice and were detected by immunohistochemistry using a specific antibody to BrDU. In some cases, BrDU was given as a pulse 3 days after angioplasty and the animals sacrificed on day 14 to follow the migration of the cells which had proliferated earlier. Characterization of the proliferating cells was performed by immunohistochemistry using antibodies to specific cytoskeletal proteins specific for smooth muscle cells and myofibroblasts. Some vessels were treated at the time of angioplasty with 14 or 28 Gy (to a depth of 2 mm) intravascular irradiation using a flexible catheter with a pure beta emitter 90 SR/Y and the effect on cell proliferation and terminal transferase-mediated UTP nick-end labelling (TUNEL) examined 3 or 7 days later. Results: The first major site of cell proliferation between 2-3 days after angioplasty is the adventitia and not the medial wall. Seven days after angioplasty cell proliferation is predominant in the neointima and is reduced in the media and adventitia. Differential staining with antibodies directed against smooth muscle alpha actin and other cytoskeletal proteins indicates that the proliferating adventitial cells are myofibroblasts. Pulse label studies with BrDU indicates that the proliferating adventitial myofibroblasts migrate into the neointima and contribute to the mass of the restenosis lesion. Fourteen days after angioplasty the

  5. Improved MR imaging of extracranial carotid artery disease

    International Nuclear Information System (INIS)

    Flow-related and phase-encoding artifacts and a nonorthogonal vessel course frequently degrade MR images of the extracranial carotid artery. Employing out-of-field saturation pulses has significantly improved imaging of the vascular wall and lumen on spin-echo sequences. Flow-related and phase-encoding artifacts have virtually been eliminated. Oblique imaging of the proximal internal carotid has achieved truer axial views of this segment. Ten patients with documented extracranial vascular disease underwent MR evaluation with this imaging protocol. There was excellent correlation between the degree of luminal stenosis on the MR image and on the angiogram. Vessel wall pathology on the endarterectomy specimen correlated with the in vivo MR appearance of the wall. Signal alterations in the plaque representing hemorrhage and calcification were detected

  6. Aberrant internal carotid artery in the middle ear

    International Nuclear Information System (INIS)

    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  7. Aberrant internal carotid artery in the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Keun Tak; Kang, Hyun Koo [Dept. of Radiology, Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2014-10-15

    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  8. Сharacteristics of flexible elastic properties of the carotid arteries in women with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Коval О.A.

    2013-10-01

    Full Text Available The article presents the results of study of the features of the carotid wall structure using ultrasound scanning with differential measurement of intima and media thickness, as well as characteristics of arterial elasticity in women with hypertension without comorbidities. It is shown that in women with hypertension vascular remodeling occurs mainly in the form of thickening of the intima-media due to increase in the media layer and is associated with remodeling of the left heart. Carotid remodeling in women with hypertension is associated with worsening of vascular elasticity - increased vascular stiffness and decreased distension, wherein correlation analysis has shown that mentioned parameters are mostly associated with thickening of the medial layer of the artery wall and increase of internal diameter of the artery, as well as with increase in left ventricular mass. Ultrasound method of estimating elastic characteristics of arterial vessels is informative, relatively inexpensive and safe.

  9. Giant Serpentine Internal Carotid Artery Aneurysm: Endovascular Parent Artery Occlusion: A Pediatric Case Report

    OpenAIRE

    Prochazka, V.; Chmelova, J.; Cizek, V.; Skoloudik, D.; Hrbac, T.

    2007-01-01

    We report on a case of a 14-year-old boy with a giant serpentine aneurysm of the left internal carotid artery cavernous segment with symptoms of acute mass-effect cranial nerve dysfunction. After a balloon occlusion test of the collateral circulation, the patient underwent parent artery occlusion with platinum Guglielmi detachable coils and fibered coils. An optimal angiographic result and successful clinical outcome were achieved with resolution of IIIrd, IVth and Vlth cranial nerve ischemic...

  10. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    OpenAIRE

    Morton Adam

    2012-01-01

    Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection fo...

  11. Brainstem infarction in a patient with internal carotid dissection and persistent trigeminal artery: a case report

    Science.gov (United States)

    2010-01-01

    Background The primitive trigeminal artery (PTA) is the most commonly described fetal anastomosis between the carotid and vertebrobasilar circulations. Case presentation We report a 42-year-old patient presenting with internal carotid dissection, and imaging features of brainstem infarction. Conclusion Based on the imaging studies we presume occlusive carotid dissection with extensive thrombosis within a persistent trigeminal artery as the cause of this brainstem ischemia. PMID:20598138

  12. Brainstem infarction in a patient with internal carotid dissection and persistent trigeminal artery: a case report

    Directory of Open Access Journals (Sweden)

    Iancu Daniela

    2010-07-01

    Full Text Available Abstract Background The primitive trigeminal artery (PTA is the most commonly described fetal anastomosis between the carotid and vertebrobasilar circulations. Case presentation We report a 42-year-old patient presenting with internal carotid dissection, and imaging features of brainstem infarction. Conclusion Based on the imaging studies we presume occlusive carotid dissection with extensive thrombosis within a persistent trigeminal artery as the cause of this brainstem ischemia.

  13. A young pregnant woman with spontaneous carotid artery dissection––unknown mechanisms

    OpenAIRE

    Mohammed, Ishaq; Aaland, Maria; Khan, Nasrin; Crossley, Ian

    2014-01-01

    Spontaneous carotid artery dissection in pregnancy has not been reported before. We present a case of a 31-year-old Caucasian woman who was 11 weeks pregnant and presented with neck pain, headache, vomiting and left side Horner's syndrome. Subsequent investigations with MR angiography confirmed spontaneous left internal carotid artery dissection.

  14. Semi-automated segmentation of carotid artery total plaque volume from three dimensional ultrasound carotid imaging

    Science.gov (United States)

    Buchanan, D.; Gyacskov, I.; Ukwatta, E.; Lindenmaier, T.; Fenster, A.; Parraga, G.

    2012-03-01

    Carotid artery total plaque volume (TPV) is a three-dimensional (3D) ultrasound (US) imaging measurement of carotid atherosclerosis, providing a direct non-invasive and regional estimation of atherosclerotic plaque volume - the direct determinant of carotid stenosis and ischemic stroke. While 3DUS measurements of TPV provide the potential to monitor plaque in individual patients and in populations enrolled in clinical trials, until now, such measurements have been performed manually which is laborious, time-consuming and prone to intra-observer and inter-observer variability. To address this critical translational limitation, here we describe the development and application of a semi-automated 3DUS plaque volume measurement. This semi-automated TPV measurement incorporates three user-selected boundaries in two views of the 3DUS volume to generate a geometric approximation of TPV for each plaque measured. We compared semi-automated repeated measurements to manual segmentation of 22 individual plaques ranging in volume from 2mm3 to 151mm3. Mean plaque volume was 43+/-40mm3 for semi-automated and 48+/-46mm3 for manual measurements and these were not significantly different (p=0.60). Mean coefficient of variation (CV) was 12.0+/-5.1% for the semi-automated measurements.

  15. Assessment of Normal Vertebral Arteries Vs. Normal Internal Carotid and Common Carotid Arteries Blood Flow Spectral Doppler Indices

    Directory of Open Access Journals (Sweden)

    Sh. Sharif Kashani

    2005-08-01

    Full Text Available Introduction & Background: Vertebrobasilar insufficiency is the main cause of cerebrovascular accidents (CVAs in 20% of cases. There are few reports regarding spectral Doppler indices (SDIs of vertebral arteries (VAs normal blood flow. The objective of this study is to provide basic reference data about SDIs of VAs nor-mal blood flow separately, and in comparison with internal and common carotid arteries (ICAs and CCAs normal blood flows SDIs, for better and earlier detection of disordered SDIs of these arteries blood flow. Patients & Methods: This cross-sectional study was performed in Amir Alam hospital by three radiologists ex-perienced in vascular color Doppler sonography (CDS and spectral Doppler sonography (SDS from February 2002 till March 2004, on 70 normal patients. CDS and SDS of right and left vertebral arteries (RVA and LVA, right and left common carotid arteries (RCCA and LCCA, and right and left internal carotid arteries (RICA and LICA were performed. SDIs consisted of peak systolic velocity (PSV, end- diastolic velocity (EDV, and resistive index (RI values of these arteries blood flows and were assessed and compared with one another. Fi-nally all data was collected in SPSS version 12 software, and analyzed with the Student's T-test. Results: In this study, the mean PSV, EDV, and RI values of RVA blood flow were respectively 41.60 ± 9.6 cm/s, 14.60 ± 3.7 cm/s and 0.65 ± 0.06; the mean PSV, EDV and RI values of LVA blood flow were respectively 42.20 ± 10.2 cm/s, 15.20 ± 4.2 cm/s, and 0.64 ± 0.05. There was not statistically significant difference between the mean PSV, EDV, and RI values of RVA and LVA blood flows (P value > 0.1. The mean PSV and EDV val-ues of VAs blood flows were significantly lower than the mean PSV and EDV values of CCAs and ICCAs blood flows respectively (p-value 0.05.

  16. Carotid artery calcification in ischemic stroke patients detected in standard dental panoramic radiographs - a preliminary study

    International Nuclear Information System (INIS)

    Purpose: Examine the prevalence of carotid artery calcifications in standard dental panoramic radiographs (OPT), their association to gender, medical history and oral status. Assess the predictive value of a dental OPT in early diagnosis of carotid artery calcifications. Material and Methods: Fourteen patients admitted to Geneva University Hospital for recent ischemic stroke and stenosis of the carotid artery confirmed by Duplex sonography. All OPTs were digitised and subsequently assessed independently by two operators. Results: From 21 carotid artery calcifications detected with Doppler sonography 15 were visible on the corresponding OPT, most of them on the right side (n=11). No correlation was found between the side of calcification and cerebral lesion. Hypertension and periodontal disease were the most prevalent cardiovascular risk factors. Conclusions: Dentists who either detect carotid artery calcifications in OPTs or see patients with severe periodontitis should consider a prophylactic specialist examination. (authors)

  17. Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Henriksen, Jan Erik; Dahl, Jordi; Johansen, Allan; Møller, Jacob E; Gerke, Oke; Vach, Werner; Haghfelt, Torben; Beck-Nielsen, Henning; Høilund-Carlsen, Poul Flemming

    2009-01-01

    for the first time and age-matched nondiabetic reference subjects (n = 40) were screened for myocardial ischemia, carotid, and peripheral arterial disease by means of myocardial perfusion scintigraphy, carotid artery ultrasonography, and peripheral ankle and toe systolic blood pressure measurements....... RESULTS: In the T2DM patients, the prevalence of myocardial ischemia, carotid, and peripheral arterial disease was 30%, 42%, and 15%, respectively, almost three times higher than in the reference subjects (P = 0.007, P = 0.001, and P = 0.09, respectively). T2DM patients with myocardial ischemia, carotid......, or peripheral arterial disease had a significantly increased risk of CVD in other vascular territories as well (OR: 1.99, 2.09, and 3.09, respectively). However, 40%, 52%, and 22% of the T2DM patients with myocardial ischemia, carotid, or peripheral arterial disease demonstrated exclusively this...

  18. Occipital Artery Arising from the Anterior Aspect of the Internal Carotid Artery Identified by Three-Dimensional Computed Tomography Angiography

    International Nuclear Information System (INIS)

    Variation of the branches of the external carotid artery (ECA) is well known, but it is extremely rare for the occipital artery (OA) to arise from the internal carotid artery (ICA). A 87-year-old man was found to have this anatomical variation on the right side by threedimensional computed tomography angiography for vascular mapping of the carotid arteries before superselective intra-arterial catheterization for advanced tongue cancer. Imaging showed the OA arose from the anterior aspect of the right ICA with the origin located 8.8 mm distal from the carotid bifurcation. The inner diameter of the origin of the OA was 2.1 mm and the angle between the OA and the ICA was 62 degrees. It is important to recognize this anatomic variation of the branches of the ECA before head and neck microsurgical reconstruction or superselective intra-arterial chemotherapy for oral cancer

  19. EVALUATION OF CAROTID ARTERY STENOSIS IN STROKE/TRANSIENT ISCHAEMIC ATTACK

    Directory of Open Access Journals (Sweden)

    Nambakam Tanuja

    2015-07-01

    Full Text Available BACKGROUND : Stroke remains the second leading cause of death worldwide, after ischaemic heart disease. Patients with carotid artery stenosis are at higher risk of development of stroke. Carotid atherosclerosis occurs in patients with atheros clerotic risk factors like diabetes mellitus, hypertension, smoking and hyperlipidemia. Carotid artery stenosis can be assessed by means of noninvasive high - resolution B - mode ultrasonography of the carotid arteries. AIMS AND O BJECTIVES: 1. To estimate the prevalence of carotid artery stenosis in ischaemic stroke/transient ishaemic attack patients. 2. To estimate whether there was any association between carotid artery stenosis and important risk factors such as diabetes mellitus, hypertension, hyper lipid emia with control group. METHODS AND MATERIALS : Acute ischaemic / TIA stroke patients with CT - Brain showing infarcts were enrolled for the study. All patients were subjected to CT scan brain study and colour Doppler study of extracranial carotid arteries. The systolic and diastolic velocity of blood flow, and the ratio of peak systolic velocities of common carotid arteries were assessed. RESULTS : DM, HTN, Smoking & Hyperlipidemia acted as risk factors for carotid stenosis. The prevalence of carotid stenosi s in our study was 60%. The prevalence of mild, moderate and severe stenosis were 34%, 10% and 16% respectively. The distribution of carotid stenosis was equal on both sides. The statistical significance was calculated using Chi - square test. Statistical si gnificance was taken when P value was <0.05. Statistical analysis was carried using standard formulae. Microsoft Excel 2007 and SPSS (Statistical Package for Social Sciences Version 17.0 software were used for data entry and analysis. CONCLUSIONS : Caroti d stenosis was one of the common causes of ischaemic stroke. There was a statistically significant correlation between increasing age, male gender, smoking, d iabetes mellitus, hypertension

  20. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2012-01-15

    Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

  1. Surgical treatment for traumatic transection of left common carotid artery

    Institute of Scientific and Technical Information of China (English)

    ZHONG Qian-jin; XIAO Ying-bin; PENG Li; HAO Jia; AN Yong; MA Rui-yan

    2005-01-01

    @@ Injury to the supraaortic artery is a rare event, with poor prognosis and high mortality.1 Improvement of the outcome may lie on the combination of several aspects, including better pre-hospital care, use of emergency cardiopulmonary bypass (CPB), improved surgical techniques and facilities, and advanced postoperative intensive care. Some researchers emphasized the importance of emergency CPB in the treatment and thought that it was responsible mainly for the improved outcome.2-6 However, there exists controversies about it.7-9 In this article, we reported that a patient with life-threatening hemorrhage due to traumatic transection of the left common carotid artery, who was admitted to our hospital in July 2003, was treated successfully with operations with help of emergency CPB and systemic hypothermia.

  2. Treatment of complex internal carotid artery aneurysms using radial artery grafts. Surgical technique, perioperative complications, and results in 17 patients

    International Nuclear Information System (INIS)

    Complex giant or large internal carotid artery aneurysms present a surgical challenge because limitations and difficulty are encountered with either clipping or endovascular treatment. Our review of previous reports suggests that no current vascular assessment can accurately predict the occurrence of ischemic complications after internal carotid artery ligation. The present study concerns surgical technique, complications, and clinical outcome of radial artery grafting followed by parent artery trapping or proximal occlusion for management of these difficult lesions. Between September 1997 and October 2005, we performed radial artery grafting followed immediately by parent artery occlusion in 17 patients with giant or large complex intracranial carotid aneurysms (3 men, 14 women; mean follow-up duration, 62 months). All patients underwent postoperative digital subtraction angiography to assess graft patency and aneurysm obliteration. All 17 aneurysms were excluded from the cerebral circulation, with all radial artery grafts patent. Among 4 patients with cranial nerve disturbances, dysfunction was temporary in 5; in the others, oculomotor nerve paresis persisted. No perioperative cerebral infarction occurred. Sensory aphasia reflecting cerebral contusions caused by temporal lobe retraction resolved within 2 months, as did hemiparesis from a postoperative epidural hematoma. With appropriate attention to surgical technique, radial artery grafting followed by acute parent artery occlusion is a safe treatment for complex internal carotid artery aneurysms. Graft patency and aneurysm thrombosis were achieved in all patients. Cranial nerve dysfunction (III, VI) caused by altered blood flow from the internal carotid artery after occlusion was the most common complication and typically was temporary. In our experience with these difficult aneurysms, not only clipping but also reconstruction of the internal carotid artery was required, especially for wide-necked symptomatic

  3. The normal internal carotid artery: a computed tomography angiographic study

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, Suvi Maaria; Valanne, Leena; Silvennoinen, Heli [Helsinki University Central Hospital and University of Helsinki, Department of Radiology, HUS Medical Imaging Center, Helsinki (Finland); Soinne, Lauri [Helsinki University Central Hospital, Department of Neurology, Helsinki (Finland)

    2014-09-15

    Systematic computed tomography angiographic (CTA) studies investigating variation in internal carotid artery (ICA) luminal diameters (LDs) are scarce. Knowledge of the normal intra-individual LD variability would provide a cut-off value for detection of more subtle collapses. In addition, low intra-individual variability would allow using contralateral LD as a reference for estimation of stenosis degree in cases where ipsilateral measurement is hampered. Therefore, our aim was to investigate intra-individual LD variation of normal ICA. We retrospectively collected multidetector high-speed CTAs of 104 patients younger than 40 years who were considered not to have carotid pathology. We carried out independent measurements of the common carotid artery (CCA) and ICA LDs bilaterally from axial source images by two observers, analysing side-to-side LD differences from averaged double measurements with a paired t test. We discovered no significant side-to-side LD differences. In the female group, the mean differences (mm) with 95 % confidence intervals were 0.08 (0.00, 0.17) for CCA and 0.03 (-0.04, 0.11) for ICA, with ICA LD standard deviation of 0.4 mm. In the male group, these were: 0.06 (-0.04, 0.17), 0.02 (-0.07, 0.11) and 0.4 mm, respectively. We detected no ICA agenesis. The intrinsic intra-individual variation of the LD of normal ICA is minimal. This uniformity may serve as the basis for detection of subtle grades of side-to-side variation caused by pathology. (orig.)

  4. Asymptomatic carotid artery stenosis in patients with severe peripheral vascular diseases

    Directory of Open Access Journals (Sweden)

    Rasoul Mirsharifi

    2009-04-01

    Full Text Available

    • BACKGROUND: The prevalence of carotid artery stenosis (CAS in the  eneral population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS among patients with severe peripheral vascular disease (PVD.
    • METHODS: Between March 2005 and February 2006, 54 consecutive  atients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A  uestionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater.
    • RESULTS: The mean age was 62.5 years (51-72. Out of 54 patients, 2 (3.7% had an occluded internal carotid artery. Significant CAS was found in 9 (16.7% and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, ankle-brachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence.
    • CONCLUSION: The prevalence of significant ACAS is higher among  atients with severe PVD. This patient population may indicate a  uitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.
    • KEYWORDS: Carotid artery stenosis, duplex ultrasound scanning, peripheral vascular disease, carotid endarterectomy,
    • cerebrovascular accident.

  5. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III.

    Science.gov (United States)

    Uberoi, Raman; Milburn, Simon; Moss, Jon; Gaines, Peter

    2009-09-01

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online. PMID:19644643

  6. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

    International Nuclear Information System (INIS)

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.

  7. Maternal carotid remodeling and increased carotid arterial stiffness in normal late-gestational pregnancy as assessed by radio-frequency ultrasound technique

    OpenAIRE

    Yuan, Li-Jun; Xue, Dan; DUAN, YUN-YOU; Cao, Tie-Sheng; Zhou, Ning

    2013-01-01

    Background The adaption of elastic arteries to transient increase in hemodynamic load in normal pregnancy (NP) remains controversial. The purpose of this study was to investigate the NP carotid remodeling and regional arterial stiffness before and after parturition. Methods Fifty-one NP women and 30 age-matched non-pregnant women were included. All women underwent right common carotid artery (RCCA) measurements with MylabTwice ultrasound instrument (Esaote, Italy). Carotid intima-medial thick...

  8. Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

    Directory of Open Access Journals (Sweden)

    Vilson Lacerda Brasileiro Junior

    2014-02-01

    Full Text Available Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57% patients. Such individuals presented with a total of 29 (41.43% carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50 of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001 was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

  9. Reconstruction and navigation of carotid artery based on ultrasonic volume data

    Science.gov (United States)

    Choi, Yoo-Joo; Song, Soo-Min; Yun, Hyun-Joo; Kwak, Byoung-Joo; Kim, Myoung-Hee

    2004-04-01

    In this paper, we introduce new diagnosis tool to observe carotid artery based on ultrasonic volume data. The main components and applied algorithms of the developed diagnosis tool are explained. As one of main components, the semi-automatic segmentation method includes an effective speckle reducing filter and an automatic ROI tracking scheme. Furthermore, we present the reconstruction method that is effective for Y-typed carotid artery and the navigation path generation method that applies interpolation of medial points of ROI. To support the objective diagnosis, we provide the automatic measurement method of artery"s diameter. To show usefulness of the developed tool, we constructed 3D model for carotid artery of 34-year-old person and the diameter of carotid artery was automatically measured.

  10. The Effect of Short-term Intra-arterial Delivery of Paclitaxel on Neointimal Hyperplasia and the Local Thrombotic Environment after Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Yajun, E, E-mail: eyj7681@yahoo.com.cn [Affiliated Hospital of Hebei University, Department of Interventional Radiology (China); He Nengshu, E-mail: eyajun@hotmail.com; Fan Hailun, E-mail: mydream510@yahoo.com.cn [Tianjin Institute of Radiology, General Hospital of Tianjin Medical University, Department of Radiology (China)

    2013-08-01

    PurposeTo evaluate the effects of short-term intra-arterial delivery of paclitaxel on neointimal hyperplasia and the local thrombotic environment after angioplasty.MethodsAn experimental common carotid artery injury model was established in 60 rats, which were divided into experimental groups (40 rats) and controls (20 rats). Local intra-arterial administration of paclitaxel was applied at 2 doses (90 and 180 {mu}g/30 {mu}l), and the effects of short-term delivery of paclitaxel on neointimal hyperplasia and the expression of tissue factor (TF), plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA) were evaluated at days 15 and 30 by hematoxylin and eosin staining and immunohistochemistry.ResultsAt 15 and 30 days after injury, neointimal thickness and area, the ratio of intimal area to medial area and the stenotic rate were all significantly decreased in the group provided the high concentrations (180 {mu}g/30 {mu}l) of paclitaxel for 2 min or 10 min and in the group provided the low concentration (90 {mu}g/30 {mu}l) of paclitaxel for 10 min (p < 0.05). At 30 days after injury, there were no significant changes in TF expression among all experimental groups. PAI-1 expression increased in the neointima of the high concentration 10 min group (p < 0.05), while t-PA expression decreased in the neointima of the high concentration 2 min group (p < 0.05).ConclusionIn the rat common carotid artery injury model, the short-term delivery of paclitaxel could effectively inhibit neointimal hyperplasia in the long term, with very little influence on the local expression of TF and PAI-1.

  11. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short (≤5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle–brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 ± 0.11 versus 0.82 ± 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery

  12. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, Wojciech, E-mail: wponcyl@poczta.onet.pl; Falkowski, Aleksander, E-mail: bakhis@hot.pl [Pomeranian Medical University, Department of Interventional Radiology (Poland); Safranow, Krzysztof, E-mail: chrissaf@mp.pl; Rac, Monika, E-mail: carmon@pum.edu.pl [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry (Poland); Zawierucha, Dariusz, E-mail: dariusz13@yahoo.com [Interventional Radiology, Sacred Heart Medical Center, River Bend (United States)

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  13. Carotid arteries in central retinal vessel occlusion as assessed by Doppler ultrasound.

    OpenAIRE

    Peternel, P; Keber, D; Videcnik, V

    1989-01-01

    Doppler ultrasound was used to detect possible flow changes in the carotid arteries of patients with central retinal artery and vein occlusion. Twenty-three patients with central retinal artery occlusion (mean age 56, SD 11, years) were examined 4 to 48 months after the development of the occlusion and compared with age and sex matched control subjects with no history of any disease known to be associated with pathological changes in carotid vessels. Significant stenosis or occlusion of one o...

  14. Shared and discrepant susceptibility for carotid artery and aortic arch calcification: A genetic association study.

    Science.gov (United States)

    Zhang, Yumeng; Wang, Li; Zhang, Zhizhong; Zhang, Zongjun; Zhou, Shuyu; Cao, Liping; Cai, Biyang; Liu, Keting; Bai, Wen; Xie, Xia; Fan, Wenping; Liu, Xinfeng; Lu, Guangming; Xu, Gelin

    2015-08-01

    Genome-wide association studies (GWASs) have identified several risk loci for coronary artery calcification. Four single-nucleotide polymorphisms (SNPs, rs1537370, rs1333049, rs2026458 and rs9349379) were associated with coronary artery calcification with P values less than 5 × 10(-8) in GWASs. It is unclear if these associations exist in other vascular beds. Thus, we evaluated the impacts of these four SNPs on carotid artery and aortic arch calcification in this study. Computed tomography was applied to quantify the calcification of carotid artery and aortic arch. 860 patients with stroke completed calcification quantification and genotype testing were included in data analysis. Each SNP was evaluated for the association with carotid artery calcification, and with aortic arch calcification using generalized linear model. Among the four tested SNPs, rs2026458 was associated with calcification in both carotid artery (β = 0.31, 95% confidence interval [CI] 0.10-0.52, P = 0.003) and aortic arch (β = 0.32, 95% CI 0.10-0.54, P = 0.004), while rs1333049 was only associated with carotid artery calcification (β = 0.28, 95% CI 0.06-0.50, P = 0.011). In gender-stratified analyses, rs2026458 had significant impacts on carotid artery (P = 0.003) and aortic arch calcification (P = 0.008) in male, but not in female patients; while rs1537370 was significantly associated with carotid artery calcification in female (P = 0.013), but not in male patients. In conclusion, SNPs associated with coronary artery calcification may also increase the risk of calcification in other arteries such as carotid artery and aortic arch. PMID:26071660

  15. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    OpenAIRE

    Su, Ta-Chen

    2011-01-01

    Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial funct...

  16. Emergency endovascular revascularization of tandem occlusions: Internal carotid artery dissection and intracranial large artery embolism.

    Science.gov (United States)

    Cohen, José E; Leker, Ronen R; Eichel, Roni; Gomori, Moshe; Itshayek, Eyal

    2016-06-01

    Internal carotid artery dissection (ICAD) with concomitant occlusive intracranial large artery emboli is an infrequent cause of acute stroke, with poor response to intravenous thrombolysis. Reports on the management of this entity are limited. We present our recent experience in the endovascular management of occlusive ICAD and major intracranial occlusion. Consecutive anterior circulation acute stroke patients meeting Medical Center criteria for endovascular management of ICAD from June 2011 to June 2015 were included. Clinical, imaging, and procedure data were collected retrospectively under Institutional Review Board approval. The endovascular procedure for carotid artery revascularization and intracranial stent thrombectomy is described. Six patients met inclusion criteria (National Institutes of Health Stroke Scale score 12-24, time from symptom onset 2-8hours). Revascularization of the extracranial carotid dissection and stent thrombectomy were achieved in 5/6 patients, resulting in complete recanalization (Thrombolysis in Myocardial Infarction flow grade 3 in a mean 2.7hours), and modified Rankin Scale score 0-2 at 90 day follow-up. In one patient, attempts to microcatheterize the true arterial lumen failed and thrombectomy was therefore not feasible. No arterial dissection, arterial rupture or accidental stent detachment occurred, and there was no intracerebral hemorrhage or hemorrhagic transformation. Our preliminary data on this selected subgroup of patients suggest the presented approach is safe, feasible in a significant proportion of patients, and efficacious in achieving arterial recanalization and improving patient outcome. Crossing the dissected segment remains the most important limiting factor in achieving successful ICA recanalization. Further evaluation in larger series is warranted. PMID:26924182

  17. Intima-media Thickness and Arterial Stiffness of Carotid Artery in Korean Patients with Behçet's Disease

    OpenAIRE

    Rhee, Moo-Yong; Chang, Hyun Kyu; Kim, Seong-Kyu

    2007-01-01

    Behçet's disease (BD) is a systemic vasculitis involving diverse sizes of arteries and veins. We performed this study to evaluate the vascular changes by assessment of the arterial stiffness and intima-media thickness (IMT) of carotid artery in Korean patients with BD. Forty-one patients with BD and age-, and sex-matched 53 healthy subjects were recruited in this study. Carotid arterial stiffness and IMT were assessed by using high-resolution B-mode ultrasonography. Arterial stiffness paramet...

  18. A STUDY OF ANATOMICAL VARIATIONS OF THE COMMON CAROTID ARTERIES: A CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    Vatsala A R

    2014-03-01

    Full Text Available Background: Anatomical variations of carotid arterial system which are not infrequently encountered have a great impact on the surgical approaches of the neck. Although the described individual variations of the carotid arteries are well-known in the literature, the combination of anomalies reported in this study has not been, to the best of our knowledge, previously described. The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck. Methods:The present study was undertaken on 80 common carotid arteries (40 left, 40 right of both sexes from embalmed adult human cadavers. The specimens were studied by detailed dissection method. Results: In the present study,fiftyone (63.8% bifurcations of common carotid arteries were high among which the most common levels of bifurcation was at the level of C 3 vertebral body (37.5%. The origin of the right common carotid artery was high and low in 10% and 2.6% of vessels respectively. Conclusion: The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck.

  19. Percutaneous transluminal angioplasty of chronic arterial occlusive disease below the knee joint

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the safety and efficacy of the percutaneous transluminal angioplasty(PTA) in patients with chronic arterial occlusive disease below the knee joint. We retrospectively analyzed the results of 36 procedures in 16 patients. There were 15 men and one woman, aged 57-75 years(mean, 62 years). Indications were disabling claudication (SVS/ISCVS grade 1, category 3) in five cases, rest pain(grade 2, category 4) in three cases, and non-healing ulceration or gangrene(grade3, category 5) in eight cases. PTA was performed by using small vessel balloon catheter of 2-4 mm and 3 mm monorail balloon catheter in tibioperoneal vessels and 5-6 mm balloon catheter in distal popliteal artery and tibioperoneal trunk. Combined thrombolytic therapy with Urokinase was performed in 14 patients. Involved infrapopliteal vessels were four distal popliteal arteries, 15 tibioperoneal trunks, six anterior tibial arteries, five posterior tibial arteries, and seven peroneal arteries. Technical success was determined when post-PTA angiogram showed less than 30% of residual stenosis. Clinical success was defined as improvement of clinical symptoms, such as disappearance of claudication or rest pain, and healing of ulcereation. Technical success was achieved in 30 of 36 arteries(83%). Clinical success was achieved in 12 of 16 patients(75%) at an average follow-up of 13.3 months(range, 2-46 months). Clinical success rate was 100% in grade 1 category 3 patients, 67% in grade 2 category 4 patients, and 63% in grade 3 category 5 patients. Complication included two distal emboli, one vessel rupture, one vessel thrombosis, and one occluding intimal flap. PTA was an effective method for treatment of chronic arterial occlusive disease below the knee joint and considered as the procedure of first choice. Severe claudicant(grade1) should be included in the indication of the tibioperoneal PTA

  20. A historical prospective cohort study of carotid artery stenosis after radiotherapy for head and neck malignancies

    International Nuclear Information System (INIS)

    Purpose: To determine carotid artery stenosis incidence after radiotherapy for head-and-neck neoplasms. Methods and Materials: This historical prospective cohort study comprised 44 head-and-neck cancer survivors who received unilateral neck radiotherapy between 1974 and 1999. They underwent bilateral carotid duplex ultrasonography to detect carotid artery stenosis. Results: The incidence of significant carotid stenosis (8 of 44 [18%]) in the irradiated neck was higher than that in the contralateral unirradiated neck (3 of 44 [7%]), although this difference was not statistically significant (p = 0.13). The rate of significant carotid stenosis events increased as the time after radiotherapy increased. The risk of ipsilateral carotid artery stenosis was higher in patients who had undergone a neck dissection vs. those who had not. Patients with significant ipsilateral stenosis also tended to be older than those without significant stenosis. No other patient or treatment variables correlated with risk of carotid artery stenosis. Conclusions: For long-term survivors after neck dissection and irradiation, especially those who are symptomatic, ultrasonographic carotid artery screening should be considered

  1. Delayed Cerebral Ischemia following to Repair of Penetrating Trauma to External Carotid artery Introduction

    Directory of Open Access Journals (Sweden)

    M. Eskandarlou

    2016-01-01

    Full Text Available Introduction: Penetrating trauma to anterior neck can induce cerebral ischemia due to carotid artery injury. Brain ischemia also can present after surgical carotid repairs. Early diagnosis and suitable treatment modality prevent from permanent neurologic deficit post operatively. Case Report: A 30 years old man with stab wound to zone two left side of neck underwent exploration and penrose insertion. Due to excessive bleeding through drain tube, patient was transferred to Besat Hospital of Hamadan. Surgical repair of external carotid artery successfully was done. Four days later patient developed right hemiparesis suddenly. According to MRI and color Doppler sonography finding of thrombosis of left common and internal carotid artery, reoperation was done. After thrombectomy cerebral ischemia and hemi-paralysis improved. Conclusions: Surgical approach to symptomatic penetrating neck trauma is oblique cervical incision, control of bleeding, repair of internal carotid, repair or ligature of external carotid artery base on some factors and preferential repair of internal jugular vein. Meticulous and fine surgical technique for both vascular repair and protection of adjacent normal vessels for avoiding to blunt trauma or compression with retractors is noticeable. Exact postoperative care as repeated clinical examination with goal of early diagnosis of internal carotid artery thrombosis and rapid diagnostic and treatment planning of this complication are important factors for taking of good result in treatment of penetrating trauma to carotid. Sci J Hamadan Univ Med Sci . 2016; 22 (4 :353-357

  2. Evaluation of internal carotid artery segmentation by InsightSNAP

    Science.gov (United States)

    Spangler, Emily L.; Brown, Christopher; Roberts, John A.; Chapman, Brian E.

    2007-03-01

    Quantification of cervical carotid geometry may facilitate improved clinical decision making and scientific discovery. We set out to evaluate the ability of InsightSNAP (ITK-SNAP), an open-source segmentation program for 3D medical images (http://www.itksnap.org, version 1.4), to semi-automatically segment internal carotid arteries. A sample of five individuals (three normal volunteers, and two diseased patients) were imaged with an MR exam consisting of a MOTSA TOF MRA image volume and multiple black blood images acquired with different contrast weightings. Comparisons were made to a manual segmentation created during simultaneous evaluation of the MOTSA image and the various black blood images (typically PD-weighted, T1-weighted, and T2-weighted). These individuals were selected as a training set to determine acceptable parameters for ITK-SNAP's semi-automatic level sets segmentation method. The conclusion from this training set was that the initial thresholding (assigning probabilities to the intensities of image pixels) in the image pre-processing step was most important to obtaining an acceptable segmentation. Unfortunately no consistent trends emerged in how this threshold should be chosen. Figures of percent over- and under-segmentation were computed as a means of comparing the hand segmented and semi-automatically segmented internal carotids. Overall the under-segmentation by ITK-SNAP (voxels included in the manual segmentation but not in the semiautomated segmentation) was 10.94% +/- 6.35% while the over-segmentation (voxels excluded in the manual segmentation but included in the semi-automated segmentation) was 8.16% +/- 4.40% defined by reference to the total number of voxels included in the manual segmentation.

  3. Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia

    International Nuclear Information System (INIS)

    Objective: Elderly patients with extensive infrainguinal peripheral vascular disease and critical chronic limb ischemia (CCLI) are poor surgical candidates. Our purpose was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in such patients. Design: Retrospective study of angiographic and clinical files in selected group. Materials and methods: Between 1996 and 2002, 38 elderly patients aged 80-94 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/38 (81.5%) patients had chronic non-healing wounds, and 14/38 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. Results: The overall procedural success rate was 32/38 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). Conclusions: Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group

  4. Delayed presentation of carotid artery dissection following major orthopaedic trauma resulting in dense hemiparesis.

    LENUS (Irish Health Repository)

    Edmundson, S P

    2012-01-31

    We report a 30-year-old patient who was involved in a high-velocity road traffic accident and developed a left-sided hemiparesis, which was noted in the post-operative period following bilateral femoral intramedullary nailing. CT scanning of the brain revealed infarcts in the right frontal and parietal lobes in the distribution of the right middle cerebral artery. CT angiography showed occlusion of the right internal carotid artery consistent with internal carotid artery dissection. He was anticoagulated and nine months later was able to walk independently. An awareness of this injury is needed to diagnose blunt trauma to the internal carotid artery. Even in the absence of obvious neck trauma, carotid artery dissection should be suspected in patients with a neurological deficit in the peri-operative period.

  5. Interobserver agreement on the diagnosis of carotid artery calcifications on panoramic radiographs

    International Nuclear Information System (INIS)

    This study was performed to investigate the interobserver agreement on the detection of carotid artery calcifications on panoramic radiographs. This study consisted of panoramic radiographs acquired from 634 male patients of the age of 50 years or older. Having excluded carotids of no diagnostic quality, 1008 carotids from the panoramic radiographs of the patients were interpreted by two oral and maxillofacial radiologists independently for the presence of carotid artery calcifications. Statistical analysis was used to calculate the interobserver agreement. Interobserver agreement was obtained for 932 carotids (92.4%). Inconsistent interpretation of 76 carotids (7.5%) between the two observers was found. Cohen's kappa value was 0.688 (p<0.001). The probability of a match between the two observers was substantially high.

  6. [Prevention of ischemic stroke in patients with asymptomatic lesions of carotid arteries].

    Science.gov (United States)

    Gavrilenko, A V; Guzenko, A S; Kuklin, A V; Kochetkov, V A

    2012-01-01

    Based on the data from both Russian and foreign literature, analysed herein are the methods of surgical and medicamentous prevention of ischaemic stroke in patients presenting with asymptomatic lesions of carotid arteries. This is followed by discussing haemodynamic parameters of the blood flow in the carotid arteries and their effect on cerebrovascular symptomatology. Also presented herein are the data concerning efficacy of different modalities of antithrombocytic therapy, followed by presenting own results regarding surgical management for stenoses and pathological kinking of carotid arteries in the patient cohort concerned. PMID:22929668

  7. Influence of carotid artery stenting on cognitive function

    Energy Technology Data Exchange (ETDEWEB)

    Quasar Grunwald, Iris [Saarland University Clinic, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Department of Neuroradiology, Homburg (Germany); Papanagiotou, Panagiotis; Backens, Martin; Politi, Maria; Vedder, Verena; Zercher, K. [Saarland University Clinic, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Reith, Wolfgang; Supprian, Tilman; Muscalla, B.; Haass, Anton; Krick, Christoph M. [Saarland University Clinic, Clinic for Neurology, Homburg (Germany); Saarland University Clinic, Clinic for Psychiatry and Psychotherapy, Homburg (Germany)

    2010-01-15

    There have only been a few studies on cognitive changes in patients with carotid occlusive disease, and the results of these show major discrepancies in the extent to which treatment affects neuropsychological function. We sought to clarify these discrepancies by evaluating the effects of carotid artery stenting (CAS) on the cognitive function. Forty-one asymptomatic CAS patients were administered a test battery of neuropsychological tests measuring cognitive speed and memory function before and 3 months after the procedure. A control group was also evaluated. To test for thromboembolic lesions, diffusion-weighted imaging was used. CAS led to a significant increase in cognitive speed (p < 0.001) but did not afford any change in memory function. This was regardless of the degree or side of stenosis or patient age or gender. CAS significantly improved functions that involve cognitive speed. Earlier studies did not differentiate between speed and memory tests and thus might have missed these changes. Further studies correlating changes in brain perfusion with increase in cognitive speed are needed. (orig.)

  8. Influence of carotid artery stenting on cognitive function

    International Nuclear Information System (INIS)

    There have only been a few studies on cognitive changes in patients with carotid occlusive disease, and the results of these show major discrepancies in the extent to which treatment affects neuropsychological function. We sought to clarify these discrepancies by evaluating the effects of carotid artery stenting (CAS) on the cognitive function. Forty-one asymptomatic CAS patients were administered a test battery of neuropsychological tests measuring cognitive speed and memory function before and 3 months after the procedure. A control group was also evaluated. To test for thromboembolic lesions, diffusion-weighted imaging was used. CAS led to a significant increase in cognitive speed (p < 0.001) but did not afford any change in memory function. This was regardless of the degree or side of stenosis or patient age or gender. CAS significantly improved functions that involve cognitive speed. Earlier studies did not differentiate between speed and memory tests and thus might have missed these changes. Further studies correlating changes in brain perfusion with increase in cognitive speed are needed. (orig.)

  9. Automatic active contour-based segmentation and classification of carotid artery ultrasound images.

    Science.gov (United States)

    Chaudhry, Asmatullah; Hassan, Mehdi; Khan, Asifullah; Kim, Jin Young

    2013-12-01

    In this paper, we present automatic image segmentation and classification technique for carotid artery ultrasound images based on active contour approach. For early detection of the plaque in carotid artery to avoid serious brain strokes, active contour-based techniques have been applied successfully to segment out the carotid artery ultrasound images. Further, ultrasound images might be affected due to rotation, scaling, or translational factors during acquisition process. Keeping in view these facts, image alignment is used as a preprocessing step to align the carotid artery ultrasound images. In our experimental study, we exploit intima-media thickness (IMT) measurement to detect the presence of plaque in the artery. Support vector machine (SVM) classification is employed using these segmented images to distinguish the normal and diseased artery images. IMT measurement is used to form the feature vector. Our proposed approach segments the carotid artery images in an automatic way and further classifies them using SVM. Experimental results show the learning capability of SVM classifier and validate the usefulness of our proposed approach. Further, the proposed approach needs minimum interaction from a user for an early detection of plaque in carotid artery. Regarding the usefulness of the proposed approach in healthcare, it can be effectively used in remote areas as a preliminary clinical step even in the absence of highly skilled radiologists. PMID:23417308

  10. The internal carotid artery does not directly supply the brain in the Monodontidae (order Cetacea).

    Science.gov (United States)

    Vogl, A W; Fisher, H D

    1981-11-01

    In this paper we describe the gross and microscopic anatomy of the internal carotid artery and demonstrate that this vessel does not directly supply blood to the brain, in the Monodontidae (order Cetacea). Our account is based on gross dissections and perfusion casts of the arterial vasculature in Delphinapterus leucas and Monodon monoceros and on histological material from the latter species. The internal carotid artery originates low in the neck and extends to the carotid rete at the base of the brain. The vessel tapers dramatically along its cervical course and changes from an artery elastic in nature to one more muscular. A single large cervical branch occurs in D. leucas and supplies cerebrally related retia in this region and prevertebral muscles. No cervical branches occur in M. monoceros. In otic regions, the internal carotid artery is small and muscular. A lumen is present; however, a split internal and external elastic lamella and a thickened subendothelial layer are evident. Though patent in the neck and ear, the vessel appears occluded within the carotid canal. At this level, the vessel is characterized by absence of a lumen and by fragmented elastic lamellae. We conclude that the internal carotid artery is anatomically closed at a level just proximal to the carotid rete and hence has no direct involvement with cerebral blood supply in the Monodontidae. Our results confirm other investigators' work on smaller cetacean species. PMID:7299829

  11. Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Wei Yue

    Full Text Available To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05-2.11, p<0.001. Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery.

  12. Reliability of digital panoramic radiographs in detecting calcified carotid artery atheromatous plaques: A clinical study

    OpenAIRE

    Neha Khambete; Rahul Kumar; Mukund Risbud; Anil Joshi

    2014-01-01

    Objectives: The objective of this study was to determine whether digital panoramic radiography is a reliable method to detect calcified carotid artery atheromatous plaques (CCAAP) as compared with ultrasonography. Study Design: Digital panoramic radiographs were obtained from 50 patients who also underwent carotid ultrasound examination. The images were interpreted by trained maxillofacial radiologist for the presence or absence of calcified atheromatous plaques. The extent of carotid cal...

  13. Contralateral Cerebral Infarction after Stent Placement in Carotid Artery: An Unexpected Complication

    OpenAIRE

    Park, Seong-Ho; Lee, Chang Young

    2008-01-01

    Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondar...

  14. 18FDG PET and ultrasound echolucency in carotid artery plaques

    DEFF Research Database (Denmark)

    Graebe, Martin; Pedersen, Sune F; Højgaard, Liselotte;

    2010-01-01

    ultrasound and PET imaging. Plaque standardized gray scale medians (GSM) were measured in longitudinal ultrasound images to quantitate echolucency, and GSM values were compared with FDG PET uptake quantified by maximum standardized uptake values (SUV). Symptomatic plaques were compared with contralateral...... carotid artery plaques considered asymptomatic, and in 17 symptomatic patients, endarterectomized plaque specimens were analyzed for CD68 expression. RESULTS: There was a negative correlation between GSM and FDG SUV (r = -0.56, p < 0.01). Whereas echo-rich plaques tended to show low FDG uptake, echolucent...... plaques ranged from high to low inflammatory activity, as depicted with PET. Quantitative FDG SUV differentiated asymptomatic from symptomatic plaques, whereas GSM values did not. There was a positive correlation between CD68 expression and FDG uptake (r = 0.50, p = 0.04). CONCLUSIONS: Our results...

  15. Covered Stent-Graft Treatment of a Postoperative Common Carotid Artery Pseudoaneurysm

    International Nuclear Information System (INIS)

    Extracranial carotid artery pseudoaneurysms are rare cases resulting from trauma, mycotic infection, head and neck carcinomas or complications related to their treatment. Trauma is the most common cause of carotid artery pseudoaneurysms. They can also present after surgery, most commonly following endarterectomy, which is a rare cause with an estimated incidence of 0.3–0.6%. A 26-year-old male patient was admitted with swelling in his left neck after left carotid endarterectomy. Angiography confirmed pseudoaneursym in the left carotid bulb and it was treated successfully with two heparin-bonded covered stent grafts. Endovascular treatment of carotid pseudoaneurysms with covered stent-grafts is a safe and efficient method providing definitive arterial reconstruction. But series with longer follow-up periods are needed to evaluate patient compatibility to lifelong antiplatelet theraphy

  16. The relationship between cerebral infarctive CT findings and cervical carotid arterial abnormalities

    International Nuclear Information System (INIS)

    The relationship between cervical carotid arterial changes and cerebral occlusive or ischemic disease was discussed in 120 consecutive cases (60 abnormal and 60 normal CT findings) which had been examined by means both of angiography and of brain CT. Even the low-grade stenosis of the carotid artery (less than 50%) had influence on the infarctive changes in CT; in these low-grade stenotic cases, clinico-pathological study sometimes revealed intimal damage, calcification, and clot formation on the damaged inner wall. Angiographically, the focal accumulation of contrast media in the carotid pathological region is a radiological expression of focal circulatory disturbance, a transient staying of the carotid blood flow, of clot-formation. More dynamic circulatory findings were revealed by Cine-Angiography. In cases of positive brain CT findings, cortical and multiple lesions more frequently had carotid changes and the accumulation of contrast media than did the basal ganglia and subcortical lesions. Even in the cases of negative brain CT findings, carotid changes were observed in about 20% of the cases. Angiographical study has the limitation that it cannot reveal the abnormality of the carotid arterial wall itself. On the other hand, carotid angio-CT was able to reveal carotid wall changes - for instance, calcification at a high density and atheromatous change at a low density: it can also investigate the range and degree. It is also useful in the follow-up study of pre-operative and post-operative changes, or anti-platelet therapy. (author)

  17. Potential Role of Axonal Chemorepellent Slit2 in Modulating Adventitial Inflammation in a Rat Carotid Artery Balloon Injury Model.

    Science.gov (United States)

    Liu, Dong; Xiao, Yan; Subramanian, Romesh R; Okamoto, Ei-Ichi; Wilcox, Josiah N; Anderson, Leonard; De Leon, Hector

    2016-05-01

    Leukocyte infiltration of adventitial and perivascular tissues is an early event in the development of vascular remodeling after injury. We investigated whether Slit/Robo-an axonal chemorepellent system in vertebrate and invertebrate development-is activated during the inflammatory phase that follows endothelial denudation. Using the rat carotid artery model of angioplasty, we conducted a time course analysis of mRNAs encoding Slit ligands (Slit2 and Slit3) and Robo receptors (Robo1, Robo2, and Robo4), as well as proinflammatory cell adhesion molecule (CAM) genes. Adventitial inflammatory cells were counted in immunostained arterial sections. E-selectin, vascular CAM-1, and intercellular CAM-1 were upregulated 2-3 hours after injury, followed by infiltration of neutrophils and monocytes as evidenced by real-time polymerase chain reaction, in situ hybridization, and immunohistochemistry. Slit2, Slit3, and Robo genes exhibited no expression changes at 3 hours; however, they were markedly upregulated 1 day after angioplasty. Intercellular CAM-1 expression was reduced by 50%, and the number of adventitial neutrophils decreased by >75% 1 day after angioplasty. Slit2 has been shown to be a potent chemorepelent of leukocytes, endothelial cells, and smooth muscle cells. Thus, we decided to further investigate the localization of Slit2 in injured vessels. Immunohistochemical stainings revealed the presence of Slit2 within the vessel wall and in the perivascular vasa vasorum of naive and injured arteries. Double immunohistochemical analyses showed that infiltrating monocytes expressed Slit2 in the perivascular and adventitial tissues of injured arteries 1 and 3 days postangioplasty. In addition, recombinant full-length Slit2 and Slit2-N/1118, an N-terminal fragment of Slit2, inhibited stromal cell-derived factor 1-mediated migration of circulating rat peripheral blood mononuclear cells. In summary, adventitial activation of CAM genes and neutrophil infiltration preceded

  18. The electron microscopic morphology of the common carotid artery in rats

    NARCIS (Netherlands)

    Pinto, YM; Pinto, SJ; Paul, M; Merker, HJ

    1998-01-01

    The common carotid arteries of normal adult rats were investigated electron-microscopically after tannic acid fixation. This fixation technique yields a better demonstrability of the structures of the connective tissue, the basal laminae and the surface coat of the cell membrane. The common carotid

  19. Percutaneous transluminal angioplasty of brachiocephalic arteries: Indications and long-term success in a series of 25 patients

    International Nuclear Information System (INIS)

    The clinical records and procedural details of 28 angioplasty procedures performed on 25 patients were reviewed. Long-term follow-up was conducted by examining the referring physicians' records and by direct telephone contact with the patient. Nine patients had neurologic symptoms only, eight patients had arm claudication symptoms only, seven patients had both neurologic and arm symptoms, and two patients underwent dilation procedures to provide graft inflow. Procedural complications were a stroke in the contralateral carotid distribution during follow-up thoracic aortography, and an embolus to the fifth digit (of no clinical significance). Long-term success of the angioplasty procedure did not correlate with initial symptoms, degree of stenosis, lesion length, or postangioplasty appearance. All patients with arm and neurologic symptoms and who were followed up for 3 years, with the exception of the patient who suffered a periprocedural stroke

  20. Incidentally diagnosed Takayasu arteritis on thyroid ultrasonography showing prominent collateral vessels of thyroidal arteries and common carotid artery occlusion

    International Nuclear Information System (INIS)

    We report a case of middle-aged woman incidentally diagnosed with Takayasu arteritis during the ultrasonography of a thyroid gland nodule. Prominent collaterals of the thyroidal arteries and a thin common carotid artery with mural thickening and deficient intraluminal flow signals were initially depicted on the ultrasonography with color Doppler. Subsequent magnetic resonance angiography and computed tomography aortography confirmed the diagnosis with the imaging features of a bilateral long segment common carotid artery occlusion and segmental stenosis of the left subclavian artery in addition to the suggestive physical findings.

  1. Blood flow changes after unilateral carotid artery ligation monitored by optical coherence tomography

    Science.gov (United States)

    Ma, Yushu; Liang, Chengbo; Suo, Yanyan; Zhao, Yuqian; Wang, Yi; Xu, Tao; Wang, Ruikang; Ma, Zhenhe

    2016-03-01

    Unilateral carotid artery ligation which could induce adaptive improvement is a classic model that has been widely used to study pathology of ischemic disease. In those studies, blood flow is an important parameter to characterize the ischemia. Optical coherence tomography (OCT) is a powerful imaging modality which can provide depth resolved images in biological tissue with high spatial and temporal resolution. SPF rats was anesthetized with isoflurane and divided into two groups. In first group, bilateral carotid artery was surgically exposed, and then left carotid artery was ligated. Blood flow changes of the contralateral carotid artery was monitored using high speed spectral domain optical coherence tomography, including the absolute flow velocity and the flow volume. In the other group, skull window was opened at the ipsilateral cerebral cortex of ligation and blood supply of small artery was measured before and after the ligation. The measured results demonstrate the blood supply compensation process after unilateral carotid artery ligation. With the superiority of high resolution, OCT is an effective technology in monitoring results of carotid artery after ligation.

  2. Value of P-31 MR spectroscopy for percutaneous transluminal angioplasty of the iliofemoral arteries

    International Nuclear Information System (INIS)

    Phosphorus metabolism of the calf muscles has been determined by P-31 MR spectroscopy for evaluation of percutaneous transluminal angioplasty (PTA) of the lower extremities. Seventeen patients with atherosclerotic stenosis or occlusion of the iliac and femoral arteries underwent P-31 MR spectroscopy before and after PTA. Seven normal controls also underwent P-31 MRS of the lower extremities. The average ratio of β-adenosine triphosphate β-ATP), phosphocreatine (PCr), and inorganic phosphate (Pi) to the total signal per minute was compared. A 1.5-T superconductive MR unit was used. In patients with atherosclerotic disease, the ratio of β-ATP was lower before PTA at all measurement points before, during, and after exercise. A minimal drop in the values was observed with exercise, and the recovery was very slow after exercise

  3. Peripheral macroembolism complicating laser angioplasty of arteries of extremities - therapy with radiologic interventional methods

    International Nuclear Information System (INIS)

    From 1987 to 1989 in the Barmherzige Brueder Hospital in Linz/Austria 160 arteries of extremities were treated with laser-assisted balloon dilatation. During these interventions peripheral macroembolism occurred 8 times. The mean length of the recanalised segment was 8.7 cm and thus longer than average (6.5 cm). All 8 cases were successfully treated by aspiration or aspiration combined with local lysis. No adverse effects on long-term results were noted. In 4 cases an early occlusion of the recanalised segment was diagnosed within 48 hours after laser-assisted angioplasty, three times accompanied by embolism. These emboli, too, were removed by aspriation and lysis. To reduce the risk of embolisation strict rules of indication concerning the age of an occlusion have to be observed and mechanical trauma has to be minimised. (orig.)

  4. Carotid anatomy does not predict the risk of new ischaemic brain lesions on diffusion-weighted imaging after carotid artery stenting in the ICSS-MRI substudy

    OpenAIRE

    Doig, D; Hobson, B. M.; Müller, M; Jäger, H R; Featherstone, R. L.; Brown, M M; Bonati, L.H.; Richards, T.

    2015-01-01

    INTRODUCTION: The International Carotid Stenting Study (ICSS, ISRCTN25337470) randomized patients with recently symptomatic carotid artery stenosis > 50% to carotid artery stenting (CAS) or endarterectomy. CAS increased the risk of new brain lesions visible on diffusion-weighted magnetic resonance imaging (DWI-MRI) more than endarterectomy in the ICSS-MRI Substudy. The predictors of new post-stenting DWI lesions were assessed in these patients. METHODS: ICSS-MRI Substudy patients allocated to...

  5. Catheterization of the Hepatic Artery Via the Left Common Carotid Artery in Rats

    International Nuclear Information System (INIS)

    The commonly used approach for rat hepatic artery catheterization is via the gastroduodenal artery, which is ligated after the procedure. A new method of rat hepatic artery catheterization via the left common carotid artery (LCCA) is described. The LCCA is repaired after catheterization. The catheterization procedures included the following: (1) opening the rat's abdominal cavity and exposing the portion of abdominal aorta at the level of the celiac trunk; (2) separating and exposing the LCCA; inserting a microguidewire and microcatheter set into the LCCA via an incision; after placement into the descending aorta, the microguidewire and microcatheter are maneuvered into the hepatic artery under direct vision; (3) after transcatheter therapy, the catheter is withdrawn and the incision at the LCCA is repaired. This technique was employed on 60 male Sprague-Dawley rats with diethylnitrosamine-induced liver cancer, using a 3F microguidewire and microcatheter set. Selective hepatic artery catheterization was successfully performed in 57 rats. One rat died during the operation and five rats died within 7 days after the procedure. It is envisaged that as experience increases, the catheterization success rate will increase and the death rate will decrease. A new approach for selective hepatic artery catheterization via the LCCA in rats is introduced, which makes repeat catheterization of this artery possible and allows large embolization particles to be delivered by using a 3F catheter

  6. Association of carotid artery intima-media thickness and cardiovascular risk factors in adult

    International Nuclear Information System (INIS)

    Increased intima-media thickness (IMT) of the common carotid artery is an early marker of atherosclerosis and a powerful predictor of coronary and cerebrovascular diseases. The purpose of this study was to evaluate the correlation between carotid artery IMT and cardiovascular risk factors. Total 134 adult were performed with Ultrasonography to measure IMT at common carotid artery, the physical measurements and blood tests, the following results were obtained. As a result, IMT showed higher value in male IMT than female IMT. And, the IMT increased according to the age increased. Also, TC and AI have positive significant correlation with IMT. In Conclusion, cardiovascular risk factors with adult are associated with increased IMT of common carotid artery

  7. [Traumatic dissection of the internal carotid artery by a safety belt: a report of two cases].

    Science.gov (United States)

    López-Sánchez, M; Ballesteros-Sanz, M A; Pérez-Ceballos, A; González-Fernández, C; López-Espadas, F

    2009-10-01

    Traumatic internal carotid artery dissection secondary to blunt trauma is a rare event accounting for 0.08 to 0.4% of all traumatic lesions. The spectrum of traumatic lesions that can affect the internal carotid artery includes minor lesions like spasm, intimal tears, or mural contusions and serious lesions like pseudoaneurysms and complete occlusion. Delayed clinical presentation is typical and can include headache, hemiparesis, partial Horner's syndrome, and cranial nerve palsy. Embolization secondary to the dissection can have devastating effects because it may cause ischemic stroke. Traumatic internal carotid artery dissection after safety belt trauma is very rare; it is usually due to direct cervical trauma on the side of the shoulder fixation point, which causes external bruising along the pathway of the safety belt. We present two cases of traumatic internal carotid artery dissection with concomitant cerebral infarcts caused by safety belts; we discuss the clinical, diagnostic, and therapeutic aspects of this lesion. PMID:19828398

  8. Segmentation of carotid arteries by graph-cuts using centerline models

    Science.gov (United States)

    Gülsün, Mehmet A.; Tek, Hüseyin

    2010-02-01

    This document presents a semi-automatic method for segmenting carotid arteries in contrast enhanced (CE)- CT angiography (CTA) scans. The segmentation algorithm extracts the lumen of carotid arteries between user specified locations. Specifically, the algorithm first detects the centerline representations between the user placed seed points. This centerline extraction algorithm is based on a minimal path detection method which operates on a medialness map. The lumen of carotid arteries is then extracted by graph-cuts optimization technique using the detected centerlines as input. The distance from the centerline representation is used to normalize the gradient based edge weights of the graph. It is shown that this algorithm can successfully segment the carotid arteries without including calcified and non-calcified plaques in the segmentation results.

  9. Medical decision-making system of ultrasound carotid artery intima-media thickness using neural networks.

    Science.gov (United States)

    Santhiyakumari, N; Rajendran, P; Madheswaran, M

    2011-12-01

    The objective of this work is to develop and implement a medical decision-making system for an automated diagnosis and classification of ultrasound carotid artery images. The proposed method categorizes the subjects into normal, cerebrovascular, and cardiovascular diseases. Two contours are extracted for each and every preprocessed ultrasound carotid artery image. Two types of contour extraction techniques and multilayer back propagation network (MBPN) system have been developed for classifying carotid artery categories. The results obtained show that MBPN system provides higher classification efficiency, with minimum training and testing time. The outputs of decision support system are validated with medical expert to measure the actual efficiency. MBPN system with contour extraction algorithms and preprocessing scheme helps in developing medical decision-making system for ultrasound carotid artery images. It can be used as secondary observer in clinical decision making. PMID:21181487

  10. Proposition of an outflow boundary approach for carotid artery stenosis CFD simulation.

    Science.gov (United States)

    Zhang, Yu; Furusawa, Toyoki; Sia, Sheau Fung; Umezu, Mitsuo; Qian, Yi

    2013-01-01

    The purpose of this study was to propose an innovative approach of setting outlet boundary conditions for the computational fluid dynamics (CFD) simulation of human common carotid arteries (CCAs) bifurcation based on the concept of energy loss minimisation at flow bifurcation. Comparisons between this new approach and previously reported boundary conditions were also made. The results showed that CFD simulation based on the proposed boundary conditions gave an accurate prediction of the critical stenosis ratio of carotid arteries (at around 65%). Other boundary conditions, such as the constant external pressure (P = 0) and constant outflow ratio, either overestimated or underestimated the critical stenosis ratio of carotid arteries. The patient-specific simulation results furthermore indicated that the calculated internal carotid artery flow ratio at CCA bifurcation (61%) coincided with the result obtained by clinical measurements through the use of Colour Doppler ultrasound. PMID:22288780

  11. Association of carotid artery intima-media thickness and cardiovascular risk factors in adult

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young [Dept. of Diagnostic Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Kim, Hwa Sun [Dept. of Radiological Technology, Ansan University, Ansan (Korea, Republic of); Kim, Shin Young [Dept. of Anatomy and Cell Biology, School of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2013-03-15

    Increased intima-media thickness (IMT) of the common carotid artery is an early marker of atherosclerosis and a powerful predictor of coronary and cerebrovascular diseases. The purpose of this study was to evaluate the correlation between carotid artery IMT and cardiovascular risk factors. Total 134 adult were performed with Ultrasonography to measure IMT at common carotid artery, the physical measurements and blood tests, the following results were obtained. As a result, IMT showed higher value in male IMT than female IMT. And, the IMT increased according to the age increased. Also, TC and AI have positive significant correlation with IMT. In Conclusion, cardiovascular risk factors with adult are associated with increased IMT of common carotid artery.

  12. Comparison of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque

    International Nuclear Information System (INIS)

    Objective: To compare the efficacy of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque. Methods: Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study, and 89 carotid arteries were evaluated by MRI and DSA. MRI examination was acquired with 3.0 T MR scanner and 8 channel phase-array surface coil. The MRI sequences consisted of pre-and post-contrast T1WI, T2WI, PDWI, TOF. Anterior-posterior and lateral views of carotid artery were performed on DSA. The degree of carotid artery stenosis was evaluated by the NASCET standard. Fibrous cap rupture, intraplaque hemorrhage, and calcification were also evaluated on MRI and DSA. Statistical comparison was performed with the Kappa value and paired Chi-square test. Results: The degree of carotid artery stenosis was 50% (16%-78%) on MRI and 47% (7%-73%) on DSA. Two imaging modalities were in good consistency in evaluation of the degree of stenosis (Kappa = 0.882, P2 =20.346, P<0.01). Furthermore, thirty-seven vessels with intraplaque hemorrhage and 71 vessels with calcification in the plaque were found on MRI but none on DSA. Conclusion: MRI is a reliable tool in assessment of the degree of the carotid stenosis and it is superior to DSA in detecting fibrous cap rupture, intraplaque hemorrhage, and calcification. (authors)

  13. Evaluation of stenotic lesions in the carotid arteries using ultrasonography and three-dimension CT angiography

    International Nuclear Information System (INIS)

    Indications for carotid endarterectomy (CEA) depend on the severity of carotid stenosis, as well as the surface characteristics of the stenotic lesion. The purpose of this study was to evaluate a diagnostic validity of three-dimensional CT angiography (3D-CTA) in patients with carotid stenosis, and to assess its applicability before CEA. Sixty-four patients with carotid artery stenosis were investigated pre-operatively by ultrasonography (US), 3D-CTA and digital subtraction angiography (DSA). The evaluation of the degree of carotid artery stenosis and its surface characteristics was done separately by each diagnostic modality. Thereafter, the data obtained by 3D-CTA were compared with those of US, DSA and pathological findings. The degree of carotid artery stenosis defined by 3D-CTA correlated well with those seen on DSA. However, arterial well irregularity, ulceration and calcifications were visualized more precisely on 3D-CTA. Assessment of surface properties of the stenostic lesion by 3D-CTA significantly correlated with data obtained by US. Comparing with other diagnostic modalities 3D-CTA provides much more precise information about the degree of the carotid artery stenosis and its surface properties. Therefore, 3D-CTA may be considered as a new alternative diagnostic tool for determination of indications for CEA. (author)

  14. Bayes Clustering and Structural Support Vector Machines for Segmentation of Carotid Artery Plaques in Multicontrast MRI

    OpenAIRE

    Qiu Guan; Bin Du; Zhongzhao Teng; Jonathan Gillard; Shengyong Chen

    2012-01-01

    Accurate segmentation of carotid artery plaque in MR images is not only a key part but also an essential step for in vivo plaque analysis. Due to the indistinct MR images, it is very difficult to implement the automatic segmentation. Two kinds of classification models, that is, Bayes clustering and SSVM, are introduced in this paper to segment the internal lumen wall of carotid artery. The comparative experimental results show the segmentation performance of SSVM is better than Bayes.

  15. Relationship Between Carotid Artery Calcification Detected in Dental Panoramic Images and Hypertension and Myocardial Infarction

    OpenAIRE

    Moshfeghi, Mahkameh; Taheri, Jamileh Beigom; Bahemmat, Nika; Evazzadeh, Mohammad Ebrahim; Hadian, Hoora

    2014-01-01

    Background: Carotid artery calcification may be related to cerebrovascular accident, which may result in death or physical and mental disabilities in survivors. Objectives: Our purpose is to study the association of carotid artery calcification (CAC) on dental panoramic radiographs and two risk factors of cerebrovascular accident (CVA) including hypertension and myocardial infarction (MI). Patients and Methods: Panoramic images of 200 patients that were all women above 50 years of age (a popu...

  16. Independent association between serum sclerostin levels and carotid artery atherosclerosis in prevalent haemodialysis patients

    OpenAIRE

    Alper KIRKPANTUR; BALCI, Mustafa; Turkvatan, Aysel; Afsar, Baris

    2015-01-01

    Background Sclerostin is a soluble inhibitor of the Wnt signalling pathway and has been shown to be associated with decreased bone turnover and vascular and/or valvular calcification in patients with chronic kidney disease. Common carotid artery intima-media thickness (CIMT) assessment and common carotid artery (CCA) plaque identification with ultrasound imaging are well-recognized tools for the identification and monitoring of atherosclerosis. The aim of the present study was to investigate ...

  17. Semi-automatic quantitative measurements of intracranial internal carotid artery stenosis and calcification using CT angiography

    OpenAIRE

    Bleeker, Leslie; Marquering, Henk A; van den Berg, René; Nederkoorn, Paul J; Majoie, Charles B

    2011-01-01

    Introduction Intracranial carotid artery atherosclerotic disease is an independent predictor for recurrent stroke. However, its quantitative assessment is not routinely performed in clinical practice. In this diagnostic study, we present and evaluate a novel semi-automatic application to quantitatively measure intracranial internal carotid artery (ICA) degree of stenosis and calcium volume in CT angiography (CTA) images. Methods In this retrospective study involving CTA images of 88 consecuti...

  18. Medical Decision-Making System of Ultrasound Carotid Artery Intima–Media Thickness Using Neural Networks

    OpenAIRE

    N. Santhiyakumari; Rajendran, P.; M. Madheswaran

    2010-01-01

    The objective of this work is to develop and implement a medical decision-making system for an automated diagnosis and classification of ultrasound carotid artery images. The proposed method categorizes the subjects into normal, cerebrovascular, and cardiovascular diseases. Two contours are extracted for each and every preprocessed ultrasound carotid artery image. Two types of contour extraction techniques and multilayer back propagation network (MBPN) system have been developed for classifyi...

  19. Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations.

    Science.gov (United States)

    Huang, Xu; Yin, Xiaoping; Xu, Yingjin; Jia, Xinwei; Li, Jianhui; Niu, Pei; Shen, Wenzeng; Kassab, Ghassan S; Tan, Wenchang; Huo, Yunlong

    2016-03-01

    Although atherosclerosis has been widely investigated at carotid artery bifurcation, there is a lack of morphometric and hemodynamic data at different stages of the disease. The purpose of this study was to determine the lesion difference in patients with carotid artery disease compared with healthy control subjects. The three-dimensional (3D) geometry of carotid artery bifurcation was reconstructed from computed tomography angiography (CTA) images of Chinese control subjects (n = 30) and patients with carotid artery disease (n = 30). We defined two novel vector angles (i.e., angles 1 and 2) that were tangential to the reconstructed contour of the 3D vessel. The best-fit diameter was computed along the internal carotid artery (ICA) center line. Hemodynamic analysis was performed at various bifurcations. Patients with stenotic vessels have larger angles 1 and 2 (151 ± 11° and 42 ± 20°) and smaller diameters of the external carotid artery (ECA) (4.6 ± 0.85 mm) compared with control subjects (144 ± 13° and 36 ± 16°, 5.2 ± 0.57 mm) although there is no significant difference in the common carotid artery (CCA) (7.1 ± 1.2 vs. 7.5 ± 1.0 mm, P = 0.18). In particular, all patients with carotid artery disease have a stenosis at the proximal ICA (including both sinus and carina regions), while 20% of patients have stenosis at the middle ICA and 20% have stenosis expansion to the entire cervical ICA. Morphometric and hemodynamic analyses suggest that atherosclerotic plaques initiate at both sinus and carina regions of ICA and progress downstream. PMID:26747497

  20. Middle Cranial Fossa Transtemporal Approach to the Intrapetrous Internal Carotid Artery

    OpenAIRE

    Andrews, James C.; Martin, Neil A.; Black, Keith; Honrubia, Vincent F.; Becker, Donald P.

    1991-01-01

    Diseases involving the proximity of the internal carotid artery at the skull base require identification of this vessel in the temporal bone to gain vascular control for any maneuver in its vicinity. This article details the technique of surgical dissection and exposure of the internal carotid artery within the skull base through a transtemporal middle cranial fossa approach. The anatomic landmarks important in utilizing this procedure include the greater superficial petrosal nerve, the mandi...

  1. Carotid Artery Segmentation in Ultrasound Images and Measurement of Intima-Media Thickness

    OpenAIRE

    Vaishali Naik; R.S. Gamad; P.P. Bansod

    2013-01-01

    Background. The segmentation of the common carotid artery (CCA) wall is imperative for the determination of the intima-media thickness (IMT) on B-mode ultrasound (US) images. The IMT is considered an important indicator in the evaluation of the risk for the development of atherosclerosis. In this paper, authors have discussed the relevance of measurements in clinical practices and the challenges that one has to face while approaching the segmentation of carotid artery on ultrasound images. Th...

  2. Acute effect of cycling intervention on carotid arterial hemodynamics: basketball athletes versus sedentary controls

    OpenAIRE

    Liu, Hai-Bin; Yuan, Wen-Xue; Qin, Kai-Rong; Hou, Jie

    2015-01-01

    Objective To compare the acute effects of a cycling intervention on carotid arterial hemodynamics between basketball athletes and sedentary controls. Methods Ten young long-term trained male basketball athletes (BA) and nine age-matched male sedentary controls (SC) successively underwent four bouts of exercise on a bicycle ergometer at the same workload. Hemodynamic variables at right common carotid artery were determined at rest and immediately following each bout of exercise. An ANCOVA was ...

  3. Transluminal Angioplasty of Peroneal Artery Branches in Diabetics: Initial Technical Experience

    International Nuclear Information System (INIS)

    The present study aimed to report the technical feasibility of percutaneous transluminal angioplasty (PTA) of obstructed or insufficient collateral branches (anterior and posterior perforating branches) from distal peroneal to foot arteries in diabetic patients with chronic critical limb ischemia (CLI) and chronic noncrossable occlusion of the anterior and posterior tibial arteries. Twenty-four diabetic CLI patients (age, 67 ± 8 years; 87% males) undergoing collateral PTA were included. Baseline clinical angiographic and follow-up data were retrospectively reviewed. Collateral PTA was associated with a concomitant PTA of other sites in 21 (83%) cases. In 15 cases the treated collateral linked the peroneal with the plantaris communis; in 9 cases, the peroneal with the dorsalis pedis. Angiographic results of collateral PTA were good in 13 cases (<30% residual stenosis), whereas the result was considered moderate (30%-49% residual stenosis) in the remaining cases. Neither perforation nor acute occlusion of the treated collaterals or other relevant complications were observed. Mean follow-up was 32 ± 17 months. Major amputation was necessary for two (8.3%) patients. Cumulative limb salvage rates at 2 and 4 years were 96% and 87%, respectively. In conclusion, this initial experience shows that PTA of the collateral branches from distal peroneal to foot arteries is a feasible technique. Future studies are required to define the clinical role of this novel approach

  4. Intravascular ultrasound imaging of peripheral arteries as an adjunct to balloon angioplasty and atherectomy.

    Science.gov (United States)

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque cross-sectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures. PMID:8653738

  5. Preliminary results of combined carotid endarterectomy and off-pump coronary artery bypass grafting in patients with coexistent carotid and coronary artery diseases

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu-jun; CHEN Xin; XIE Dong-hua; SHI Kai-hu; XU Ming

    2009-01-01

    Background Coexistent carotid and coronary artery diseases are common and patients with them remain at a high risk for perioperative stroke or myocardial infarction after coronary bypass surgery.The aim of this study was to investigate the effect of combined carotid endarterectomy (CEA) and off-pump coronary artery bypass grafting (CABG) in patients with coexistent carotid and coronary artery diseases.Methods Between January 2002 and December 2007, consecutive patients with coexistent carotid and coronary artery diseases underwent one-stage unilateral CEA and off-pump CABG in Heart institute of Nanjing First Hospital Affiliated to Nanjing Medical University. Perioperative complications were assessed and follow-up was carried out. Results A total of 51 cases of isolated off-pump CABG and unilateral CEA, including 34 right and 17 left, were performed. The mean blocked time of carotid artery in CEA was (25.5±7.0) minutes. The mean number of distal grafts per patient was 3.30±0.45. The mean ventilation time, intensive care unit stay, and postoperative hospital stay was (11.3±5.4) hours, (2.1 ±0.9) days, and (12.5±6.1) days respectively. None of the patients had stroke or myocardial infarct. There was one perioperative death due to acute cardiac failure, resulting in an operative mortality of 1.96%. Follow-up was completed for 47 patients (92.16%) with a mean follow-up of (39.5±12.5) months. None of the patients manifested stroke, new angina or newly developed cardiac infarct. No late death occurred.Conclusion Combined CEA and off-pump CABG is a safe and effective procedure in selected patients with coexistent carotid and coronary artery diseases.

  6. Successful recanalization for internal carotid artery occlusion with persistent primitive trigeminal artery manifesting only as ischemia of the posterior circulation

    OpenAIRE

    Hiramatsu, Ryo; Ohnishi, Hiroyuki; Kawabata, Shinji; Miyachi, Shigeru; KUROIWA, Toshihiko

    2016-01-01

    Background Internal carotid artery (ICA) occlusion mainly manifests as ischemia of the anterior circulation. There are very few reports of ICA occlusion manifesting as only ischemia of the posterior circulation related to a fetal type posterior communicating artery or other arteries. Case presentation The authors experienced a case of ICA occlusion with persistent primitive trigeminal artery (PPTA) manifesting only as ischemia of the posterior circulation. In this case, the initial NIHSS scor...

  7. A study on the carotid artery ultrasonography for the metabolic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Hye Jung; Cho, Pyong Kon [Dept. of Radiological Science, Catholic University of Daegu, Daegu (Korea, Republic of); Kang, Young Han [Dept. of Radiology, Catholic University Hospital of Daegu, Daegu (Korea, Republic of)

    2013-09-15

    The primary goal of this study was to ascertain the primary factors to the affect for the carotid artery intima-media thickness (IMT), the prevalence of metabolic syndrome and other risks can possibly influence the carotid artery IMT. All patients data (total specimens: 289, male: 197, female: 92) including the carotid artery ultrasonography examination. The all data were analyzed by the use of SPSS software, version 21.0 (SPSS, Chicago, IL USA), with the descriptive statistics method. The Results of this study was found to be highly increased in the males than the females. The prevalence of metabolic syndrome in all of the participants was 30.5 percentages. The carotid artery IMT in the subjects with metabolic syndrome was significantly high in both genders, compared to the rest, who were without metabolic syndrome. The Pearsons correlation coefficient of metabolic syndrome and CIMT was 0.378(p<0.01). In conclusions, the present study also supports the association between the carotid artery IMT and the metabolic syndromes with cardiovascular risk factors. Usage of B-mode ultrasonography to measure the carotid artery IMT was found to be highly effective in the current analysis.

  8. A study on the carotid artery ultrasonography for the metabolic syndrome

    International Nuclear Information System (INIS)

    The primary goal of this study was to ascertain the primary factors to the affect for the carotid artery intima-media thickness (IMT), the prevalence of metabolic syndrome and other risks can possibly influence the carotid artery IMT. All patients data (total specimens: 289, male: 197, female: 92) including the carotid artery ultrasonography examination. The all data were analyzed by the use of SPSS software, version 21.0 (SPSS, Chicago, IL USA), with the descriptive statistics method. The Results of this study was found to be highly increased in the males than the females. The prevalence of metabolic syndrome in all of the participants was 30.5 percentages. The carotid artery IMT in the subjects with metabolic syndrome was significantly high in both genders, compared to the rest, who were without metabolic syndrome. The Pearsons correlation coefficient of metabolic syndrome and CIMT was 0.378(p<0.01). In conclusions, the present study also supports the association between the carotid artery IMT and the metabolic syndromes with cardiovascular risk factors. Usage of B-mode ultrasonography to measure the carotid artery IMT was found to be highly effective in the current analysis

  9. Surgical treatment of a giant extracranial internal carotid artery aneurysm: A case report

    Directory of Open Access Journals (Sweden)

    Pasternak Janko

    2007-01-01

    Full Text Available Introduction. True aneurysms of the extracranial internal carotid artery are rare lesions. Surgical treatment is considered to be the best therapeutic option. However, the use of the intraluminal shunt remains controversial. Case report. We reported a case of a giant extracranial internal carotid artery aneurysm treated by reconstructive surgery. A 76-year-old woman was referred with a pulsatile mass inside her mouth, associated with dizziness and dysarthria. There was no history of cerebrovascular symptoms, neck pain, or cervical trauma. A magnetic resonance scan showed a 45 mm aneurysm of the internal carotid artery (ICA, and kinking of ICA. Angiography demonstrated a saccular ICA aneurysm, with a lengthening and tortuosity of the ICA. The aneurysm and the carotid artery branches were easily exposed through a standard anterior cervical incision. After resection of the aneurysm, a Javid shunt was inserted between the common and internal carotid arteries, and end-to-end repair of ICA was easily performed due to ICA redundancy. The aneurysm was of atherosclerotic origin. Four months after the operation, the patient showed a complete recovery from peripheral neurological deficit. Discussion. Our results show that surgical reconstruction is a satisfactory therapeutic choice in the management of extracranial carotid artery aneurysms in order to avoid rupture, thromboembolism and cerebrovascular insufficiency. To date, there has been little experience with endoluminal exclusion techniques and the long-term effectiveness is still uncertain. .

  10. Intima-media thickness and arterial stiffness of carotid artery in Korean patients with Behçet's disease.

    Science.gov (United States)

    Rhee, Moo-Yong; Chang, Hyun Kyu; Kim, Seong-Kyu

    2007-06-01

    Behçet's disease (BD) is a systemic vasculitis involving diverse sizes of arteries and veins. We performed this study to evaluate the vascular changes by assessment of the arterial stiffness and intima-media thickness (IMT) of carotid artery in Korean patients with BD. Forty-one patients with BD and age-, and sex-matched 53 healthy subjects were recruited in this study. Carotid arterial stiffness and IMT were assessed by using high-resolution B-mode ultrasonography. Arterial stiffness parameters such as carotid arterial distensibility coefficient, stiffness index, and incremental elastic modulus (E(inc)) were significantly increased in BD patients compared with those in healthy subjects, but not in IMT. Positive relationship was noted between age and IMT, whereas age of onset was significantly associated with arterial stiffness in BD. This finding suggests impaired endothelial function before visible structural changes of arterial wall in BD. Age and age of onset may be an independent risk factor for carotid IMT and arterial stiffness, respectively. Further studies in more large populations are required to confirm our results. PMID:17596642

  11. Short- and Long-Term Major Cardiovascular Adverse Events in Carotid Artery Interventions: A Nationwide Population-Based Cohort Study in Taiwan

    OpenAIRE

    Ming-Lung Tsai; Chun-Tai Mao; Dong-Yi Chen; I-Chang Hsieh; Ming-Shien Wen; Tien-Hsing Chen

    2015-01-01

    Introduction Carotid artery stenosis is one of the leading causes of ischemic stroke. Carotid artery stenting has become well-established as an effective treatment option for carotid artery stenosis. For this study, we aimed to determine the efficacy and safety of carotid stenting in a population-based large cohort of patients by analyzing the Taiwan National Healthcare Insurance (NHI) database. Methods 2,849 patients who received carotid artery stents in the NHI database from 2004 to 2010 we...

  12. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  13. Rotational digital subtraction angiography of carotid artery bifurcation stenoses

    International Nuclear Information System (INIS)

    Purpose: A prospektive study was designed to evaluate, whether multiplanar imaging with rotational digital subtraction angiography (R-DSA) could improve assessment of carotid artery bifurcation stenosis. Patients and methods: 45 patients with suspected stenosis of the ICA were examined with DSA in standard projections (0 -(45 )-90 ) and additional R-DSA of each ICA from 0-90 in 10 steps. We compared imaging quality and degree of stenosis as well as exposure of the patients to radiation and contrast media. Results: 79/82 R-DSA (96%) were suitable for evaluation of stenosis, 58/82 (70%) matched the quality standard of single projection DSA. Specificity and sensitivity of the R-DSA to diagnose high grade ACI stenosis were 100% and 94%, respectively. 7/79 R-DSA revealed a higher and 3/79 a lower degree of stenosis than the corresponding DSA. Regarding the degree of stenosis there was no significant difference between the two modalities (p>0,05), but R-DSA detected 4 stenoses greater than 60% that were estimated to be lower than 60% by DSA. Radiation dose for R-DSA was equivalent to one DSA run (170 cGycm2). The average amount of contrast media (25 ml) was slightly higher than for 2-3 single-projection DSA (19,8 ml). Conclusions: R-DSA provides high quality imaging of the carotid bifurcation with multiplanar projections facilitating exact grading of vessel stenosis. The number of cases (n=2) is to small to judge the value of R-DSA as to (tandem-) stenosis of the distal ICA. Still, diagnostic value and low radiation exposure justify the use of R-DSA as additional series to standard protocols. (orig.)

  14. Incidental direct carotid-cavernous fistula in a patient with high-grade internal carotid artery stenosis

    International Nuclear Information System (INIS)

    The concurrent occurrence of internal carotid artery (ICA) stenosis and carotid-cavernous fistula (CCF) is infrequent. We report the case of a 59-year-old man with symptomatic high-grade stenosis of left ICA who was referred to our hospital for surgical treatment. An ipsilateral direct CCF was found incidentally during operation. Ultimately, the two lesions were successfully treated with a covered stent while the ICA was preserved. The result of our study may provide further insight into this rare combination of diseases. (author)

  15. Plasma Homocysteine Levels Predict the Risk of Acute Cerebral Infarction in Patients with Carotid Artery Lesions.

    Science.gov (United States)

    Wu, Wei; Guan, Yi; Xu, Kan; Fu, Xi-Jia; Lei, Xiao-Feng; Lei, Li-Jian; Zhang, Zhi-Qing; Cheng, Yan; Li, Yun-Qian

    2016-05-01

    This study examined the association between elevated plasma homocysteine (Hcy) levels and the risk of acute cerebral infarction in patients with carotid artery lesions. A total of 78 patients were divided into two groups, the high Hcy group (n = 38; Hcy levels >15 umol/L) and the low Hcy group (n = 40; Hcy levels ≤15 umol/L). High-resolution B-mode ultrasounds were performed to assess intima media thickness (IMT), infarcts, plaques, and stenosis in the extracranial carotid artery of these patients. All patients underwent 3 T MR scanners to evaluate cerebral artery stenosis in the intracranial cerebral artery. The plasma Hcy levels did not show any statistically significant differences when comparisons were based on gender, age, blood pressure, diabetes, hyperlipidemia, and systolic and diastolic pressures. Importantly, the incidence of carotid plaque and severe stenosis of intracranial and extracranial artery were significantly higher in the high Hcy group compared to the low Hcy group. Pearson's test indicated that plasma Hcy levels positively correlated with IMT, total number of plaques and unstable plaques. Overall, the elevated plasma Hcy levels correlated with increased frequency of carotid plaque formation, extra- and intracranial arterial stenosis, and the degree of stenosis. In conclusion, we find a significant correlation between elevated plasma Hcy levels and the increased incidence of acute cerebral infarction in patients with carotid artery lesions. PMID:26063590

  16. A gene-centric study of common carotid artery remodelling

    Science.gov (United States)

    Harrison, Seamus C.; Zabaneh, Delilah; Asselbergs, Folkert W.; Drenos, Fotios; Jones, Gregory T.; Shah, Sonia; Gertow, Karl; Sennblad, Bengt; Strawbridge, Rona J.; Gigante, Bruna; Holewijn, Suzanne; De Graaf, Jacqueline; Vermeulen, Sita; Folkersen, Lasse; van Rij, Andre M.; Baldassarre, Damiano; Veglia, Fabrizio; Talmud, Philippa J.; Deanfield, John E.; Agu, Obi; Kivimaki, Mika; Kumari, Meena; Bown, Matthew J.; Nyyssönen, Kristiina; Rauramaa, Rainer; Smit, Andries J.; Franco-Cereceda, Anders; Giral, Philippe; Mannarino, Elmo; Silveira, Angela; Syvänen, Ann-Christine; de Borst, Gert J.; van der Graaf, Yolanda; de Faire, Ulf; Baas, Annette F.; Blankensteijn, Jan D.; Wareham, Nicholas J.; Fowkes, Gerry; Tzoulaki, Ionna; Price, Jacqueline F.; Tremoli, Elena; Hingorani, Aroon D.; Eriksson, Per; Hamsten, Anders; Humphries, Steve E.

    2013-01-01

    Background Expansive remodelling is the process of compensatory arterial enlargement in response to atherosclerotic stimuli. The genetic determinants of this process are poorly characterized. Methods Genetic association analyses of inter-adventitial common carotid artery diameter (ICCAD) in the IMPROVE study (n = 3427) using the Illumina 200k Metabochip was performed. Single nucleotide polymorphisms (SNPs) that met array-wide significance were taken forward for analysis in three further studies (n = 5704), and tested for association with Abdominal Aortic Aneurysm (AAA). Results rs3768445 on Chromosome 1q24.3, in a cluster of protein coding genes (DNM3, PIGC, C1orf105) was associated with larger ICCAD in the IMPROVE study. For each copy of the rare allele carried, ICCAD was on average 0.13 mm greater (95% CI 0.08–0.18 mm, P = 8.2 × 10−8). A proxy SNP (rs4916251, R2 = 0.99) did not, however, show association with ICCAD in three follow-up studies (P for replication = 0.29). There was evidence of interaction between carotid intima-media thickness (CIMT) and rs4916251 on ICCAD in two of the cohorts studies suggesting that it plays a role in the remodelling response to atherosclerosis. In meta-analysis of 5 case–control studies pooling data from 5007 cases and 43,630 controls, rs4916251 was associated with presence of AAA 1.10, 95% CI 1.03–1.17, p = 2.8 × 10−3, I2 = 18.8, Q = 0.30). A proxy SNP, rs4916251 was also associated with increased expression of PIGC in aortic tissue, suggesting that this may the mechanism by which this locus affects vascular remodelling. Conclusions Common variation at 1q24.3 is associated with expansive vascular remodelling and risk of AAA. These findings support a hypothesis that pathways involved in systemic vascular remodelling play a role in AAA development. PMID:23246012

  17. Carotid artery lumen segmentation in 3D free-hand ultrasound images using surface graph cuts.

    Science.gov (United States)

    Lorza, Andrés M Arias; Carvalho, Diego D B; Petersen, Jens; van Dijk, Anouk C; van der Lugt, Aad; Niessen, Wiro J; Klein, Stefan; de Bruijne, Marleen

    2013-01-01

    We present a new approach for automated segmentation of the carotid lumen bifurcation from 3D free-hand ultrasound using a 3D surface graph cut method. The method requires only the manual selection of single seed points in the internal, external, and common carotid arteries. Subsequently, the centerline between these points is automatically traced, and the optimal lumen surface is found around the centerline using graph cuts. To refine the result, the latter process was iterated. The method was tested on twelve carotid arteries from six subjects including three patients with a moderate carotid artery stenosis. Our method successfully segmented the lumen in all cases. We obtained an average dice overlap with respect to a manual segmentation of 84% for healthy volunteers. For the patient data, we obtained a dice overlap of 66.7%. PMID:24579183

  18. 3-D Registration on Carotid Artery imaging data: MRI for different timesteps

    CERN Document Server

    Bizopoulos, Paschalis A; Michalis, Lampros K; Koutsouris, Dimitrios D; Fotiadis, Dimitrios I

    2016-01-01

    A common problem which is faced by the researchers when dealing with arterial carotid imaging data is the registration of the geometrical structures between different imaging modalities or different timesteps. The use of the "Patient Position" DICOM field is not adequate to achieve accurate results due to the fact that the carotid artery is a relatively small structure and even imperceptible changes in patient position and/or direction make it difficult. While there is a wide range of simple/advanced registration techniques in the literature, there is a considerable number of studies which address the geometrical structure of the carotid artery without using any registration technique. On the other hand the existence of various registration techniques prohibits an objective comparison of the results using different registration techniques. In this paper we present a method for estimating the statistical significance that the choice of the registration technique has on the carotid geometry. One-Way Analysis of...

  19. Angiography for renal artery stenosis: no additional impairment of renal function by angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Lufft, Volkmar; Fels, Lueder M.; Egbeyong-Baiyee, Daniel; Olbricht, Christoph J. [Abteilung Nephrologie, Medizinische Hochschule Hannover (Germany); Hoogestraat-Lufft, Linda; Galanski, Michael [Abteilung Diagnostische Radiologie, Medizinische Hochschule Hannover (Germany)

    2002-04-01

    The aim of this study was to compare renal function between patients with renal angiography and patients with renal angiography and angioplasty (AP) for renal artery stenosis (RAS). Forty-seven patients with suspected RAS were prospectively investigated by digital subtraction angiography (DSA) using non-ionic low osmolar contrast media (CM). In 22 patients RAS was detected and in 16 cases an angioplasty was performed in the same session. The following parameters were determined 1 day prior to and after the DSA, respectively: serum creatinine (S-Crea, {mu}mol/l) and single-shot inulin clearance (In-Cl, ml/min) for the evaluation of renal function; and urine alpha 1-microglobuline (AMG, {mu}g/g Crea) and beta-N-acetyl-glucoseaminidase (beta-NAG, U/g Crea) as markers of tubular toxicity. Serum creatinine was measured additionally 2 days after CM had been injected. In both groups with and without AP 174{+-}65 and 104{+-}56 ml of CM (p<0.0005) were used, respectively. There were no differences with regard to renal function or risk factors for CM nephrotoxicity between both groups. In the group with AP S-Crea and In-Cl (each: mean{+-}SD) did not change significantly (before DSA: 171{+-}158 and 61{+-}24, after DSA: 189{+-}177 and 61{+-}25, respectively), beta-NAG (median) rose from 4 to 14 (p<0.05) and AMG from 8 to 55 (n.s., because of high SD). In the group without AP S-Crea increased from 134{+-}109 to 141{+-}113 (p<0.01), In-Cl dropped from 65{+-}26 to 62{+-}26 (p<0,01), beta NAG (median) rose from 4 to 8 (p=0.01), and AMG from 7 to 10 (n.s.). A rise in baseline S-Crea by more than 25% or 44 {mu}mol/l occurred in 4 and 2 patients in the group with and without AP, respectively. Creatinine increase was reversible in all cases within 7 days. In this study using sensitive methods to detect changes of renal function and tubular toxicity no additional renal function impairment in DSA with angioplasty for RAS compared with DSA alone could be demonstrated. Our data suggest

  20. Gore-Tex small-vessel angioplasty: A suitable substitute for the use of autogenous saphenous vein grafts

    OpenAIRE

    Garcia-Rinaldi, Raul; Rea, John E.; Gallagher, Michael W.; Laevsky, Marlene J.; Ogburn, Michael; Porter, Robert H.

    1980-01-01

    Autogenous saphenous vein has been the material of choice for small-vessel angioplasty and for circulatory access graft reconstruction. In an effort to conserve autogenous saphenous vein, we used expanded polytetrafluoroethylene (PTFE) grafts in 45 patients over a 12-month period. We used Gore-Tex* to reconstruct 17 circulatory access grafts, 16 carotid arteries, two brachial arteries, seven femoral arteries, and three popliteal anterior or posterior tibial arteries. The indications for recon...

  1. Clinical experience of cerebral protection with balloon occlusion during carotid artery stenting

    International Nuclear Information System (INIS)

    Purpose: To asses the technical feasibility and the results of cerebral protection with the GuardWire Plus Temporary Occlusion and Aspiration System during carotid artery stenting for high-grade stenosis. Patients and Methods: In 20 patients 20 carotid artery stenoses were treated with stent placement under cerebral protection. A contralateral carotid occlusion was an exclusion criteria for the use of the protection device. In all cases only aspiration, but no flushing was used before deflation of the occlusion balloon. In 17 of 20 patients diffusion-weighted (DW-)MRT imaging of the brain was performed before and 24 hours after the procedure. Results: The stent implantation was successfully performed in all patients. In 3 patients neurologic symptoms occurred during the occlusion time. In these 3 patients the symptoms immediately disappeared after deflation of the balloon. In one case there was dilatation of the internal carotid artery at the site of the balloon inflation. In 3 of the 17 DW-MR images new ipsilateral cerebral lesions, in one case a new contralateral lesion occurred after the procedure. Conclusions: The cerebral protection procedure is technically feasible. The occlusion of the internal carotid artery was not tolerated by all patients. The DW-MR imaging demonstrated cerebral lesions indicating the occurrence of cerebral microemboli during the procedure. Further investigations are necessary to determine if the use of the cerebral protection device will improve the results of the carotid artery stenting for high-grade stenoses. (orig.)

  2. Clinical impact of radiographic carotid artery involvement in neck metastases from head and neck cancer.

    Science.gov (United States)

    Teymoortash, A; Rassow, S; Bohne, F; Wilhelm, T; Hoch, S

    2016-04-01

    The treatment of lymph node metastases involving the carotid artery is controversial. The aim of the present study was to determine the outcomes of head and neck cancer patients with radiographic carotid artery involvement in neck metastases. A total of 27 patients with head and neck cancer and radiologically diagnosed advanced metastases involving the common carotid artery or internal carotid artery were enrolled. All patients underwent a primary or salvage neck dissection and surgical carotid peeling. The oncological outcome and survival of all patients were analyzed. Loco-regional control was observed in 13 of the 27 patients (48.1%). During follow-up, five patients (18.5%) developed second primaries and 11 (40.7%) developed distant metastases. The survival time was poor independent of regional control. The median overall survival was 1.55 years and disease-free survival was 0.71 year. Radiographic carotid artery involvement in neck metastases in head and neck cancer appears to correlate with a poor long-term prognosis, with a high rate of distant metastases despite loco-regional control. PMID:26723499

  3. Outpatient angioplasty and stenting facilitated by percutaneous arterial suture closure devices

    International Nuclear Information System (INIS)

    Aim: To review our practice of outpatient percutaneous vascular interventions facilitated by an arterial suture device. Materials and methods: A retrospective review of all patients attending this tertiary centre for iliac or femoral intervention was undertaken between February 2001 and December 2004. All patients who underwent angioplasty or stenting had their puncture sites closed using a Perclose suture. Patients were kept flat for 15 min and allowed to fully mobilize at 60 min. Puncture sites were scored for visible bruising, haematoma and pain at discharge and on outpatient follow-up. Patient preference for future outpatient treatment was assessed. Results: Fifty-seven outpatients underwent 81 punctures. Forty-eight (84%) patients underwent iliac angioplasty; of those 42% underwent stent placement. Six patients (10%) required inpatient admission, five secondary to failed suture deployment. One patient had a non-closer-related puncture site intimal flap occlusion successfully repaired at surgery. Fifty-one (90%) patients discharged with a mean time of 157 min (60-280 min). Forty-six (92%) patients had no visible bruising or palpable haematoma on discharge. No patient had a haematoma greater than 2.5 cm. No discharged patient required readmission. Thirty percent reported a moderate to severe groin pain score (2-5/5) at discharge, increasing to 40% at follow-up. Forty-seven (98%) of the 48 patients, who expressed a preference, would be happy to undergo outpatient treatment again. Conclusion: Outpatient treatment is feasible, well tolerated and preferable to patients, but 10% will require inpatient admission. A planned post-procedure analgesia regimen or advice should be considered

  4. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    Science.gov (United States)

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long

  5. Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery

    International Nuclear Information System (INIS)

    Background: To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA). Methods: Thirty-eight symptomatic stenoses of the vertebral origin were treated with flexible balloon-expandable coronary stents. Angiographic and clinical follow-up examinations were obtained in 26 patients at a mean of 11 months. Results: The immediate post-procedural angiographic results showed no residual stenosis in 33 vessels and mild residual stenoses in five vessels. Periprocedurally, there were two asymptomatic technical complications and one TIA. During follow-up re-stenosis could be detected in 10 cases (36%), and vessel occlusions in two patients. Two stents were broken. One of the restenosis caused a TIA within the follow-up period. Conclusions: Flexible balloon-expandable coronary stents proved to be save and effective in preventing vertebrobasilar stroke but were incapable to preserve the proximal vertebral artery lumen. For the VA origine an adequate stent, self-expanding, bioresorbable, or drug-eluting has to be found

  6. Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Weber, W. [Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen (Germany); Mayer, T.E. [Department of Neuroradiology, Klinikum Grosshadern, University of Munich (Germany); Henkes, H. [Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen (Germany); Kis, B. [Department of Neurology, Alfried Krupp Hospital, Essen (Germany) and Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Virchow Street 174, D-45147 Essen (Germany)]. E-mail: bernhard.kis@uni-duisburg-essen.de; Hamann, G.F. [Department of Neurology, Klinikum Grosshadern, University of Munich (Germany); Holtmannspoetter, M. [Department of Neuroradiology, Klinikum Grosshadern, University of Munich (Germany); Brueckmann, H. [Department of Neuroradiology, Klinikum Grosshadern, University of Munich (Germany); Kuehne, D. [Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen (Germany)

    2005-11-01

    Background: To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA). Methods: Thirty-eight symptomatic stenoses of the vertebral origin were treated with flexible balloon-expandable coronary stents. Angiographic and clinical follow-up examinations were obtained in 26 patients at a mean of 11 months. Results: The immediate post-procedural angiographic results showed no residual stenosis in 33 vessels and mild residual stenoses in five vessels. Periprocedurally, there were two asymptomatic technical complications and one TIA. During follow-up re-stenosis could be detected in 10 cases (36%), and vessel occlusions in two patients. Two stents were broken. One of the restenosis caused a TIA within the follow-up period. Conclusions: Flexible balloon-expandable coronary stents proved to be save and effective in preventing vertebrobasilar stroke but were incapable to preserve the proximal vertebral artery lumen. For the VA origine an adequate stent, self-expanding, bioresorbable, or drug-eluting has to be found.

  7. Randomized Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions: The SUPER Study

    Energy Technology Data Exchange (ETDEWEB)

    Chalmers, Nicholas, E-mail: nicholas.chalmers@cmft.nhs.uk [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Walker, Paul T. [James Cook University Hospital, Department of Radiology (United Kingdom); Belli, Anna-Maria [St. George' s Healthcare NHS Trust, Department of Radiology (United Kingdom); Thorpe, Anthony P. [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Sidhu, Paul S. [King' s College Hospital, Department of Radiology (United Kingdom); Robinson, Graham [Hull Royal Infirmary, Department of Radiology (United Kingdom); Ransbeeck, Mariella van [Johnson and Johnson Medical NV/SA, Cordis (Belgium); Fearn, Steven A. [Johnson and Johnson Medical Ltd., Cordis (United Kingdom)

    2013-04-15

    To determine whether primary stenting reduces the rate of restenosis compared with balloon angioplasty alone in the endovascular treatment of long superficial femoral artery lesions; and to assess the effect of treatment on quality of life. A total of 150 patients with superior femoral artery occlusion or severe stenosis of 5-22 cm length from 17 UK centers were randomized to either primary stenting with the SMART stent or balloon angioplasty (i.e., percutaneous transluminal angioplasty, PTA). Bailout stent placement was permitted in case of inadequate result from PTA. The primary end point was restenosis measured by duplex ultrasound at 1 year. Quality-of-life assessments were performed by the EuroQol (EQ)-5D questionnaire. Mean lesion length was 123.0 mm in the stent group and 116.8 mm in the PTA group. A total of 140 (93.3 %) of 150 had total occlusions. At 12 months' follow-up, restenosis measured by Duplex ultrasound was not significantly different between the stent and PTA groups by intention-to-treat or as-treated analyses: 47.2 versus 43.5 % (p = 0.84) and 40.8 versus 46.7 % (p = 0.68), respectively. There were fewer target lesion revascularizations in patients randomized to stenting, but this did not reach statistical significance (12.5 vs. 20.8 %, p = 0.26). There was no difference in the rate of amputation. Patients in both groups reported improved quality of life. Primary stenting of long lesions in predominantly occluded superficial femoral arteries does not reduce the rate of binary restenosis compared with balloon angioplasty and bailout stenting. Both treatment strategies conferred a meaningful and sustained improvement to the quality of life of patients with severe superficial femoral artery disease.

  8. Endovascular coil embolization in internal carotid artery bifurcation aneurysms

    International Nuclear Information System (INIS)

    Aim: To present the clinical and radiological results of coil embolization in internal carotid artery (ICA) bifurcation aneurysms (BA). Materials and methods: The records of 65 patients with 66 ICA BA were retrieved from data prospectively accrued between September 1999 and July 2013. Clinical and morphological outcomes of the aneurysms were assessed, including technical aspects of treatment. Results: The aneurysms under study were directed either superiorly (41/66, 62.1%), anteriorly (24/66, 36.4%), or posteriorly (1/66, 1.5%), and all were devoid of perforators. Aneurysmal necks were situated symmetrically at the terminal ICA (37/66, 56.1%) or slightly deviated to the proximal A1 segment (29/66, 43.9%). The steam-shaped S microcatheter (73.8%) was most commonly used to select the aneurysms, and the single microcatheter technique was most commonly applied (56.1%) to perform coil embolization, followed by balloon remodelling (21.2%), multiple microcatheter (15.1%), and stent-protection (7.6%). Successful aneurysmal occlusion was achieved in 100% of cases, with no procedure-related morbidity or mortality. Imaging performed in the course of follow-up (mean duration 27.3 months) confirmed stable occlusion of most lesions (47/53, 88.7%). Conclusion: Through tailored technical strategies, ICA BA are amenable to safe and effective endovascular coil embolization, with a tendency for stable occlusion long-term

  9. Carotid artery stenting by GuardWire and Wallstent RP

    International Nuclear Information System (INIS)

    In our institute, carotid artery stenting (CAS) has been performed using GuardWire and Wallstent RP, regardless of plaque pathology. In this study, we evaluated our results (high-intensity area on diffusion-weighted imaging (DWI), stroke/death/myocardial infarction within 30 days, ipsilateral stroke/neurological death after 31 days, and retreatment after CAS). Between April 2005 and December 2009, 76 CAS procedures were performed on 74 patients. DWI obtained after CAS showed a high-intensity area in 13 of 75 procedures (17.3%). Two patients (2.6%) died of stroke and myocardial infarction within 30 days after CAS. One patient (1.3%) had symptomatic cerebral infarction; the other, intracranial hemorrhage. Ipsilateral stroke and neurological death after 31 days occurred in 1 patient (1.3%), who had ipsilateral cerebral infarction at 24 months. Retreatment after CAS was required in 2 patients (2.6%). CAS performed using GuardWire and Wallstent RP is an effective and safe procedure. It is important to achieve proficiency in the use of technical devices to perform successful CAS. (author)

  10. A new radial strain and strain rate estimation method using autocorrelation for carotid artery

    Science.gov (United States)

    Ye, Jihui; Kim, Hoonmin; Park, Jongho; Yeo, Sunmi; Shim, Hwan; Lim, Hyungjoon; Yoo, Yangmo

    2014-03-01

    Atherosclerosis is a leading cause of cardiovascular disease. The early diagnosis of atherosclerosis is of clinical interest since it can prevent any adverse effects of atherosclerotic vascular diseases. In this paper, a new carotid artery radial strain estimation method based on autocorrelation is presented. In the proposed method, the strain is first estimated by the autocorrelation of two complex signals from the consecutive frames. Then, the angular phase from autocorrelation is converted to strain and strain rate and they are analyzed over time. In addition, a 2D strain image over region of interest in a carotid artery can be displayed. To evaluate the feasibility of the proposed radial strain estimation method, radiofrequency (RF) data of 408 frames in the carotid artery of a volunteer were acquired by a commercial ultrasound system equipped with a research package (V10, Samsung Medison, Korea) by using a L5-13IS linear array transducer. From in vivo carotid artery data, the mean strain estimate was -0.1372 while its minimum and maximum values were -2.961 and 0.909, respectively. Moreover, the overall strain estimates are highly correlated with the reconstructed M-mode trace. Similar results were obtained from the estimation of the strain rate change over time. These results indicate that the proposed carotid artery radial strain estimation method is useful for assessing the arterial wall's stiffness noninvasively without increasing the computational complexity.

  11. Standard B-Mode Ultrasound Measures Local Carotid Artery Characteristics as Reliably as Radiofrequency Phase Tracking in Symptomatic Carotid Artery Patients.

    Science.gov (United States)

    Steinbuch, Jeire; Hoeks, Arnold P G; Hermeling, Evelien; Truijman, Martine T B; Schreuder, Floris H B M; Mess, Werner H

    2016-02-01

    Local arterial stiffness can be assessed with high accuracy and precision by measuring arterial distension on the basis of phase tracking of radiofrequency ultrasound signals acquired at a high frame rate. However, in clinical practice, B-mode ultrasound registrations are made at a low frame rate (20-50 Hz). We compared the accuracy and intra-subject precision of edge tracking and phase tracking distension in symptomatic carotid artery patients. B-mode ultrasound recordings (40 mm, 37 fps) and radiofrequency recordings (31 lines covering 29 mm, 300 fps) were acquired from the left common carotid artery of 30 patients (aged 45-88 y) with recent cerebrovascular events. To extract the distension, semi-automatic echo edge and phase tracking algorithms were applied to B-mode and radiofrequency recordings, respectively. Both methods exhibited a similar intra-subject precision for distension (standard deviation = 44 μm and 47 μm, p = 0.66) and mean distension (difference: -6 ± 69 μm, p = 0.67). Intra-subject distension inhomogeneity tends to be larger for edge tracking (difference: 15 ± 35 μm, p = 0.04). Standard B-mode scanners are suitable for measuring local artery characteristics in symptomatic carotid artery patients with good precision and accuracy. PMID:26525651

  12. Evaluation of carotid artery stenosis with three-dimensional CT angiography and surgical revascularization

    Energy Technology Data Exchange (ETDEWEB)

    Ohtaki, Masafumi; Tanabe, Sumiyoshi; Uede, Teiji; Hashi, Kazuo [Sapporo Medical Univ. (Japan). School of Medicine

    1996-11-01

    The accuracy of three-dimensional CT angiography (3D-CTA) for delineating atherosclerotic carotid stenosis was examined in comparison with digital subtraction angiography (DSA) in symptomatic patients. In cases undergoing carotid endarterectomy (CEA), the clinical usefulness of 3D-CTA for surgical planning was also evaluated in the light of intraoperative findings. From July 1992 to Jun 1995, 52 patients suffering from internal carotid ischemia and/or presenting carotid bruit were evaluated to detect carotid bifurcation stenosis by 3D-CTA. Shaded surface reconstruction (SSR) for three-dimensional display and maximum intensity projection (MIP) were employed in multiple projection to evaluate sites of stenosis. DSA was performed in 18 out of 31 patients having atherosclerotic carotid stenosis shown by 3D-CTA. MIP reconstructions accurately delineated sites of stenosis close to DSA and allowed precise depiction of ulcerated plaque and intramural calcification. The percentage of carotid stenosis was determined by comparing the narrowest point to the internal carotid artery (ICA) beyond the bulb on both 3D-CTA and DSA. Assessment of carotid stenosis was highly correlated between 3D-CTA and DSA (r=0.987, p< 0.0001). In this series, 9 carotid arteries in 8 patients underwent CEA for severe stenosis. 3 patients with ICA occlusion and 1 patient with elongated severe stenosis underwent STA-MCA anastomosis. Using MIP reconstructions and two-dimensional original images it was found that ICA occlusion was apparently distinguished from high grade ICA stenosis. SSR provided valuable informations during CEA for atherosclerotic plaque regarding anatomical relationship with the internal jugular vein and bony structures. This advanced means of 3D-CTA can be adequate as a screening method to detect carotid stenosis in symptomatic patients and useful for surgical planning of CEA and post-operative follow-up examination. (author)

  13. Evaluation of carotid artery stenosis with three-dimensional CT angiography and surgical revascularization

    International Nuclear Information System (INIS)

    The accuracy of three-dimensional CT angiography (3D-CTA) for delineating atherosclerotic carotid stenosis was examined in comparison with digital subtraction angiography (DSA) in symptomatic patients. In cases undergoing carotid endarterectomy (CEA), the clinical usefulness of 3D-CTA for surgical planning was also evaluated in the light of intraoperative findings. From July 1992 to Jun 1995, 52 patients suffering from internal carotid ischemia and/or presenting carotid bruit were evaluated to detect carotid bifurcation stenosis by 3D-CTA. Shaded surface reconstruction (SSR) for three-dimensional display and maximum intensity projection (MIP) were employed in multiple projection to evaluate sites of stenosis. DSA was performed in 18 out of 31 patients having atherosclerotic carotid stenosis shown by 3D-CTA. MIP reconstructions accurately delineated sites of stenosis close to DSA and allowed precise depiction of ulcerated plaque and intramural calcification. The percentage of carotid stenosis was determined by comparing the narrowest point to the internal carotid artery (ICA) beyond the bulb on both 3D-CTA and DSA. Assessment of carotid stenosis was highly correlated between 3D-CTA and DSA (r=0.987, p< 0.0001). In this series, 9 carotid arteries in 8 patients underwent CEA for severe stenosis. 3 patients with ICA occlusion and 1 patient with elongated severe stenosis underwent STA-MCA anastomosis. Using MIP reconstructions and two-dimensional original images it was found that ICA occlusion was apparently distinguished from high grade ICA stenosis. SSR provided valuable informations during CEA for atherosclerotic plaque regarding anatomical relationship with the internal jugular vein and bony structures. This advanced means of 3D-CTA can be adequate as a screening method to detect carotid stenosis in symptomatic patients and useful for surgical planning of CEA and post-operative follow-up examination. (author)

  14. Comparison of the safety of simultaneous bilateral carotid artery stenting versus unilateral carotid artery stenting: 30-day and6-month results

    Institute of Scientific and Technical Information of China (English)

    DONG Hui; JIANG Xiong-jing; PENG Meng; JI Wei; WU Hai-ying; HUI Ru-tai; XU Bo; YANG Yue-jin; GAO Run-lin

    2012-01-01

    Background Severe bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly.Such patients have high stroke risk.Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis.However,the optimal procedural strategy of bilateral carotid stenosis remains unclear.The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).Methods In this single-center retrospective study,we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009.Thirty-nine patients (16.7%) of them underwent SBCAS,and the others (n=195) underwent UCAS.Indication for CAS was defined as carotid artery diameter reduction >60% (symptomatic) or >80% (asymptomatic).Six-month and 30-day hemodynamic depression (HD),hyperperfusion syndrome (HPS),stroke,death and myocardial infarction (MI) after carotid stenting were assessed.Results SBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD:28.2% vs.20.0%,P=0.396; HPS:2.6% vs.2.1%,P=0.262).Moreover,there was no statistically significant difference between SBCAS group and UCAS group in major stroke,death,MI and their combinations within 30 days (major stroke:0 vs.3.6%,P=0.604; death:2.6% vs.1.5%,P=0.520; MI:2.6% vs.0.5%,P=0.306; and their combinations:5.1% vs.4.6%,P=1.000)and 6 months (major stroke:0 vs.3.6%,P=0.604; death:5.1% vs.2.1%,P=0.262; MI:5.1% vs.1.0%,P=0.130 and their combinations:7.7% vs.5.1%,P=0.459).Conclusions The patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up.Our finding suggests that SBCAS appears to be as safe as UCAS.

  15. Pulse-wave timing between the cervical carotid and intracranial arteries by means of wavelet transform

    NARCIS (Netherlands)

    Journee, HL; de Jonge, AB; Hamoen, DJ; Smit, A; van Bruggen, AC; Mooij, JJA; Boom, H; Robinson, C; Rutten, W; Neuman, M; Wijkstra, H

    1997-01-01

    Wavelet Transform (WT) is applied in a method for timing the blood pulse wave between the internal carotid artery: and one of the intracranial arteries. The required accuracy is a few milliseconds. In contrast to the Fourier Transform (FT), WT is an appropriate technique for the detection of non-sta

  16. Percutaneous embolization of arteriovenous fistulas of the external carotid and vertebral arteries

    International Nuclear Information System (INIS)

    The angiographic study of eight patients with nine arteriovenous fistulas (AVF) in the cervico-cranial area, seven in branches of the external carotid artery and two in the extracranial vertebral artery, is presented. The therapeutical strategy for these lesions is discussed, especially regarding the embolic agent to be used in each case. (M.A.C.)

  17. A Lumped Parameter Method to Calculate the Effect of Internal Carotid Artery Occlusion on Anterior Cerebral Artery Pressure Waveform

    OpenAIRE

    Abdi, M.; Navidbakhsh, M.; Razmkon, A.

    2016-01-01

    Background and Objective Numerical modeling of biological structures would be very helpful tool to analyze hundreds of human body phenomena and also diseases diagnosis. One physiologic phenomenon is blood circulatory system and heart hemodynamic performance that can be simulated by utilizing lumped method. In this study, we can predict hemodynamic behavior of one artery of circulatory system (anterior cerebral artery) when disease such as internal carotid artery occlusion is occurred. Method ...

  18. Coronary Artery Calcium, Carotid Artery Wall Thickness and Cardiovascular Disease Outcomes in Adults 70 to 99 Years Old

    OpenAIRE

    Newman, Anne B; Naydeck, Barbara L.; Ives, Diane G.; Boudreau, Robert M.; Sutton-Tyrrell, Kim; O Leary, Daniel H.; Kuller, Lewis H.

    2008-01-01

    Few population studies have evaluated the associations of both coronary artery calcium (CAC) and carotid ultrasound with cardiovascular events, especially in adults > 70 years of age. At the Pittsburgh Field Center of the Cardiovascular Health Study, 559 men and women, mean age 80.2 (SD 4.1) years had CAC score assessed by electron beam computerized tomography scan and common and internal carotid intimal-medial wall thickness (CCA-IMT and ICA-IMT) by carotid ultrasound between 1998−2000 and w...

  19. Usefulness of CT angiography after metallic stent implantation of the internal carotid artery

    International Nuclear Information System (INIS)

    To evaluate the usefulness of CT angiography in patients with implantation of metallic stent for stenosed internal carotid artery. Seven patients with atherosclerotic stenosis of the internal carotid artery underwent metallic stent implantation. All were male and their ages ranged from 36 to 69 years. A total of seven stents were placed in the internal carotid artery in five patients and in the carotid bifurcation in two. Spiral CT scans were obtained and CT angiographic images were reconstructed using MPR or curved MPR techniques at a workstation. The interval between CT and conventional angiography did not exceed six days except in one patient, in whom it was 61days. CT and conventional angiography were compared for stent position with respect to the carotid bifurcation, stent deformation, intraluminal filling defect, and luminal caliber and outflow. Luminal patency of the implanted stent was measured according to NASCET(North American Symptomatic Carotid Endarterectomy Trial) criteria, and statistically processed (p>.05). The presence or absence of intrastent thrombus and vascular wall calcification was determined using axial source images. In all patients, CT angiographic findings matched those obtained by conventional angiography. Complications such as migration or deformation of an implanted stent, intraluminal filling defect, change of luminal caliber or outflow of implanted stent were not observed in any patient. In two studies in which Wilcoxon signed rank test was used, degree of stent expansion correlated closely(p=0.237). Axial source images showed that in no patient was an intrastent thrombus present, though in five, vascular wall calcification of internal carotid arteries outside the stent was noted. CT angiography is useful for the assessment of positional change, occlusion, and luminal patency of a stent-implanted internal carotid artery

  20. Usefulness of CT angiography after metallic stent implantation of the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Man Won; Kim, Hyeon Chul; Kim, Jae Kyu; Seo, Jeong Jin; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam Univ. Hospital, Kwangju (Korea, Republic of)

    1999-11-01

    To evaluate the usefulness of CT angiography in patients with implantation of metallic stent for stenosed internal carotid artery. Seven patients with atherosclerotic stenosis of the internal carotid artery underwent metallic stent implantation. All were male and their ages ranged from 36 to 69 years. A total of seven stents were placed in the internal carotid artery in five patients and in the carotid bifurcation in two. Spiral CT scans were obtained and CT angiographic images were reconstructed using MPR or curved MPR techniques at a workstation. The interval between CT and conventional angiography did not exceed six days except in one patient, in whom it was 61days. CT and conventional angiography were compared for stent position with respect to the carotid bifurcation, stent deformation, intraluminal filling defect, and luminal caliber and outflow. Luminal patency of the implanted stent was measured according to NASCET(North American Symptomatic Carotid Endarterectomy Trial) criteria, and statistically processed (p>.05). The presence or absence of intrastent thrombus and vascular wall calcification was determined using axial source images. In all patients, CT angiographic findings matched those obtained by conventional angiography. Complications such as migration or deformation of an implanted stent, intraluminal filling defect, change of luminal caliber or outflow of implanted stent were not observed in any patient. In two studies in which Wilcoxon signed rank test was used, degree of stent expansion correlated closely(p=0.237). Axial source images showed that in no patient was an intrastent thrombus present, though in five, vascular wall calcification of internal carotid arteries outside the stent was noted. CT angiography is useful for the assessment of positional change, occlusion, and luminal patency of a stent-implanted internal carotid artery.

  1. Automatic segmentation of the lumen of the carotid artery in ultrasound B-mode images

    Science.gov (United States)

    Santos, André M. F.; Tavares, Jão. Manuel R. S.; Sousa, Luísa; Santos, Rosa; Castro, Pedro; Azevedo, Elsa

    2013-02-01

    A new algorithm is proposed for the segmentation of the lumen and bifurcation boundaries of the carotid artery in B-mode ultrasound images. It uses the hipoechogenic characteristics of the lumen for the identification of the carotid boundaries and the echogenic characteristics for the identification of the bifurcation boundaries. The image to be segmented is processed with the application of an anisotropic diffusion filter for speckle removal and morphologic operators are employed in the detection of the artery. The obtained information is then used in the definition of two initial contours, one corresponding to the lumen and the other to the bifurcation boundaries, for the posterior application of the Chan-vese level set segmentation model. A set of longitudinal B-mode images of the common carotid artery (CCA) was acquired with a GE Healthcare Vivid-e ultrasound system (GE Healthcare, United Kingdom). All the acquired images include a part of the CCA and of the bifurcation that separates the CCA into the internal and external carotid arteries. In order to achieve the uppermost robustness in the imaging acquisition process, i.e., images with high contrast and low speckle noise, the scanner was adjusted differently for each acquisition and according to the medical exam. The obtained results prove that we were able to successfully apply a carotid segmentation technique based on cervical ultrasonography. The main advantage of the new segmentation method relies on the automatic identification of the carotid lumen, overcoming the limitations of the traditional methods.

  2. Left common carotid artery arising from brachiocephalic trunk and their aberrant course displacing trachea

    Directory of Open Access Journals (Sweden)

    Pratiksha Yadav

    2016-09-01

    Full Text Available Bovine arch commonly refer a group of congenital variations in the branches of arch of aorta, in which there is aberrant origin of left common carotid artery. These are usually detected incidentally, however rarely they can cause dysphagia lusoria. We report a case of bovine arch and aberrant left common carotid artery in a 62 years old female who had come with complaint of mild dyspnea. On radiograph there was superior mediastinal widening and shift of trachea to right side. CT scan was advised for further evaluation. On CECT there was only two main branches arised from arch of aorta, brachiocephalic trunk and right subclavian artery. There was aberrant origin of left common carotid artery seen from brachiocephalic trunk. The brachiocephalic trunk was very tortuous and displacing trachea to right side. [Int J Res Med Sci 2016; 4(9.000: 4220-4222

  3. Treatment of internal carotid artery dissections with endovascular stent placement: report of two cases

    International Nuclear Information System (INIS)

    Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of trauma-related extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpetrosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed

  4. Inferior knee arterial endoluminal angioplasty in treating severe lower limb ischemia though the DEEP balloon catheter

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of inferior knee arterial endoluminal angioplasty for treating severe lower limb ischemia with the use of the DEEP balloon catheter. Methods: Eleven patients (17 limbs) with severe ischemia of lower extremities from August 2007 to April 2008 were retrospectively studied. All involved limbs suffered from rest pain including 6 limbs (6/17)complicated with ulcer, 2 (2/17) with toe gangrene or 3 (3/17)with both of the complaints. ABI (Ankle bxancial index) were 0.2-0.5 and 0.51-0.7 in 12 limbs and 5 limbs respectively, with average value 0.47. Results: The success rate of operation was 100% (17/17). Pain relieved obviously in 13 limbs (13/17) and reduced in 2 limbs (2/17). 2 limbs (2/17) still suffered from pain and underwent upper-knee amputation and other 2 with ulcerations(2/ 17)were healed. 3 (3/17) with toe gangrene underwent partial foot amputation, 1 with dried gangrene remained unchanged and the other was lost. Another one showed ulcer healed and toe was lost. Increase of ABI was more than 0.5 in 10 limbs(10/17) and 0.3-0.5 in 5 limbs(5/17) with average value of 0.83. 10 patients with sixteen limbs were followed up in an average period of 4.3 months (1-9 months). Of the 15 immediate pain-relieved limbs, 12(12/15) limbs remained free of pain and pain recurred in 3 other limbs; and 2 of them with pain-reduced after PTA again; the other 1 underwent amputation, Average value of ABI was 0.70. Conclusions: Inferior arterial endoluminal angioplasty for the treatment of severe limb ischemia with application of the DEEP balloon catheter show high successful rate and short-term encouraging clinical results but mid-term and long-terms follow up should be undertaken for further investigation. (authors)

  5. Self-Expandable Stent Placement in Infrapopliteal Arteries After Unsuccessful Angioplasty Failure: One-Year Follow-up

    International Nuclear Information System (INIS)

    The purpose of this prospective study was to evaluate whether stent placement in infrapopliteal arteries is helpful in failed percutaneous transluminal angioplasty (PTA). Infrapopliteal PTA was performed in 70 arteries of 66 patients with chronic critical lower limb ischemia. The group comprised 55 males and 11 females, with an average age of 63.4 (range, 42-82) years. Diabetes mellitus was present in 92.4% of patients. Only the palpable anterior tibial and posterior tibial arteries were evaluated. Stents (Xpert stent; Abbot Vascular, Redwood City, CA, USA) were placed in 16 arteries where PTA was not successful (the failure was defined as residual stenosis >30% after PTA). In 54 arteries simple PTA was performed and was technically successful. Twenty-four nondilated arteries with no significant stenosis served as a comparison group. The 12-month patency rate was evaluated according to a combination of palpation and Doppler ultrasound. In all cases stent placement restored the flow in the artery immediately after unsuccessful PTA. Twelve-month follow-up showed a patency rate of 82% in the PTA group, 78% in the stent group, and 69% in the comparison group. We conclude that stent placement in the case of unsuccessful infrapopliteal PTA changed technical failure to success and restored flow in the dilated artery. At 12-month follow-up the patency rate of infrapopliteal arteries stented for PTA failure did not differ significantly either from nonstented arteries with an optimal PTA result or from a comparison group of nonintervened arteries.

  6. Clinical results of carotid artery stenting with a nitinol self-expanding stent (SMART stent)

    Energy Technology Data Exchange (ETDEWEB)

    Drescher, Robert; Mathias, Klaus D.; Jaeger, Horst J.; Bockisch, Georg; Demirel, Eren; Gissler, Martin H.; Hauth, Elke [Department of Radiology, Staedtische Kliniken Dortmund, Beurhausstrasse 40, 44139 Dortmund (Germany); Department of Radiology and Microtherapy, University Witten/Herdecke (Germany)

    2002-10-01

    Our objective was to assess the technical feasibility and the clinical results of internal carotid artery (ICA) stenting using a nitinol self-expanding stent (SMART stent). In 13 patients 13 high-grade stenoses of the internal carotid artery were treated via an implantation of a SMART stent. In all cases a predilation of the stenosis and a postdilation within the stent were performed. Follow-up examinations were carried out in all patients after a period of 6 months. In each case the implantation of the stent was performed without technical complications. In 12 of 13 cases the stent was placed in the patients' internal carotid artery, in 1 case from the internal to the common carotid artery (CCA). The average degree of stenosis of 78% (70-95%) was reduced to an average of 2.8% (0-21%). The 6-month follow-up angiography showed an average degree of restenosis of 11.8% (0-29%) in 8 of 13 patients. Duplex sonography in the remaining 5 patients demonstrated patent stents. One patient showed brief neurological symptoms during the intervention. No further complications occurred during follow-up time. Treatment of internal carotid artery stenosis with the SMART stent seems technically feasible, safe, and promises long-term patency. (orig.)

  7. Robust information gain based fuzzy c-means clustering and classification of carotid artery ultrasound images.

    Science.gov (United States)

    Hassan, Mehdi; Chaudhry, Asmatullah; Khan, Asifullah; Iftikhar, M Aksam

    2014-02-01

    In this paper, a robust method is proposed for segmentation of medical images by exploiting the concept of information gain. Medical images contain inherent noise due to imaging equipment, operating environment and patient movement during image acquisition. A robust medical image segmentation technique is thus inevitable for accurate results in subsequent stages. The clustering technique proposed in this work updates fuzzy membership values and cluster centroids based on information gain computed from the local neighborhood of a pixel. The proposed approach is less sensitive to noise and produces homogeneous clustering. Experiments are performed on medical and non-medical images and results are compared with state of the art segmentation approaches. Analysis of visual and quantitative results verifies that the proposed approach outperforms other techniques both on noisy and noise free images. Furthermore, the proposed technique is used to segment a dataset of 300 real carotid artery ultrasound images. A decision system for plaque detection in the carotid artery is then proposed. Intima media thickness (IMT) is measured from the segmented images produced by the proposed approach. A feature vector based on IMT values is constructed for making decision about the presence of plaque in carotid artery using probabilistic neural network (PNN). The proposed decision system detects plaque in carotid artery images with high accuracy. Finally, effect of the proposed segmentation technique has also been investigated on classification of carotid artery ultrasound images. PMID:24239296

  8. Associations between bicycling and carotid arterial stiffness in adolescents: The European Youth Hearts Study.

    Science.gov (United States)

    Ried-Larsen, M; Grøntved, A; Østergaard, L; Cooper, A R; Froberg, K; Andersen, L B; Møller, N C

    2015-10-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys using their bicycle every day of the week displayed a higher carotid arterial compliance {standard beta 0.47 [95% confidence interval (CI) 0.07-0.87]} and distension [standard beta 0.38 (95% CI -0.04 to 0.81)]. Boys using their bicycle every day of the week furthermore displayed a lower Young's elastic modulus [standard beta -0.48 (95% CI -0.91 to -0.06)]. Similar trends were observed when investigating the association between commuter bicycling and carotid arterial stiffness. These associations were not observed in girls. Our observations suggest that increasing bicycling in adolescence may be beneficial to carotid arterial health among boys. PMID:25156494

  9. The relationship between cerebral infarctive CT findings and cervical carotid arterial abnormalities; The accumulation of contrast media in angiography and carotid angio-CT

    Energy Technology Data Exchange (ETDEWEB)

    Hatanaka, Mitsuaki (Towada City Hospital, Aomori (Japan)); Shimizu, Toshio; Manabe, Hiroshi; Suzuki, Naoya

    1990-04-01

    The relationship between cervical carotid arterial changes and cerebral occlusive or ischemic disease was discussed in 120 consecutive cases (60 abnormal and 60 normal CT findings) which had been examined by means both of angiography and of brain CT. Even the low-grade stenosis of the carotid artery (less than 50%) had influence on the infarctive changes in CT; in these low-grade stenotic cases, clinico-pathological study sometimes revealed intimal damage, calcification, and clot formation on the damaged inner wall. Angiographically, the focal accumulation of contrast media in the carotid pathological region is a radiological expression of focal circulatory disturbance, a transient staying of the carotid blood flow, of clot-formation. More dynamic circulatory findings were revealed by Cine-Angiography. In cases of positive brain CT findings, cortical and multiple lesions more frequently had carotid changes and the accumulation of contrast media than did the basal ganglia and subcortical lesions. Even in the cases of negative brain CT findings, carotid changes were observed in about 20% of the cases. Angiographical study has the limitation that it cannot reveal the abnormality of the carotid arterial wall itself. On the other hand, carotid angio-CT was able to reveal carotid wall changes - for instance, calcification at a high density and atheromatous change at a low density: it can also investigate the range and degree. It is also useful in the follow-up study of pre-operative and post-operative changes, or anti-platelet therapy. (author).

  10. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure.

    Science.gov (United States)

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud's disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  11. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure

    Science.gov (United States)

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud’s disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  12. The baboon (Papio anubis extracranial carotid artery: An anatomical guide for endovascular experimentation

    Directory of Open Access Journals (Sweden)

    Laufer Ilya

    2001-12-01

    Full Text Available Abstract Background As novel endovascular strategies are developed for treating neurological disease, there is an increasing need to evaluate these techniques in relevant preclinical models. The use of non-human primates is especially critical given their structural and physiological homology with humans. In order to conduct primate endovascular studies, a comprehensive understanding of the carotid anatomy is necessary. We therefore performed a detailed examination of the vessel lengths, lumen diameters and angles of origin of the baboon extracranial carotid system. Methods We characterized the extracranial carotid system often male baboons (Papio anubis, range 15.1–28.4 kg by early post-mortem dissection. Photographic documentation of vessel lengths, lumen diameters, and angles of origin were measured for each segment of the carotid bilaterally. Results The common carotid arteries averaged 94.7 ± 1.7 mm (left and 87.1 ± 1.6 mm (right in length. The average minimal common carotid lumen diameters were 3.0 ± 0.3 mm (left and 2.9 ± 0.2 mm (right. Each animal had a common brachiocephalic artery arising from the aorta which bifurcated into the left common carotid artery and right braciocephalic artery after 21.5 ± 1.6 mm. The vascular anatomy was found to be consistent among animals despite a wide range of animal weights. Conclusions The consistency in the Papio anubis extracranial carotid system may promote the use of this species in the preclinical investigation of neuro-interventional therapies.

  13. CARDIAC TRANSPLANT REJECTION AND NON-INVASIVE COMON CAROTID ARTERY WALL FUNCTIONAL INDICES

    OpenAIRE

    A. O. Shevchenko; I. U. Tunjaieva; A. A. Nasyrova; B. L. Mironkov; I. M. Ilinsky; N. P. Mozhejko; I. I. Muminov; O. P. Shevchenko

    2015-01-01

    Allograft rejection would entail an increase in certain blood biomarkers and active substances derived from activated inflammatory cells which could influence entire vascular endothelial function and deteriorate arterial wall stiffness. We propose that carotid wall functional indices measured with non-invasive ultrasound could we valuable markers of the subclinical cardiac allograft rejection. Aim. Our goal was to analyze the clinical utility of functional common carotid wall (CCW) variables ...

  14. AUTOMATIC SEGMENTATION ALGORITHM FOR THE LUMEN OF THE CAROTID ARTERY IN ULTRASOUND B-MODE IMAGES

    OpenAIRE

    Santos, AMF; João Manuel R. S. Tavares; Sousa, L. de; Santos, R.; Castro, P.; Azevedo, E.

    2012-01-01

    A new algorithm is proposed for the identification and segmentation of the lumen and bifurcation boundaries of the carotid artery in 2D longitudinal ultrasound B-mode images. It uses the hipoechogenic characteristics defining the lumen of the carotid for its identification and echogenic characteristics for the identification of the bifurcation. The input image is preprocessed with the application of an anisotropic diffusion filter for speckle removal, and morphologic operators for the detecti...

  15. Automatic segmentation of the lumen of the carotid artery in ultrasound B-mode images

    OpenAIRE

    Santos, AMF; tavares, jmrs; Sousa, L. de; Santos, R.; Castro, P.; Azevedo, E.

    2013-01-01

    A new algorithm is proposed for the segmentation of the lumen and bifurcation boundaries of the carotid artery in B-mode ultrasound images. It uses the hipoechogenic characteristics of the lumen for the identification of the carotid boundaries and the echogenic characteristics for the identification of the bifurcation boundaries. The image to be segmented is processed with the application of an anisotropic diffusion filter for speckle removal and morphologic operators are employed in the dete...

  16. Carotid and femoral atherosclerotic plaques show different morphology. : Patterns of Peripheral Arterial Disease

    OpenAIRE

    Herisson, Fanny; Heymann, Marie-Françoise; Chétiveaux, Maud; Charrier, Céline; Battaglia, Séverine; Pilet, Paul; Rouillon, Thierry; Krempf, Michel; Lemarchand, Patricia; Heymann, Dominique; Gouëffic, Yann

    2011-01-01

    OBJECTIVE: Results of endovascular repair vary according to the arterial bed. We hypothesized that these differences may be related to the plaque features. To explore this hypothesis, we designed a prospective study that compared carotid and femoral atheroma. METHODS AND RESULTS: Patients that underwent femoral or carotid endarterectomy were included in our study. Demographic data and blood sampling were obtained prior to surgery. Plaques were evaluated for AHA grading, calcification and lipi...

  17. The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jeong-Ho [Keimyung University Dongsan Medical Center, Department of Neurology (Korea, Republic of); Kang, Jihoon; Yeo, Min-Ju; Kim, Beom Joon; Jang, Min Uk; Bae, Hee-Joon [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of); Kwon, O-Ki; Hwang, Gyo Jun; Oh, Chang Wan [Seoul National University Bundang Hospital, Department of Neurosurgery (Korea, Republic of); Jung, Cheolkyu [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of); Lee, Ji Sung [Soonchunhyang University Medical Center, Biostatistical Consulting Unit (Korea, Republic of); Han, Moon-Ku, E-mail: mkhan@snu.ac.kr [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of)

    2015-04-15

    PurposeCarotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.MethodsWe collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.ResultsThe mean age was 68.8 years (82.8 % males; range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.ConclusionsOur study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.

  18. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    International Nuclear Information System (INIS)

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity

  19. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schleder, Stephan, E-mail: stephan.schleder@ukr.de [University Hospital Regensburg, Department of Radiology (Germany); Diekmann, Matthias [Radiology Center Rahlstedt (Germany); Manke, Christoph [General Hospital Fulda, Department of Radiology (Germany); Heiss, Peter [University Hospital Regensburg, Department of Radiology (Germany)

    2015-02-15

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.

  20. Percutaneous transluminal ultrasonic angioplasty: preliminary clinical report of ultrasound plaque ablation in totally occluded peripheral arteries.

    Science.gov (United States)

    Monteverde-Grether, C; Valez y Tello de Meneses, M; Nava-López, G; Jauregui, R; Borges, J; Abundes, A; López-Cuéllar, M; Armilla, M

    1991-01-01

    Peripheral arterial obstructive disease has been treated with ultrasound ablation. Thirty two patients (pts), mean age 67 +/- 10 years underwent angiosonoplasty, with a prototype ultrasonic system, due to severe claudication (31%), rest pain (44%), rest pain and ulceration (25%). Angiosonoplasty was successful in 26/32 (81%) stenoses, (1/2 iliac, 9/2 femorals, 11/12 popliteal, 5/6 tibial). Angiography before and after angiosonoplasty confirmed that the lesions were successfully opened, (81%, p less than 0.05). A mean of 3 +/- 2 passes were required to adequately remove sufficient plaque. Balloon angioplasty was used in combination with angiosonoplasty in 11/32 (34%) occluded vessels. Complications included groin hematoma in 4 pts (12%) and vascular spasm in two patients (6%). Within 24 hours, 27/32 (94%) pts were discharged clinically improved. Reocclusion occurred in 4 pts (12%) immediately after the procedure. Ankle brachial indices significantly increased from 0.52 +/- 0.10 before to 0.70 +/- 0.12 after (p less than 0.05). In conclusion, the use of ultrasound energy to ablate atherosclerotic plaque would appear safe, and has shown no restenosis and a low incidence of complications over a six month period. PMID:1840288

  1. Cigarette smoking in military pilots and intima-media thickness of the carotid arteries

    OpenAIRE

    Jovelić Stojan; Hajduković Zoran; Jovelić Aleksandra; Rađen Slavica

    2005-01-01

    Background. It is well known that smoking is associated with an increase in arterial wall thickness. However, most studies of this problem have been undertaken in age and sex heterogeneous groups, as well as in patients with already present other conventional risk factors. The aim of this study was to assess the effect of cigarette smoking on arterial wall thickness of the common carotid artery in asymptomatic pilots. Methods. The imaging of intima−media thickness of the posterior wall of the...

  2. Development of 3D ultrasound techniques for carotid artery disease assessment and monitoring

    International Nuclear Information System (INIS)

    Quantitative measurements of carotid plaque burden are used to monitor patients and evaluate established interventions as well as new treatment options. Three-dimensional ultrasound (3D US) techniques were developed to noninvasively monitor the progression of carotid artery disease in both symptomatic and asymptomatic patients. Three-dimensional carotid US images were acquired and reconstructed, and methods for quantitative assessment were developed. The measurement of intima-media thickness (IMT) based on two-dimensional ultrasound (2D US) images was extended to a 3D vessel-wall-plus- plaque thickness (VWT), obtained by computing the distance between the carotid wall and lumen surfaces on a point-by-point basis. VWT measurements were superimposed on the arterial wall to produce 3D VWT maps. VWT changes were determined by comparing the 3D VWT maps obtained at two different time points. To facilitate the visualization and interpretation of the VWT and VWT-Change maps, a technique to flatten these maps was developed. Carotid remodeling involving changes in both arterial wall and plaque thickness was assessed with VWT maps obtained from in vivo 3D ultrasound images. 3D carotid ultrasound image evaluation with VWT mapping provides a feasible means for the analysis of plaque burden volumes and changes. (orig.)

  3. Endarterectomy and saphenous vein ‘Y’ patchplasty technique for severe carotid artery bifurcation lesion

    Directory of Open Access Journals (Sweden)

    Cüneyt Eriş

    2013-09-01

    Full Text Available Arteriosclerosis, is mostly affect coronary and carotid arteriesespecially the ostium and bifurcation due to the natureof the flow. Arterial bifurcation lesions cause dilemmafor the treating physician during both surgical and invasiveprocedures because they require a higher clinical experienceand longer processing time. In carotid artery surgery,it is accepted that patchplasty prevents perioperativeand postoperative restenosis, and as a result of this, itreduces the incidence of ipsilateral stroke. In the presenttime synthetic patch materials (PTFE, Dacron and autologouspatch materials (saphenous and jugular veins areused. We report a case of carotid endarterectomy and ‘Y’shaped saphenous patchplasty to the carotid bifurcation.According to our research in the literature, we didn’t findany case with ‘Y’ shaped saphenous vein patch. Therewas only one Y shaped carotid patchplasty case by usingPTFE material. Our original technic is advantageous interms of easy preparation and application as well as itssuccessful outcome.Key words: Carotid artery diseases, saphenous vein,patchplasty

  4. Unilateral dysgenesis of the internal carotid artery: spectrum of imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    De Mendonca, J.L.F.; Viana, S.L.; Freitas, F.M.O.; Matos, V.L. [Magnetic Resonance Dept., Clinica Radiologica Vila Rica, Brasilia (Brazil)], E-mail: radiolog@uol.com.br; Viana, M.A.C.B. [Hospital de Base do Distrito Federal, Brasilia (Brazil); Silva, R.F. [Diagnostik, Hospital das Clinicas de Brasilia, Brasilia (Brazil); Quaglia, L.A.N. [Hospital Santa Lucia, Brasilia (Brazil); Guerra, J.G. [Hospital Regional de Taguatinga, Brasilia (Brazil)

    2008-04-15

    Dysgenesis of the internal carotid artery (ICA) is a broad term comprising hypoplasia, aplasia and agenesis of the vessel. It is a rare anomaly, often clinically silent, that can be confidently diagnosed by means of noninvasive imaging methods. After a review of teaching files, 7 patients with unilateral carotid dysgenesis were found, 2 with agenesis of the ICA, 3 with carotid aplasia, and 2 with hypoplasia of the vessel. Computed tomography (CT) and magnetic resonance angiography (MRA) of the brain were performed in all patients, with a complete magnetic resonance of the brain in 3 of them, a CT angiography of the brain in one, and MRA of the cervical arteries in 3. The fetal pattern of arterial circulation was found in 3 patients with agenesis/aplasia of the ICA and the adult pattern was found in 2 patients, being the brain circulation of normal pattern in the patients with hypoplasia of the ICA. Two patients presented signs of reduced flow to the brain hemisphere ipsilateral to the carotid dysgenesis; one of them with an old homolateral brain infarction. Far from being just an anatomic curiosity, the dysgenesis of the ICA may have serious consequences if not recognized prior to endarterectomies, carotid ligation or transsphenoidal surgery. As much as one-third of these patients will have intracranial aneurysms as well. The imaging methods, instead being mutually exclusive, are complementary in the evaluation of carotid dysgenesis. (author)

  5. Unilateral dysgenesis of the internal carotid artery: spectrum of imaging findings

    International Nuclear Information System (INIS)

    Dysgenesis of the internal carotid artery (ICA) is a broad term comprising hypoplasia, aplasia and agenesis of the vessel. It is a rare anomaly, often clinically silent, that can be confidently diagnosed by means of noninvasive imaging methods. After a review of teaching files, 7 patients with unilateral carotid dysgenesis were found, 2 with agenesis of the ICA, 3 with carotid aplasia, and 2 with hypoplasia of the vessel. Computed tomography (CT) and magnetic resonance angiography (MRA) of the brain were performed in all patients, with a complete magnetic resonance of the brain in 3 of them, a CT angiography of the brain in one, and MRA of the cervical arteries in 3. The fetal pattern of arterial circulation was found in 3 patients with agenesis/aplasia of the ICA and the adult pattern was found in 2 patients, being the brain circulation of normal pattern in the patients with hypoplasia of the ICA. Two patients presented signs of reduced flow to the brain hemisphere ipsilateral to the carotid dysgenesis; one of them with an old homolateral brain infarction. Far from being just an anatomic curiosity, the dysgenesis of the ICA may have serious consequences if not recognized prior to endarterectomies, carotid ligation or transsphenoidal surgery. As much as one-third of these patients will have intracranial aneurysms as well. The imaging methods, instead being mutually exclusive, are complementary in the evaluation of carotid dysgenesis. (author)

  6. Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty

    International Nuclear Information System (INIS)

    Vertebrobasilar artery occlusion (VBO) produces high mortality and morbidity due to low recanalization rate utilization in endovascular therapy. The use of percutaneous transluminal angioplasty (PTA) to improve recanalization rate additional to local intra-arterial fibrinolysis (LIF) was investigated in this study. Results obtained following recanalization therapy in acute intracranial VBO are reported. Eighteen consecutive patients with acute VBO underwent LIF with or without PTA, from August 2000 to May 2006. Eight patients were treated using LIF alone, and ten required additional PTA. Rate of recanalization, neurological status before treatment, and clinical outcomes were evaluated. Of 18 patients, 17 achieved recanalization. One procedure-related complication of subarachnoid hemorrhage occurred. Overall survival rate was 94.4% at discharge. Seven patients achieved good outcomes [modified Rankin scale (mRS) 0-2], and the other 11 had poor outcomes (mRS 3-6). Five of six patients who scored 9-14 on the Glasgow Coma Scale (GCS) before treatment displayed good outcomes, whereas ten of 12 patients who scored 3-8 on the GCS showed poor outcomes. GCS prior to treatment showed a statistically significant correlation to outcomes (p < 0.05). Moreover, the National Institutes of Health Stroke Scale (NIHSS) before treatment correlated well with mRS (correlation coefficient 0.487). No statistical difference between the good and poor outcome groups was observed for the duration of symptoms, age, etiology, and occlusion site. Endovascular recanalization can reduce mortality and morbidity of acute VBO. Good GCS and NIHSS scores prior to treatment can predict the efficacy of endovascular recanalization. (orig.)

  7. Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Kashiwagi, Junji; Okahara, Mika [Shinbeppu Hospital, Department of Radiology, Beppu, Oita (Japan); Kiyosue, Hiro; Tanoue, Shuichi; Sagara, Yoshiko; Mori, Hiromu [Oita University Faculty of Medicine, Department of Radiology, Yufu, Oita (Japan); Hori, Yuzo [Nagatomi Neurosurgical Hospital, Department of Radiology, Oita, Oita (Japan); Abe, Toshi [Kurume University School of Medicine, Department of Radiology, Kurume, Fukuoka (Japan)

    2010-05-15

    Vertebrobasilar artery occlusion (VBO) produces high mortality and morbidity due to low recanalization rate utilization in endovascular therapy. The use of percutaneous transluminal angioplasty (PTA) to improve recanalization rate additional to local intra-arterial fibrinolysis (LIF) was investigated in this study. Results obtained following recanalization therapy in acute intracranial VBO are reported. Eighteen consecutive patients with acute VBO underwent LIF with or without PTA, from August 2000 to May 2006. Eight patients were treated using LIF alone, and ten required additional PTA. Rate of recanalization, neurological status before treatment, and clinical outcomes were evaluated. Of 18 patients, 17 achieved recanalization. One procedure-related complication of subarachnoid hemorrhage occurred. Overall survival rate was 94.4% at discharge. Seven patients achieved good outcomes [modified Rankin scale (mRS) 0-2], and the other 11 had poor outcomes (mRS 3-6). Five of six patients who scored 9-14 on the Glasgow Coma Scale (GCS) before treatment displayed good outcomes, whereas ten of 12 patients who scored 3-8 on the GCS showed poor outcomes. GCS prior to treatment showed a statistically significant correlation to outcomes (p < 0.05). Moreover, the National Institutes of Health Stroke Scale (NIHSS) before treatment correlated well with mRS (correlation coefficient 0.487). No statistical difference between the good and poor outcome groups was observed for the duration of symptoms, age, etiology, and occlusion site. Endovascular recanalization can reduce mortality and morbidity of acute VBO. Good GCS and NIHSS scores prior to treatment can predict the efficacy of endovascular recanalization. (orig.)

  8. Septic Bleeding of the Common Carotid Artery Following Total Thyroidectomy: An Atypical Complication

    Directory of Open Access Journals (Sweden)

    T. Jamaan

    2010-01-01

    Full Text Available Septic rupture of the common carotid artery following total thyroidectomy may rapidly lead to exsanguination. We present a case report of a 16-year-old girl, diagnosed with a questionable thyroglossal duct cyst. Following the initial operative intervention with local excision of the cyst including resection of the medial part of the hyoid bone, pathology revealed papillary carcinoma. Thus secondary total thyroidectomy with locoregional lymphadenectomy was performed. One week later, a wound infection developed, necessitating lavage and drainage. On the 8th postoperative day, a dramatic bleeding of the right common carotid artery occurred. To our knowledge, this is the first reported case in the literature with a septic bleeding of the common carotid artery following total thyroidectomy after one week.

  9. Extracranial Internal Carotid Artery Aneurysms: Report of a Ruptured Case and Review of the Literature

    International Nuclear Information System (INIS)

    Aneurysms of the extracranial carotid arteries (ECAA) are extremely rare. Schechter et al. documented 835 cases in the literature up to 1977. One hundred and sixteen cases of ECAA have been documented in the Chinese literature since 1981, suggesting a higher prevalence of carotid aneurysmal disease in China than in the West. Four percent of all peripheral artery aneurysms are reported to be ECAA. Those arising from the internal carotid artery (EICAA) are even more rare. Two recent reviews reported 24 and 25 cases of EICAA during 21 and 17 years, respectively, the majority of them is treated surgically. Our literature review revealed only a few true EICAA managed endovascularly, but none of them with a covered stent. We describe a rare such case of ruptured atherosclerotic EICAA which was treated percutaneously

  10. Clinical study on external carotid artery infusion (trans-femoral) treatment of recurrent nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect and safety of external carotid artery infusion treatment of recurrent nasopharyngeal carcinoma (NPC). Methods: 20 cases of recurrent NPC (13 male and 7 female, age 36-65 years, mean 50 years) diagnosed by clinical examination (including nasopharyngoscope), serology (VCA-IgA) and imaging (CT, MR) and treated by external carotid artery infusion (trans-femoral) with adriamycin (or epi-adriamycin), cisplatin (or carboplatin), Pingyangmycin and 5-Fluorouracil. Results: Of all the patients, 8 cases (40%) had a complete response (CR), 7 cases (35%) had a partial response (PR). The overall response rate (CR + PR) was 75%. Cumulative survival rates at 1, 3 years were 90% (18/20), 50%(10/20) respectively. No severe side-effects and complications found. Conclusion: External carotid artery infusion (trans-femoral) should be effective and safe in the treatment of recurrent NPC

  11. Treatment of traumatic trigeminal-cavernous fistula by coil embolization and compression of carotid artery

    Directory of Open Access Journals (Sweden)

    Yang Xinjian

    2007-01-01

    Full Text Available We report a case of a traumatic cavernous fistula supplied by a persistent primitive trigeminal artery. The process of treatment was unique in this case. Fistula was subcompletely occluded by coiling from primitive trigeminal artery. Residual fistula was helped to form thrombosis by compression of the carotid artery with hand in the procedure. Long-term follow-up was satisfactory. Traumatic cavernous fistula supplied by a persistent primitive trigeminal artery could be treated by embolization and temporal compression of the parent artery might be useful for residual minimal fistula.

  12. Recurrent epistaxis occurred shortly after superselective embolization of external carotid artery: its causes and prevention strategy

    International Nuclear Information System (INIS)

    Objective: To discuss the causes of recurrent epistaxis occurred shortly after superselective embolization of external carotid artery and to make some suggestions related to the prevention strategy. Methods: superselective embolization of external carotid artery was carried out in 62 patients with severe epistaxis. Recurrence occurred in 9 cases within one week and in 7 cases within two weeks after the treatment. And the selective angiography together with the embolization therapy was performed again. The initial angiograms and the detailed embolization procedures were carefully reviewed and the possible causes of epistaxis recurrence were analyzed. Results: In 10 patients the recurrent epistaxis was caused by recanalization of the branches of external carotid artery. The lesions were fed by multiple branches of external carotid artery, but in 4 cases some of them were missed to be occluded in initial embolization procedure, resulting in recurrent epistaxis. In another two cases the recurrent epistaxis was caused by the establishment of collateral blood supply to the lesions. Conclusion: Careful observation of angiograms to find out all feeding arteries to the lesion and complete embolization of all feeding arteries with un-absorbable embolic agents can avoid the recurrence of epistaxis. (authors)

  13. Robust carotid artery recognition in longitudinal B-mode ultrasound images.

    Science.gov (United States)

    Sifakis, Emmanouil G; Golemati, Spyretta

    2014-09-01

    Automatic segmentation of the arterial lumen from ultrasound images is an important task in clinical diagnosis. Carotid artery recognition, the first task in lumen segmentation, should be performed in a fully automated, fast, and reliable way to further facilitate the low-level task of arterial delineation. In this paper, a user-independent, real-time algorithm is introduced for carotid artery localization in longitudinal B-mode ultrasound images. The proposed technique acts directly on the raw image, and exploits basic statistics along with anatomical knowledge. The method's evaluation and parameter value optimization were performed on a threefold cross validation basis. In addition, the introduced algorithm was systematically compared with another algorithm for common carotid artery recognition in B-mode scans, separately for multi-frame and single-frame data. The data sets used included 2,149 images from 100 subjects taken from three different institutions and covering a wide range of possible lumen and surrounding tissue representations. Using the optimized values, the carotid artery was recognized in all the processed images in both multi-frame and single-frame data. Thus, the introduced technique will further reinforce automatic segmentation in longitudinal B-mode ultrasound images. PMID:24968172

  14. Cigarette smoking in military pilots and intima-media thickness of the carotid arteries

    Directory of Open Access Journals (Sweden)

    Jovelić Stojan

    2005-01-01

    Full Text Available Background. It is well known that smoking is associated with an increase in arterial wall thickness. However, most studies of this problem have been undertaken in age and sex heterogeneous groups, as well as in patients with already present other conventional risk factors. The aim of this study was to assess the effect of cigarette smoking on arterial wall thickness of the common carotid artery in asymptomatic pilots. Methods. The imaging of intima−media thickness of the posterior wall of the distal 1 cm of both common carotid arteries was performed using a B mode ultrasound device, in 39 pilots (37.05 ± 6.66 years, for whom smoking was the single cardiovascular risk factor. Comparisons were made with 49 non-smokers (35.12 ± 7.39 years. Results. The posterior walls of both common carotid arteries were thicker in smokers (left, p < 0.05; right, p > 0,05. Intima-media thickness was significantly lower on the right side than on the left side in both smokers and nonsmokers (p < 0.01. Conclusion. Cigarette smoking as the single cardiovascular risk factor was associated with the wall thickness of the carotid arteries in our study. This finding indicated that early atherosclerosis was already present in pilots - smokers entering middle age.

  15. CT angiography and Color Doppler ultrasonography features and sensitivity in detection of carotid arteries diseases

    Directory of Open Access Journals (Sweden)

    Samir Kamenjaković

    2013-04-01

    Full Text Available Introduction: The aim of this research was to compare specifi city and sensitivity of Color Doppler ultrasonographywith CT angiography.Methods: A total of one hundred patients suffering from carotid artery disease (n=200 were tested in this research in the period from June till October, 2011. Average age of the patients was 61.5 years, and most of the patients were in the age group ranging from 55 to 65 years. The level of carotid artery stenosis is measured according to Standards of the North America Symptomatic Carotid Endarterectomy Trail study,by method of Color Doppler ultrasonography and CT angiography.Results: Stenosis <50% registered by Doppler ultrasonography was found in 62% and by CT angiography in 64% patients. Stenosis from 70 to 79% registered by Doppler ultrasonography was found in 88% and by CT angiography in 82% patients. In patients with level of stenosis 70-79% there was a tendencyof registering the stenosis to be higher by Color Doppler ultrasonography, than by CT angiography. In the case of the occlusion, there was also the similar observation, with variation of 8% carotid arteries.Conclusion: Extracranial Doppler and color duplex ultrasound enable reliable detection of both stenosis and occlusion of carotid arteries and accordingly they occupy an important place in radiological algorithm. When it comes to CT angiography it can be concluded that it can provide accurate and exact information regarding the condition of blood vessels as good as Digital Subtractive Angiography can.

  16. Carotid artery image segmentation using modified spatial fuzzy c-means and ensemble clustering.

    Science.gov (United States)

    Hassan, Mehdi; Chaudhry, Asmatullah; Khan, Asifullah; Kim, Jin Young

    2012-12-01

    Disease diagnosis based on ultrasound imaging is popular because of its non-invasive nature. However, ultrasound imaging system produces low quality images due to the presence of spackle noise and wave interferences. This shortcoming requires a considerable effort from experts to diagnose a disease from the carotid artery ultrasound images. Image segmentation is one of the techniques, which can help efficiently in diagnosing a disease from the carotid artery ultrasound images. Most of the pixels in an image are highly correlated. Considering the spatial information of surrounding pixels in the process of image segmentation may further improve the results. When data is highly correlated, one pixel may belong to more than one clusters with different degree of membership. In this paper, we present an image segmentation technique namely improved spatial fuzzy c-means and an ensemble clustering approach for carotid artery ultrasound images to identify the presence of plaque. Spatial, wavelets and gray level co-occurrence matrix (GLCM) features are extracted from carotid artery ultrasound images. Redundant and less important features are removed from the features set using genetic search process. Finally, segmentation process is performed on optimal or reduced features. Ensemble clustering with reduced feature set outperforms with respect to segmentation time as well as clustering accuracy. Intima-media thickness (IMT) is measured from the images segmented by the proposed approach. Based on IMT measured values, Multi-Layer Back-Propagation Neural Networks (MLBPNN) is used to classify the images into normal or abnormal. Experimental results show the learning capability of MLBPNN classifier and validate the effectiveness of our proposed technique. The proposed approach of segmentation and classification of carotid artery ultrasound images seems to be very useful for detection of plaque in carotid artery. PMID:22981822

  17. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    International Nuclear Information System (INIS)

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  18. Carotid thin fluttering bands: A new element of arterial wall remodelling? An ultrasound study.

    Science.gov (United States)

    Costanzo, Luca; Sole, Andrea; Tamburino, Corrado; Di Pino, Luigi

    2015-10-01

    Carotid artery ultrasound is a non-invasive and reproducible technique used for early atherosclerotic assessment. Intimal flap has been described in the presence of dissection or mobile plaque rupture, however presence of carotid thin fluttering bands (TFBs) have not been described yet. To investigate frequency, characteristics and impact of TFBs in carotid lumen of patients who underwent carotid ultrasound scan (CUS). 3341 patients were admitted from January 2009 to January 2014. Patients with history of cerebral ischemia (CI) were excluded. In the cases in which TFBs were observed, a 3-months clinical and CUS follow-up (FU) was performed. TFBs were found in 71 patients (2.1%). The mean age was 63.41 ± 11.20 years (range 42-89). All patients showed a mean increase in intima-media thickness. We identified two subgroups: in 22 patients the TFB was related to a carotid plaque while in 49 no carotid plaque was found. TFB mostly originated in the carotid bulb (88.7%) and was similarly located in carotid arteries (49.3% left-side and 50.7% right-side). CUS and clinical FU were available for all patients (mean duration 25.34 months, median 19). CI occurred in none of the patients. TFB disappeared in 13 patients (18.3%) with no sign or symptoms of CI. In 3 of 49 patients without carotid plaque (6.1%), progressive thickening beneath TFB was observed. TFB is a rare finding. Longer FU is needed to evaluate its prognosis. To date, the pathophysiology is unknown, however it could be related to vascular remodeling. PMID:26179862

  19. Delayed cerebral infarction due to stent folding deformation following carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Kwon Duk; Lee, Kyung Yul; Suh, Sang Hyun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Byung Moon [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    We report a case of delayed cerebral infarction due to stent longitudinal folding deformation following carotid artery stenting using a self-expandable stent with an open-cell design. The stented segment of the left common carotid artery was divided into two different lumens by this folding deformation, and the separated lumens became restricted with in-stent thrombosis. Although no established method of managing this rare complication exists, a conservative approach was taken with administration of anticoagulant and dual antiplatelet therapy. No neurological symptoms were observed during several months of clinical follow-up after discharge.

  20. Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia

    International Nuclear Information System (INIS)

    Congenital absence of the unilateral internal carotid artery (ICA) was found in a patient during MR imaging examination for right trigeminal neuralgia. Magnetic resonance angiography showed complete absence of the right ICA and a large tortuous basilar artery (BA). The source images revealed a deformed right trigeminal nerve resulting from compression by the BA. Computed tomography of the skull base showed absence of the right carotid canal, suggesting agenesis of the right ICA. Longstanding hemodynamic stress may have caused the BA to become extremely tortuous, resulting in the trigeminal neuralgia. (orig.)

  1. Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga (Japan); Hirakawa, N.; Totoki, T. [Department of Anesthesiology, Saga Medical School, 5-1-1, Nabeshima, Saga (Japan)

    2002-09-01

    Congenital absence of the unilateral internal carotid artery (ICA) was found in a patient during MR imaging examination for right trigeminal neuralgia. Magnetic resonance angiography showed complete absence of the right ICA and a large tortuous basilar artery (BA). The source images revealed a deformed right trigeminal nerve resulting from compression by the BA. Computed tomography of the skull base showed absence of the right carotid canal, suggesting agenesis of the right ICA. Longstanding hemodynamic stress may have caused the BA to become extremely tortuous, resulting in the trigeminal neuralgia. (orig.)

  2. [Spontaneous dissection of the internal carotid artery: description of a case with lower cranial nerve palsy].

    Science.gov (United States)

    Macarini, Luca; Zeppa, Pio; Genovese, Eugenio Annibale; Scialpi, Michele; Raucci, Antonio

    2012-11-01

    Spontaneous dissection of the extracranial internal carotid artery is a well recognized cause of headache and juvenile stroke; lower cranial nerve palsy as a complication of dissection is rare. We report the case of a female patient with bilateral dissecting aneurysm of the internal carotid artery, associated with unilateral cranial nerve XII palsy and oculosympathetic palsy. Neuroradiological findings, in particular those obtained by Magnetic Resonance imaging, allow the identification of the dissecting pathology and the correlation of the aneurysmal formation with nerve palsy. PMID:23096747

  3. Giant mycotic aneurysm of the internal carotid artery in a child: endovascular treatment

    International Nuclear Information System (INIS)

    We present a case of a giant mycotic aneurysm of the left internal carotid artery in a child, the result of direct extension of a deep neck space infection. This lesion is life threatening and may put the patient at risk of unwarranted biopsy or drainage if not recognized. Diagnosis and treatment planning rely heavily on cross-sectional imaging, and angiography is frequently necessary. This case is unique for two reasons: (1) we present for the first time the MRI findings and (2) we describe an alternative to surgical ligation -- neurointerventional embolotherapy. Minimally invasive transcatheter embolization was successfully performed on our patient to occlude the abnormal left internal carotid artery segment. (orig.)

  4. The impact of stent implantation on the patency rate of femoropopliteal artery after subintimal angioplasty for occlusive arteriosclerosis

    International Nuclear Information System (INIS)

    Objective: To assess the impact of stent implantation on the patency rate of femoropopliteal artery after subintimal angioplasty for occlusive arteriosclerosis. Methods: During the period from January 2007 to May 2009, a total of 43 patients with occlusive femoropopliteal arteriosclerosis (43 diseased legs) were treated in authors' hospital. Of the 43 patients, simple percutaneous subintimal angioplasty was performed in 24 (non-stent group), while percutaneous subintimal angioplasty with subsequent stent implantation was carried out in the remaining 19 (stent group). After the treatment, CTA or Doppler ultrasonic examination was performed to check the results. Interventional therapy was respected in some cases who developed restenosis. Results: The 12-month limb salvage rate was 98%. Perioperative minor complications occurred in 7% of patients (3/43). Two-year mortality rate was 7% (3/43). During the follow-up period, arterial restenosis or occlusion occurred in 22 cases. Three cases in non-stent group developed arterial occlusion within one month after the treatment. Repeated interventional procedure was carried out for 12 diseased legs. The primary patency rates of non-stent group at 6, 12 and 24 months were (83.3±7.6)%, (74.0±9.2)% and (56.1±13.5)%, respectively, while those of stent group were (89.5±7.0)%, (77.5±9.9)% and (32.2±16.6)%, respectively. The primary assisted patency rates at 12 and 24 months in non-stent group were (90.9±6.1)% and (64.2±14.7)%, respectively, while those in stent group were (94.4±5.4)% and (39.0±15.90%, respectively. The difference in both the primary patency rate and primary assisted patency rate between the two groups were of no significance (P>0.05). Cox-regression analysis indicated that the number of patent distal vessels, the type of femoropopliteal occlusive diseases and the history of smoking bore a close relationship to the two-year primary patency rate after subintimal angioplasty (r=-4.417, 2.502, 3.115; SX=1

  5. Renal Angioplasty in Non-atheromatous Renal Artery Stenosis: Technical Results and Clinical Outcome in 43 Patients

    International Nuclear Information System (INIS)

    This study retrospectively reviewed the technical and clinical results of percutaneous transluminal renal artery angioplasty (PTRA) for non-atheromatous renal artery stenosis (RAS) in a Tertiary Renal Referral Centre. Forty-three patients (including 9 children) underwent 49 PTRA procedures for stenoses of 63 arteries over the period 1984-2001 (14 patients had bilateral stenosis treated during one procedure. There were 29 females and 14 males (age range 1-72 years, median 37 years). The etiology of the RAS was classical beaded FMD (medial fibroplasia) in 24, atypical or 'variant FMD' with a more focal stenosis (intimal fibroplasia) in 11, neurofibromatosis type 1 (NF) in 7 and Takayasu's Arteritis in 1. Five of the NF patients had angioplasty for stenoses following vascular repair procedures. A technically good result was obtained in 34/34 arteries with 'classical' RAS, 9/13 atypical arteries, 11/15 arteries of NF patients and in the one Takayasu's case. Clinical follow-up for a mean of 16 months revealed a cure rate of hypertension in classical FMD of 35% with improvement in a further 55%. In the atypical FMD cases, follow-up was obtained on 6 patients with 2 cures and the other 4 demonstrating benefit. There was a better chance of cure in younger patients. In native artery PTRA in children with NF, only 1 out of 3 patients was 'cured' post-PTRA, and 2 out of 3 failed. However, in postsurgical stenoses in NF patients 1 out of 4 patients was 'cured' and 3 out of 4 improved. In conclusion, classical FMD responds well to PTRA with better results in younger patients. Atypical FMD, especially in children and when associated with NF, is less predictable. Stenoses consequent to revascularization surgery respond well to PTRA

  6. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, H.J.; Mehring, U.M.; Gissler, H.M.; Mathias, K.D. [Dept. of Diagnostic Radiology, Staedtische Kliniken Dortmund (Germany); Dept. of Radiology and MicroTherapy, Univ. of Witten/Herdecke (Germany)

    2000-11-01

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  7. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    International Nuclear Information System (INIS)

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  8. Evaluation of carotid artery elasticity in patients with obstructive sleep apnea syndrome using quantitative arterial stiffness technique

    Institute of Scientific and Technical Information of China (English)

    俞飞虹

    2012-01-01

    Objective To explore the changes and clinical value of carotid elasticity index in patients with obstructive sleep apnea syndrome (OSAS) by quantitative arterial stiffness(OAS) technique. Methods Seventy-two OSAS patients were divided into 2 groups according to whether there was coexisting hypertension

  9. Arteriosclerosis of carotid arteries in identical twins discordant in tobacco smoking

    International Nuclear Information System (INIS)

    Duplex Doppler US has proved to be an accurate method of evaluating the arteriosclerotic process in extracranial carotid arteries. Tobacco smoking is generally considered to be a factor promoting arteriosclerosis. The authors performed duplex US examinations of the carotid arteries of 48 pairs (96 individuals) of monozygotic twins discordant for smoking. The ages of the examinees ranged from 31 years to 77 years (mean, 52 years). Doppler measurements of femoral and popliteal arteries were also made. A difference in the grade of arteriosclerosis was perceived in 40 pairs of twins, in each case to the benefit of the nonsmoker. The most common change was a difference in intimal thickness. Carotid artery stenoses, 15%-60%, were found in seven cases. In addition, a difference in the size of minor plaques of the carotid bifurcations was verified in 26 pairs of twins. Three smokers were found to have an obstructive lesion in the lower extremity arteries. Arteriosclerotic changes were more common and more pronounced in smokers with a long exposure to tobacco

  10. Echogenicity of the Common Carotid Artery Intima-Media Complex in Stroke.

    Science.gov (United States)

    Aizawa, Kunihiko; Elyas, Salim; Adingupu, Damilola D; Casanova, Francesco; Gooding, Kim M; Shore, Angela C; Strain, W David; Gates, Phillip E

    2016-05-01

    The grey-scale median of the common carotid artery intima-media complex (IM-GSM) characterizes arterial wall composition, and a low IM-GSM is associated with increased cardiovascular mortality in the elderly. We aimed to determine differences in the IM-GSM between a cohort with cerebrovascular disease and a healthy cohort. Eighty-two healthy individuals (control group: 63.2 ± 8.7 y) and 96 patients with either stroke or transient ischemic attacks (CRVD group: 68.6 ± 9.8 y) were studied. Common carotid artery intima-media thickness and IM-GSM obtained by ultrasound were analyzed using semi-automated edge-detection software. The IM-GSM was significantly lower in the CRVD group than in the control group (106 ± 24 vs. 124 ± 27 au, p GSM was similar for the infarct and non-infarct sides in CRVD. In the pooled cohort of all participants, the lower the quartile of IM-GSM, the greater were the carotid artery intima-media thickness and carotid artery remodeling. These results suggest the presence of an altered atherosclerotic phenotype in the intima-media complex of CRVD patients that can be detected by ultrasound. PMID:26944528

  11. Accordion effect during carotid artery stenting. Report of two cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Tsutsumi, Masanori; Kazekawa, Kiyoshi; Onizuka, Masanari; Aikawa, Hiroshi; Iko, Minoru; Kodama, Tomonobu; Nii, Kouhei; Matsubara, Shuko; Etou, Housei; Tanaka, Akira [Fukuoka University Chikushi Hospital, Department of Neurosurgery, Fukuoka (Japan)

    2007-07-15

    The term ''accordion effect'' is used to describe a mechanical distortion of tortuous arteries mimicking spasm or dissection. This phenomenon has been reported in patients undergoing percutaneous coronary intervention. To our knowledge, this is the first documentation of the accordion effect during carotid artery intervention. Two patients who developed the accordion effect during carotid artery stenting (CAS) are described. Angiograms obtained just after CAS showed a stenosing lesion with wall irregularity at the distal part of the stent. This lesion disappeared and tortuosity of the internal carotid artery developed after withdrawing the guidewire until its floppy segment rested equally on the lesion. In another patient, the lesion did not disappear completely until the guiding catheter had been withdrawn to the proximal portion of the common carotid artery. We conclude that these stenosing lesions reflected the accordion effect. It is essential to differentiate the accordion effect from dissection, spasm, and thrombosis because the management is importantly different. We report our findings and present a review of the literature. (orig.)

  12. Segmentation of the Common Carotid Artery Walls Based on a Frequency Implementation of Active Contours: Segmentation of the Common Carotid Artery Walls

    OpenAIRE

    Bastida-Jumilla, M Consuelo; Menchón-Lara, Rosa M; Morales-Sánchez, Juan; Verdú-Monedero, Rafael; Larrey-Ruiz, Jorge; Sancho-Gómez, José Luis

    2012-01-01

    Atherosclerosis is one of the most extended cardiovascular diseases nowadays. Although it may be unnoticed during years, it also may suddenly trigger severe illnesses such as stroke, embolisms or ischemia. Therefore, an early detection of atherosclerosis can prevent adult population from suffering more serious pathologies. The intima–media thickness (IMT) of the common carotid artery (CCA) has been used as an early and reliable indicator of atherosclerosis for years. The IMT is manually compu...

  13. Idiopathic infantile arterial calcification in a 12-year-old girl presenting as chronic mesenteric ischemia: imaging findings and angioplasty results

    International Nuclear Information System (INIS)

    We report an unusual case of chronic mesenteric ischemia presenting in a 12-year-old girl with idiopathic infantile arterial calcinosis (IIAC). This is the first reported case in the literature of chronic mesenteric ischemia in the setting of IIAC. The girl presented with a classical history of postprandial abdominal pain. Imaging demonstrated significant stenoses of the celiac axis, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). Angioplasty of the celiac axis and SMA was attempted, with successful dilation of the SMA only. At 3-, 6- and 12-month follow-ups, the child's symptoms had almost resolved. This case report has three important ramifications: chronic mesenteric ischemia is a possible clinical presentation in children with IACC, pre-angioplasty imaging is important in guiding treatment approach, and angioplasty was effective in this case of chronic mesenteric ischemia and offers hope for other similarly affected children. (orig.)

  14. Postoperative internal carotid artery restenosis after local anesthesia: presence of risk factors versus intraoperative shunt.

    Science.gov (United States)

    Hudorovic, Narcis; Lovricevic, Ivo; Hajnic, Hrvoje; Ahel, Zaky

    2010-08-01

    Published data suggest that the regional anesthetic technique used for carotid endarterectomy (CEA) increases the systolic arterial blood pressure and heart rate. At the same time local anesthesia reduced the shunt insertion rate. This study aimed to analyze risk factors and ischemic symptomatology in patients with postoperative internal carotid artery restenosis. The current retrospective study was undertaken to assess the results of CEA in 8000 patients who were operated during a five-year period in six regional cardiovascular centers. Carotid color coded flow imaging, medical history, clinical findings and atherosclerotic risk factors were analyzed. Among them, there were 33 patients (0.4%) with postoperative re-occlusion after CEA. The patients with restenosis were re-examined with carotid color coded flow imaging and data were compared with 33 consecutive patients with satisfactory postoperative findings to serve as a control group. In the restenosis group eight risk factors were analyzed (hypertension, smoking, hyperlipidemia, diabetes mellitus, history of stroke, transitory ischemic attack, heart attack and coronary disease), and compared with risk factors in control group. Study results suggested that early postoperative internal carotid artery restenosis was not caused by atherosclerosis risk factors but by intraoperative shunt usage. PMID:20439301

  15. The application of MR and CT angiography in the evaluation of carotid artery stenosis and follow-up of carotid endarterectomy

    International Nuclear Information System (INIS)

    Objective: To estimate the accuracy of MR angiography (MRA) and CT angiography (CTA) in the evaluation of the carotid artery stenosis. Methods: Eleven patients were studied with MRA and CTA. The results were compared with DSA, CT virtual endoscopy (CTVE), and Doppler ultrasound (DUS). MRA was performed with 2D and 3D TOF sequences. CTA was post processed using MIP and SSD. CTVE was performed using navigator function. Three patients with severe stenosis received carotid endarterectomy. Results: There was a total of 22 carotid arteries studied, with 8 mild, 3 moderate, 5 severe stenosis, 1 occlusion, and 5 normal. Agreement on stenosis between CTA and DSA was found in 11 of 12 carotid arteries. Agreement on stenosis between MRA and DSA was found in 9. Plaques were delineated in CTA, CTVE, and confirmed by pathology in 3 cases. Postoperative MRA and CTA proved the release of stenosis. Conclusion: MRA and DUS can be used as a screening technique to evaluate carotid artery stenosis and as a convenient follow-up modality for post-endarterectomy. CTA has a high degree of accuracy for the assessment of carotid artery stenosis compared with DSA, and it could provide information on calcified plaque

  16. Correlation of arterial stiffness index with carotid atherosclerosis in patients with primary hypertension

    Institute of Scientific and Technical Information of China (English)

    Wen-Hua Cai; Li-Min Li; Xue-Min Wang; Cui-Qing Sun; Hai-Wei Zhao; Hui Wang; Rui-Chao Liu

    2016-01-01

    Objective:To explore the correlation of arterial stiffness index with carotid atherosclerosis in patients with primary hypertension.Methods:A total of 86 patients with primary hypertension who were admitted in our hospital from January, 2013 to September, 2015 were included in the study, and divided into the carotid atherosclerosis group (IMT≥0.9 mm, with plaque being detected) and the pure hypertension group (normal IMT) according to the carotid artery color Doppler ultrasound results. According to the ambulatory blood pressure monitoring results, the carotid atherosclerosis group was divided into the low BPV (7.02-9.57) group and the high BPV (>9.57-14.29) group. The non-invasive ambulatory blood pressure monitoring apparatus was used for 24 h blood pressure monitoring, measuring time in the daytime: 6:00-21:59, measuring one time every 30 min; measuring time in the nighttime: 22:00-5:59, measuring one time every 60 min. The dSBP, dDBP, nSBP, nDBP, 24 h SBP, and 24 h DBP were recorded. BPV was expressed as 24 h SCV and 24 h DCV.Results:The dSBP, nSBP, 24 h SBP, 24 h DBP, and 24 h SCV in the carotid atherosclerosis group were significantly higher than those in the pure hypertension group, while the comparison of dDBP, nDBP, and 24 h DCV between the two groups was not statistically significant. The common carotid artery and external carotid artery IMT, and the mean IMT in the high BPV group were significantly higher than those in the low BPV group, and the number of carotid plaques being detected was significantly greater than that in the low BPV group.Conclusions:BPV is involved in the arterial functional and structural changes, resulting in the target organ damage. Detection of carotid IMT is of great significance in evaluating the early vascular damage and predicting the cardiovascular events; therefore, BPV monitoring should be strengthened during the diagnosis and treatment of hypertension.

  17. ULTRASONOGRAPHIC ASSESSMENT OF COMMON CAROTID ARTERY ATHEROSCLEROSIS IN PATIENTS OF RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Jayakumar

    2015-02-01

    Full Text Available BACKGROUND & OBJECTIVES: Patients with Rheumatoid Arthritis (R.A. have a marked increase in Carotid Atherosclerosis independent of traditional risk factors like family history of myocardial infarction in first degree male relatives younger than 55 years of age or first degree female relatives younger than 65 years of age, smoking, hypertension (D efined as blood pressure of 140/90 mm hg or higher, diabetes mellitus and fasting serum cholesterol levels including age. Chronic inflammation and possibly disease severity and duration are atherogenic in Rheumatoid Arthritis patients. Preclinical disease may also be identified by using ultrasonography to determine carotid intimal - media thickness, an indirect measure of atherosclerosis. The common carotid artery Intima media thickness in Rheumatoid Arthritis patients is positively associated with disease duration, Early Rheumatoid Arthritis (D uration less or = 1 year is associated with lesser Intima media thickness than was Rheumatoid Arthritis of longer duration. Increased carotid artery Intima media thickness and the presence of carotid plaque are associated with markers of systemic inflammation in patients with Rheumatoid Arthritis and in healthy subjects. OBJECTIVE OF THE STUDY: To determine preclinical atherosclerosis occurring prematurely in patients of Rheumatoid Arthritis by ultrasonograhic measurement Common Carotid Artery Intima media thickness and to evaluate the risk factors associated with arterial intima media thickness in patient of Rheumatoid Arthritis. RESULTS: In RA patients, common carotid artery IMT was significantly higher when compared to healthy controls (0.65 ± 0.06 v/s 0.57 ± 0.049 and was significantly associated with the duration of RA, swollen joint count and erosive changes on hand x - ray independently of other confounding variables. CONCLUSION: Patients with rheumatoid arthritis have a marked increase in carotid atherosclerosis independent of traditional risk factors

  18. Carotid artery disease in cerebrovasculas asymptomatic volunteerscorrelations with risk factors, CBF and CT findings

    International Nuclear Information System (INIS)

    In an effort to determine the prevalence of carotid artery disease in cerebrovascular asymptomatic volunteers, 125 randomly chosen active and retired employees of the state of Styria, Austria (82 men, 43 women, age 24 - 75, mean 49.6 +/- 10.5 years) were examined. High resolution Duplex-scanning reveales minimal to mild atherosclerotic plaques (<50% diameter stenosis), predominantly in the carotid bifurcation in 37/125 cases (29.6%). When controlling for age and sex, the incidences of hypertension, diabeter mallitus, cardiac disorders, peripheral vascular disease, cigarette smoking and elevated serum cholesterol were not significally different in the sonographycally affected and not affected group. Besides age (p=0.0002) to be significant predictors of the presence of asymptomatic atherosclerotic carotid artery disease. (author). 7 refs.; 2 tabs

  19. The Association of Coronary Artery Calcification and Carotid Artery Intima-Media Thickness With Distinct, Traditional Coronary Artery Disease Risk Factors in Asymptomatic Adults

    OpenAIRE

    Rampersaud, Evadnie; Bielak, Lawrence F.; Parsa, Afshin; Shen, Haiqing; Post, Wendy; Ryan, Kathleen A.; Donnelly, Patrick; Rumberger, John A.; Sheedy, Patrick F; Peyser, Patricia A.; Shuldiner, Alan R.; Mitchell, Braxton D.

    2008-01-01

    Coronary artery calcification (CAC) and common carotid artery intima-media thickness (CIMT) are measures of subclinical vascular disease. This 2000–2006 study aimed to characterize the associations among coronary artery disease risk factors, CAC quantity, and CIMT and to estimate shared genetic and environmental contributions to both CAC and CIMT among 478 asymptomatic Amish adults in Lancaster County, Pennsylvania. Heritability for CAC quantity and CIMT, adjusted for age and sex, was 0.42 (P...

  20. Normal flow-mediated vasodilatation of the brachial artery and carotid artery intima-media thickness in subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    M.D. Cabral

    2009-05-01

    Full Text Available Subclinical hypothyroidism (SHT is a disease for which exact therapeutic approaches have not yet been established. Previous studies have suggested an association between SHT and coronary heart disease. Whether this association is related to SHT-induced changes in serum lipid levels or to endothelial dysfunction is unclear. The aim of this study was to determine endothelial function measured by the flow-mediated vasodilatation of the brachial artery and the carotid artery intima-media thickness (IMT in a group of women with SHT compared with euthyroid subjects. Triglycerides, total cholesterol, HDL-C, LDL-C, apoprotein A (apo A, apo B, and lipoprotein(a were also determined. Twenty-one patients with SHT (mean age: 42.4 ± 10.8 years and mean thyroid-stimulating hormone (TSH levels: 8.2 ± 2.7 µIU/mL and 21 euthyroid controls matched for body mass index, age and atherosclerotic risk factors (mean age: 44.2 ± 8.5 years and mean TSH levels: 1.4 ± 0.6 µIU/mL participated in the study. Lipid parameters (except HDL-C and apo A, which were lower and IMT values were higher in the common carotid and carotid bifurcation of SHT patients with positive serum thyroid peroxidase antibodies (TPO-Ab (0.62 ± 0.2 and 0.62 ± 0.16 mm for the common carotid and carotid bifurcation, respectively when compared with the negative TPO-Ab group (0.55 ± 0.24 and 0.58 ± 0.13 mm, for common carotid and carotid bifurcation, respectively. The difference was not statistically significant. We conclude that minimal thyroid dysfunction had no adverse effects on endothelial function in the population studied. Further investigation is warranted to assess whether subclinical hypothyroidism, with and without TPO-Ab-positive serology, has any effect on endothelial function.

  1. A novel automatic algorithm for the segmentation of the lumen of the carotid artery in ultrasound B-mode images

    OpenAIRE

    Santos, AMF; dos santos, rm; castro, pmac; Azevedo, E.; Sousa, L. de; tavares, jmrs

    2013-01-01

    A novel algorithm is proposed for the segmentation of the lumen and bifurcation boundaries of the carotid artery in B-mode ultrasound images. It uses the image contrast characteristics of the lumen and bifurcation of the carotid artery in relation to other tissues and structures for their identification. The relevant ultrasound data regarding the artery presented in the input image is identified using morphologic operators and processed by an anisotropic diffusion filter for speckle noise rem...

  2. Clinical & radiological evaluation of atherosclerotic changes in carotid & coronary arteries in asymptomatic & clinically symptomatic individuals as a tool for pre-symptomatic diagnosis of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Venkatraman Bhat

    2016-01-01

    Interpretation & conclusions: Age-related progression of atherosclerosis was evident in internal carotid arteries. Significant association was observed in the IMT thickness of right common carotid (RCC and coronary disease in symptomatic group; whereas IMT of left common carotid and internal carotid arteries did not show any association. RCC IMT between 0.5-0.7mm showed maximal association with significant symptomatic narrowing of coronary arteries. Patients with IMT beyond 0.7mm had no association with symptoms.

  3. Automatic segmentation of the carotid artery in ultrasound B-mode images

    OpenAIRE

    André M.F. Santos; João Manuel R. S. Tavares; Elsa Azevedo; Luísa Sousa

    2013-01-01

    B-mode ultrasound imaging is well-known and used in the medical imaging field; however, it presents various difficulties, specifically in tasks of image segmentation and surface reconstruction, due to intrinsic adverse characteristics, such like low contrast and noise [1,2]. Despite this, B-mode ultrasound imaging has been used in the diagnosis of several cardiac diseases, particularly, carotid artery diseases like atherosclerosis, known as the quot;hardening of the artery, after the accumula...

  4. Adaptation of the MARACAS algorithm for carotid artery segmentation and stenosis quantification on CT images

    OpenAIRE

    Zuluaga, M. A.; Orkisz, M.; Delgado, E. J. F.; Doré, V.; Pinzón, A. M.; Hoyos, M. H.

    2010-01-01

    This paper describes the adaptations of MARACAS algorithm to the segmentation and quantification of vascular structures in CTA images of the carotid artery. The MARACAS algorithm, which is based on an elastic model and on a multi-scale eigen-analysis of the inertia matrix, was originally designed to segment a single artery in MRA images. The modifications are primarily aimed at addressing the specificities of CT images and the bifurcations. The algorithms implemented in this new version are c...

  5. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography

    OpenAIRE

    Garima Yeluri; C Anand Kumar; Namita Raghav

    2015-01-01

    Background: The human tissues continuously undergo modification as deposition of calcium (CA) salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC) as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P), and alkaline phospha...

  6. PHACE(S) Syndrome With Absent Intracranial Internal Carotid Artery and Anomalous Circle of Willis.

    Science.gov (United States)

    Winter, Pieta R; Itinteang, Tinte; Leadbitter, Philip; FitzJohn, Trevor; Tan, Swee T

    2015-06-01

    The authors present a case of PHACE(S) (posterior fossa malformations, hemangioma, arterial anomalies, cardiac defects, eye anomalies, and sternal cleft or supraumbilical raphe) syndrome with a right-sided segmental infantile hemangioma, and describe in detail, the associated absent ipsilateral intracranial internal carotid artery and anomalous Circle of Willis. Propranolol therapy led to accelerated, complete involution. Nadolol may reduce the theoretical risk of treating PHACE(S) patients with β-blockers. PMID:26080245

  7. Carotid artery stiffness, high-density lipoprotein cholesterol and inflammation in men with pre-hypertension

    OpenAIRE

    Heffernan, Kevin S; Karas, Richard H.; Kuvin, Jeffrey T.; Jae, Sae Young; Vieira, Victoria J.; Fernhall, Bo

    2009-01-01

    Low circulating levels of high density lipoprotein cholesterol (HDL-C) are associated with increased risk for cardiovascular events. HDL-C has a variety of poorly understood atheroprotective effects, including altering lipid metabolism and reducing inflammation. Increased arterial stiffness is an important predictor of subsequent cardiovascular risk. Therefore, in the current study, we sought to determine whether HDL-C levels are associated with carotid arterial stiffness. In addition we exam...

  8. An insight into elasticity analysis of common carotid artery using ultrasonography.

    Science.gov (United States)

    Raj, Jean Rossario; Rahman, Smk; Anand, Sneh

    2016-08-01

    Elastance is a distinguished marker in diagnosing various arterial diseases as studies have reported carotid artery-related diseases linked with stiffness index (β) values greater than 5. This study was to estimate elasticity of common carotid artery by measuring the diameter during systolic and diastolic phases using pixel tracing of successive frames and blood pressure. The B-mode ultrasonography video containing arterial wall motion was captured and fragmented into image frames. Each pixel on the greyscale image was converted into RGB intensity values. The diameter of the artery as well as the thickness of the wall was measured by tracing the pixel displacements from successive frames during arterial pulsation. The study was conducted on 19 subjects aged 25-40 years. The systolic and diastolic carotid artery lumen diameters and carotid intima-media thickness were calculated as 7.1 ± 0.7, 6.3 ± 0.6 and 0.5 ± 0.05 mm (mean ± standard deviation), respectively. The mean stiffness index (β), Peterson's modulus and Young's modulus of elasticity were 5.2 ± 1.1, 69 ± 15 kPa and 453 ± 99 kPa, respectively. The pixel displacements in tunica intima, tunica media and tunica adventitia were not homogeneous, due to varied macro-constituents such as endothelial tissues, smooth muscle cells, elastin lamina, fibrous tissue and micro-constituents such as collagen, fibroblast and elastin. We found that women have smaller arteries, and the stiffness increased during the systolic phase. PMID:27246916

  9. Pulsatility index in carotid arteries is increased in levothyroxine-treated Hashimoto disease.

    Science.gov (United States)

    Owecki, M; Sawicka-Gutaj, N; Owecki, M K; Ambrosius, W; Dorszewska, J; Oczkowska, A; Michalak, M; Fischbach, J; Kozubski, W; Ruchała, M

    2015-07-01

    The aim of this case-control study was to evaluate carotid hemodynamic variables and traditional cardiovascular risk factors in women with Hashimoto thyroiditis (HT). The study group consisted of 31 females with HT on levothyroxine (L-T4) and 26 euthyroid women with HT without L-T4 matched for age and body mass index (BMI) as controls. Carotid intima-media thickness (CIMT), carotid extra-media thickness (CEMT), and pulsatility indexes in common carotid artery (PI CCA) and in internal carotid artery (PI ICA) were measured. BMI, waist circumference, lipid profile, fasting glucose and insulin levels, and parameters of thyroid function [TSH, free thyroxine (FT4) and antithyroperoxidase antibodies (TPOAbs)] were assessed. The study and the control groups did not differ in age, BMI, waist circumference, lipid profile, fasting glucose, and insulin levels. Results are expressed as median (IQR). Treated HT group had higher FT4 levels than nontreated [17.13 (5.11) pmol/l vs. 14.7 (2.27) pmol/l; p=0.0011] and similar TSH [1.64 (2.08) IU/ml vs. 2.07 (3.14) IU/ml; p=0.5915]. PI CCA and PI ICA were higher in the study group than in controls (p=0.0224 and p=0.0477, respectively). The difference remained statistically significant for PI ICA and PI CCA after adjustment for other variables (coefficient=0.09487; standard error=0.04438; p=0.037 and coefficient=0.1786; standard error=0.0870; p=0.0449, respectively). CIMT and CEMT were similar in both groups (p=0.8746 and p=0.0712, respectively). Women with HT on L-T4 replacement therapy have increased PI in common and internal carotid arteries than nontreated euthyroid HT patients. Therefore, it seems that hypothyroidism, but not autoimmune thyroiditis per se, influences arterial stiffness. PMID:25671800

  10. Giant, thrombosed, sellar-suprasellar internal carotid artery aneurysm with persistent, primitive trigeminal artery causing hypopituitarism.

    Science.gov (United States)

    Tungaria, Arun; Kumar, Vijendra; Garg, Pallav; Jaiswal, Awadhesh K; Behari, Sanjay

    2011-05-01

    A rare case of a giant, thrombosed, sellar-suprasellar paraclinoid internal carotid artery (ICA) aneurysm with persistent primitive trigeminal artery (PPTA) causing hypopituitarism that manifested as hypogonadism, hypothyroidism, and hypocortisolism is reported. There were no visual/neurological deficits, diabetes insipidus, or episodes of subarachnoid hemorrhage. The alteration in the flow dynamics of the circle of Willis due to the presence of PPTA may have been responsible for both the genesis of the giant aneurysm as well as for the induction of thrombogenesis within its lumen. As the digital subtraction angiogram showed complete thrombosis within the aneurysm and hormonal replacement therapy was effective in ensuring complete normalization of symptoms, the patient was unwilling to undergo surgical clipping of the aneurysm and removal of the suprasellar clot in an attempt to restore pituitary functions. Hypopituitarism recurred when the patient stopped her hormonal supplementation therapy after 7 years, and she again became symptom-free on restarting the therapy. To the best of the authors' knowledge, this represents the first reported case in the literature of hypopituitarism consequent to a giant, thrombosed, sellar-suprasellar ICA aneurysm with an associated PPTA on the side of the aneurysm. PMID:21234615

  11. 3D-NMR angiography of atherosclerotic carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    Magnetic Resonance Angiography was performed as part of a routine brain examination, and to assess the potential of MRA as a noninvasive modality to display the peripheral carotid and the vertebral artery in the diagnosis of cerebrovascular disease. (author). 8 refs.; 3 figs

  12. Pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis

    International Nuclear Information System (INIS)

    A case of pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis resulting from trauma is presented. CT and angiographic manifestations of this pseudoaneurysm and the resulting hypoglossal nerve paralysis are discussed. Correlative CT and angiographic findings of this association have not previously been described in the literature. (orig.)

  13. Association between the surfactant protein D (SFTPD) gene and subclinical carotid artery atherosclerosis

    DEFF Research Database (Denmark)

    Sorensen, Grith L; Bladbjerg, Else Marie; Steffensen, Rudi; Tan, Qihua; Madsen, Jens; Drivsholm, Thomas; Holmskov, Uffe

    2016-01-01

    intima-media thickness (IMT) and protruding plaques in the right carotid artery. Associations between cardiovascular traits and the levels of pSP-D (n = 687) or two coding SFTPD SNPs rs3088308 and rs721917 (n = 396) were investigated using multiple linear regressions and logistic regressions. RESULTS...

  14. Relationship between resting heart rate and carotid artery structure in young hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    宋江宏

    2014-01-01

    Objective To investigate the relationship between resting heart rate(RHR)and carotid artery structure in young hypertensive patients.Methods A total of 663 primary hypertensive patients aged between 18 and 45(38.01±5.78)were chosen from the First Affiliated Hospital of Xinjing Medical University from January,2009 to January,2012.Patients under this study were

  15. Doses to Carotid Arteries After Modern Radiation Therapy for Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Maraldo, M.V.; Brodin, Nils Patrik; Aznar, Marianne Camille;

    2013-01-01

    Hodgkin lymphoma (HL) survivors are at an increased risk of stroke because of carotid artery irradiation. However, for early-stage HL involved node radiation therapy (INRT) reduces the volume of normal tissue exposed to high doses. Here, we evaluate 3-dimensional conformal radiation therapy (3D-C...

  16. Giant cervical internal carotid artery pseudoaneurysm in a child: endovascular treatment

    International Nuclear Information System (INIS)

    We report a child with a giant upper cervical internal carotid artery pseudoaneurysm presenting with dysphagia, respiratory distress and a sentinel mild epistaxis, then massive epistaxis. Rupture of the pseudoaneurysm during treatment occurred, as in one reported case. Prompt endovascular treatment yielded a good outcome. (orig.)

  17. In vivo transfer of lipoprotein(a) into human atherosclerotic carotid arterial intima

    DEFF Research Database (Denmark)

    Nielsen, Lars Bo; Grønholdt, Marie-Louise; Schroeder, T V; Stender, S; Nordestgaard, B G

    1997-01-01

    The aim of this study was to compare the atherogenic potential of lipoprotein(a) [Lp(a)] and LDL by measuring the intimal clearance of these two plasma lipoproteins in the atherosclerotic intima of the human carotid artery in vivo. Autologous 131I-Lp(a) and 125I-LDL were mixed and reinjected intr...

  18. Serum carotenoids reduce progression of early atherosclerosis in the carotid artery wall among Eastern Finnish men.

    Directory of Open Access Journals (Sweden)

    Jouni Karppi

    Full Text Available BACKGROUND: Several previous epidemiologic studies have shown that high blood levels of carotenoids may be protective against early atherosclerosis, but results have been inconsistent. We assessed the association between atherosclerotic progression, measured by intima-media thickness of the common carotid artery wall, and serum levels of carotenoids. METHODS: We studied the effect of carotenoids on progression of early atherosclerosis in a population-based study. The association between concentrations of serum carotenoids, and intima-media thickness of the common carotid artery wall was explored in 840 middle-aged men (aged 46-65 years from Eastern Finland. Ultrasonography of the common carotid arteries were performed at baseline and 7-year follow-up. Serum levels of carotenoids were analyzed at baseline. Changes in mean and maximum intima media thickness of carotid artery wall were related to baseline serum carotenoid levels in covariance analyses adjusted for covariates. RESULTS: In a covariance analysis with adjustment for age, ultrasound sonographer, maximum intima media thickness, examination year, body mass index, systolic blood pressure, smoking, physical activity, serum LDL cholesterol, family history of coronary heart disease, antihypertensive medication and serum high sensitivity C-reactive protein, 7-year change in maximum intima media thickness was inversely associated with lycopene (p = 0.005, α-carotene (p = 0.002 and β-carotene (p = 0.019, respectively. CONCLUSIONS: The present study shows that high serum concentrations of carotenoids may be protective against early atherosclerosis.

  19. Successful surgical repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery with prior reconstruction of the carotid artery

    International Nuclear Information System (INIS)

    We report the successful repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery (BCA) in a 70-year-old man. He had undergone a mediastinal tumor resection through a median sternotomy in 1995. Pathological examination revealed non-Hodgkin's lymphoma. Two years later, he underwent radiation therapy of 65 Gray for metastasis to the supraclavicular lymph nodes. On January 18, 2000, plastic surgeons planned to perform a pectoralis major musculocutaneous flap to repair a radiation skin ulcer. During the operation, the BCA was lacerated, possibly in an area of radiation tissue damage. We performed a prosthetic graft (10-mm Gelseal) replacement of the BCA. The right subclavian artery had to be ligated. Postoperative digital subtraction angiography (DSA) showed excellent reconstruction of the artery. Magnetic resonance angiography of the brain showed a deficit in the anterior communicating artery and stenosis of the posterior communicating artery, which indicated that the reconstruction procedure was reasonable. Seven months later, on August 18, 2000, the patient was transferred to our hospital because of swelling of the right neck and oozing from the previous cutaneous wound. CT scan and DSA demonstrated the presence of a pseudoaneurysm of the proximal anastomosis site, which required emergency surgery. Before this third sternotomy, a saphenous vein graft was interposed between both external carotid arteries. Removal of the prosthetic graft and resection of the pseudoaneurysm were performed under mild hypothermia and cardiopulmonary bypass with left common carotid arterial perfusion. Then, the wound was closed completely using a left pectoralis major musculocutaneous flap. The postoperative course was uneventful and DSA showed good patency of the graft and intracranial arteries. The patient was discharged without neurological complications. We conclude that prior reconstruction of the carotid artery is a safe and effective procedure for patients with

  20. Endothelial dysfunction, carotid artery plaque burden, and conventional exercise-induced myocardial ischemia as predictors of coronary artery disease prognosis

    Directory of Open Access Journals (Sweden)

    Ishihara Masayuki

    2008-12-01

    Full Text Available Abstract Background While both flow-mediated vasodilation (FMD in the brachial artery (BA, which measures endothelium-dependent vasodilatation, and intima-media thickness (IMT in the carotid artery are correlated with the prognosis of coronary artery disease (CAD, it is not clear which modality is a better predictor of CAD. Furthermore, it has not been fully determined whether either of these modalities is superior to conventional ST-segment depression on exercise stress electrocardiogram (ECG as a predictor. Thus, the goal of the present study was to compare the predictive value of FMD, IMT, and stress ECG for CAD prognosis. Methods and Results A total of 103 consecutive patients (62 ± 9 years old, 79 men with clinically suspected CAD had FMD and nitroglycerin-induced dilation (NTG-D in the BA, carotid artery IMT measurement using high-resolution ultrasound, and exercise treadmill testing. The 73 CAD patients and 30 normal coronary patients were followed for 50 ± 15 months. Fifteen patients had coronary events during this period (1 cardiac death, 2 non-fatal myocardial infarctions, 3 acute heart failures, and 9 unstable anginas. On Kaplan-Meier analysis, only FMD and stress ECG were significant predictors for cardiac events. Conclusion Brachial endothelial function as reflected by FMD and conventional exercise stress testing has comparable prognostic value, whereas carotid artery plaque burden appears to be less powerful for predicting future cardiac events.

  1. The subpetrous carotid wall hematoma. A sign of spontaneous dissection of the internal carotid artery on non-enhanced computed tomography. A retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Jensen-Kondering, U. [Univ. Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Radiology and Neuroradiology; Univ. Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Neurology; Huhndorf, M.; Madjidyar, J.; Jansen, O. [Univ. Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Radiology and Neuroradiology

    2015-03-15

    Spontaneous dissection of the internal carotid artery (CAD) is an increasingly recognized cause for stroke especially in young and middle-aged patients. We hypothesized that non-enhanced cranial computed tomography (NECCT) can visualize the subpetrous carotid wall hematoma and thus enable identification of patients with CAD. We retrospectively reviewed patients with confirmed CAD (n=21) and a control group with ischemic symptoms but without CAD (n=42) who received NECCT at admission. Two independent neuroradiologists rated the presence and shape of SPH, density and diameter of the subpetrous internal carotid artery. Additionally, we correlated the shape of the subpetrous carotid wall hematoma with the grade of stenosis on subsequent angiographic imaging. The subpetrous carotid wall hematoma was present in 14 of 21 patients (Cohen's k = 0.67). Mean diameter was 6.95 ± 1.05 mm in dissected vessels and 5.71 ± 1.52 mm in the contralateral vessel (p<0.05). Mean difference in vessel density was 15.05 ± 8.01 HU (p<0.01). Median grade of stenosis was significantly higher in patients with a full moon- shaped (n=11) than crescent-shaped (n=3) subpetrous carotid wall hematoma (21% vs. 80%, p<0.05). Two-thirds of patients with CAD were correctly identified on NECCT. The extracranial carotid artery should be evaluated in patients with symptoms of cerebral ischemia.

  2. Carotid artery occlusion and collateral circulation in C57Black/6J mice detected by synchrotron radiation microangiography

    International Nuclear Information System (INIS)

    Using monochromatic synchrotron radiation, we performed microangiography in C57BL/6J mice and investigated their vasculature after unilateral and bilateral carotid artery occlusion. Bilateral occlusion of the carotid artery was made by a ligation of the left common carotid artery followed by a ligation of the right internal carotid artery (ICA) two days later (n=12). Five days after the second surgery, angiography was performed. Unilateral occlusion was made by clipping the right ICA and then angiography was performed immediately (n=5). The control mice did not undergo any occlusion (n=5). We removed the brain of the bilateral occlusion mice after angiography and examined the infarction area. The cerebral microvessels in all animals were clearly visualized. In the control mice, the posterior communicating artery (Pcom) was not visualized. In the unilateral occlusion mice, the anastomosis of the pterygopalatine artery (PPA) and the external carotid artery (ECA) were recognized. The PPA is thus considered to play a role in the collateral vessel between the ICA and the ECA. The Pcom was not visualized. In the bilateral occlusion mice, the Pcom was observed either unilateraly (n=5) or bilateraly (n=5). The Pcom supplied blood flow to the anterior circulation from the vertebrobasilar arteries. The bilateral occlusion mice that had at least one visualized Pcom did not have any infarction. We could successfully visualize the cerebral vasculature of normal mice and carotid artery occluded mice in an in vivo study. Microangiography can demonstrate the development of vasculature and the blood flow dynamics in mice. (author)

  3. Differential Associations of Weight Dynamics With Coronary Artery Calcium Versus Common Carotid Artery Intima-Media Thickness: The CARDIA Study

    OpenAIRE

    Lee, Duk-Hee; Steffes, Michael W.; Gross, Myron; Park, Kyong; Holvoet, Paul; Kiefe, Catarina I.; Lewis, Cora E.; Jacobs, David R.

    2010-01-01

    Change and fluctuation in body mass index (BMI; weight (kg)/height (m)2) may be associated differently with coronary artery calcification (CAC) than with carotid artery intima-media thickness (IMT). The authors analyzed data on 2,243 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, initially aged 18–30 years, who were examined every 2–5 years over a 20-year period (1985–2006). BMI at year 0 was associated positively and linearly with CAC at year 20; however...

  4. Renal dynamic imaging for the treatment assessment of renal artery angioplasty and stenting in patients with atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To investigate the value of renal dynamic imaging with 99Tcm-DTPA on the evaluation and prediction of the outcome after percutaneous transluminal renal artery angioplasty and stenting (PTRAS) in patients with atherosclerotic renal artery stenosis (ARAS). Methods: Seventy-six patients with unilateral ARAS underwent PTRAS successfully. All the patients received baseline renal dynamic imaging within 2 weeks before the surgery and follow-up imaging 6 months after PTRAS. GFR (per 1.73 m2 of body surface area) of kidney with ARAS was measured with the Gates method. ARAS was classified as mild (50%-69%),moderate (70%-89%), and severe (≥90%) stenosis according to the results of renoarteriography before the surgery. GFR was graded as Ⅰ (GFR≥30 ml · min-1), Ⅱ (15 ml · min-1 ≤GFR <30 ml · min-1) and Ⅲ (GFR < 15 ml · min-1), on the baseline dynamic imaging.Blood pressure was also measured before and after the surgery. The t test, χ2 test, Fisher exact test and multiple logistic regression analysis were used for statistical analysis with SPSS 13.0. Results: The baseline GFR of kidney with mild and moderate ARAS was significant higher than that with severe stenosis ((26.79 ± 15.34) vs (19.48 ±11.56) ml · min-1, t=2.262, P=0.027). The blood pressure was improved in 32% (24/75), and not changed in 68% (51/75) of patients.Improvement of blood pressure was observed in 39.62% (21/53) of patients with a baseline GFR≥ 15 ml · min-1, and in 13.64% (3/22) of patients with a baseline GFR <15 ml · min-1 (χ2=4.825, P=0.028). Using multivariate analysis, baseline GFR ≥ 15 ml · min-1 was the only predictor of blood pressure improvement (OR=0.465, P=0.032). GFR in kidney with ARAS was improved in 22.37% (17/76), stable in 68.42% (52/76), and worse in 9.21% (7/76) of patients. The 33.33% (8/24) and 17.65% (9/51) of patients with and without blood pressure improvement, respectively, achieved GFR improvement. However, the difference was not statistically

  5. Changes of nitric oxide and endothelin serum level after carotid balloon denudation or stent assisted angioplasty: an experimental and clinical observation%颈动脉球囊扩张与支架置入术后血清一氧化氮和内皮素变化的实验与临床观察

    Institute of Scientific and Technical Information of China (English)

    刘加春; 王大明; 钱江南; 李雅国; 王利军; 姜学丽; 翟乐乐; 陆军; 祁鹏

    2009-01-01

    Objective To observe the changes of nitric oxide (NO) and endothelin (ET) serum level in the Guangxi BA-MA minipigs whose carotid arteries were injured by balloon denudation and in the patients with catotid stent assisted angioplasty. Methods Twelve Guangxi BA-MA minipigs were choosen. High fat/cholesterol feeding and endovascular balloon denudation were used to create a carotid artery atherosclerotic stenosis animal model. Blood samples were collected from peripheral veins before starting the procedure, and again, at 2 and 3 weeks after the procedure, respectively. Serum NO and ET concentrations of blood samples were tested. Nineteen patients with carotid artery stenosis who underwent stent assisted angioplasty were randomly selected, and their serum NO and ET were tested using the same methods as above. Results In the animal group, there was a significant decrease of mean NO concentration at 2 weeks after carotid injury (t-test, P<0.05 ), however, no significant change of ET was observed. A very significant increase of ET was observed at 3 weeks after the procedure (t-test, P <0.01 ). In the patient group, there were no significant differences among serum NO or ET concentration of peripheral vein blood before, immediately after, and 6 h after the endovascular treatment. Conclusions In this study, a decrease of NO concentration and an increase of ET concentration of peripheral vein blood are found in BA-MA minipigs after carotid arteries are injured by balloon denudation, which might be a cue for the formation of atherosclerosis. However, no significant changes are observed in this group of patients who underwet carotid angioplasty treatment. Therefore, further studies are needed.%目的:观察小型猪颈动脉球囊扩张前后和颈动脉狭窄患者狭窄扩张、支架置入术前后血清一氧化氮(NO)和内皮素(ET)的变化.方法:选取12头广西巴马小型猪,分别于颈动脉球囊损伤前、损伤后2周和3周检测静脉血血清中NO

  6. Carotid Artery Doppler Assessment In Patients Accussed Of Strokes

    OpenAIRE

    H. Mazaher; S. Sharif Kashani

    2005-01-01

    Carotid Doppler ultrasound assessment mostly indicated in patients accussed of TIAs or in younger patients with nonpersistant neurologic deficits. This assessment should be consisted of gray scale sonography, color Doppler Sonography, spectral Doppler sonography and power Doppler sonography. By gray scale sonography atherosclerotic plaques assessed from the point of Homogenousity, degree of echogenicity, surface regularity, calcification, length, Thichkness and sites of involvement. In color ...

  7. Treatment of carotid artery aneurysms with covered stents; Aneurysmabehandlung der Arteria carotis interna mit gecoverten Stents

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, A.; Alfke, K.; Doerner, L.; Jansen, O. [UKSH Kiel (Germany). Neurochirurgie Neuroradiologie; Bartsch, T.; Stingele, R. [UKSH Kiel (Germany). Neurologie

    2007-10-15

    Purpose: Evaluation of the use of covered stents in treating pseudoaneurysms of the cervical and intracranial/extradural carotid artery and determination of the periprocedural and short- to mid-term complication rate. Materials and Methods: 8 patients with 9 spontaneous dissecting aneurysms of the cervical carotid artery - 5 of which were symptomatic - plus one patient with ofthalmoplegia due to an aneurysm of the cavernous carotid artery were studied. While the latter was treated with a PTFE-covered balloon-mounted stainless steel stent (Jostent/Graftmaster), a self-expanding PTFE-covered Nitonol Stent (Symbiot) was used in all other cases. Intervention was performed with local anesthesia. Aspirin and Clopidogrel were both used as antiplatelet drugs. Clinical signs and symptoms and vascular imaging with DS, MR, CT angiography and ultrasound were recorded during patient follow-up, with a mean follow-up period of 14.6 months (4 - 30). Results: We were able to treat 8 out of 10 aneurysms (80 %) using covered stents. The aneurysms were immediately occluded and the associated stenoses of the parent vessel were eliminated. No clinically relevant complications occurred during the procedure or in the follow-up interval. In two cases, elongation of the carotid artery prevented the stent from being positioned over the aneurysm neck. These cases were shown to be stable with the use of antiplatelet drugs. Conclusion: Covered stents can be used in the treatment of pseudoaneurysms of the carotid artery as an alternative to long-term antithrombotic medication or surgery. In our study treatment was effective (80 %) and free of complications in the short- and mid-term follow-up. Possible indications, technique and the use of imaging modalities for patient follow-up are discussed. (orig.)

  8. Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty Experiência inicial com dispositivo de reversão de fluxo para proteção cerebral na angioplastia carotídea

    Directory of Open Access Journals (Sweden)

    Sidnei José Galego

    2013-03-01

    Full Text Available PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction and minor (hematoma adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with OBJETIVO: Relatar os achados iniciais da utilização do GORE Flow Reversal System® (Sistema de Fluxo de Reversão, com foco em eventos adversos maiores/menores nos primeiros 30 dias do pós-operatório. MÉTODOS: Os primeiros 24 pacientes submetidos a angioplastia carotídea com a utilização do sistema GORE, de junho de 2010 a maio de 2012, foram avaliados retrospectivamente com relação a indicações, detalhes anatômicos, dificuldades técnicas e desfechos clínicos imediatos, incluindo eventos adversos maiores (acidente vascular cerebral, morte, infarto agudo do miocárdio e menores (hematoma. RESULTADOS: Hipertensão sistêmica estava presente em 100% dos pacientes, diabete melito em 58,3% e doença coronariana em 37,5%. Arco aórtico tipo II foi encontrado em 62,5% dos pacientes e lesão de aterosclerose predominantemente na bifurcação carotídea que afeta as artérias carótidas internas e comuns em 79,2%. Dados angiográficos revelaram artérias carótidas contralaterais com estenose <50% em 95,8% de casos e preservação de fluxo sanguíneo cerebral em 95,8%. Todos os

  9. Flow Velocities After Carotid Artery Stenting: Impact of Stent Design. A Fluid Dynamics Study in a Carotid Artery Model with Laser Doppler Anemometry

    International Nuclear Information System (INIS)

    Purpose. To study the influence of a newly developed membrane stent design on flow patterns in a physiologic carotid artery model. Methods. Three different stents were positioned in silicone models of the carotid artery: a stainless steel stent (Wall-stent), a nitinol stent (SelfX), and a nitinol stent with a semipermeable membrane (MembraX). To increase the contact area of the membrane with the vessel wall, another MembranX model was modified at the outflow tract. The membrane consists of a biocompatible silicone-polyurethane copolymer (Elast-Eon) with a pore size of 100 μm. All stents were deployed across the bifurcation and the external carotid artery origin. Flow velocity measurements were performed with laser Doppler anemometry (LDA), using pulsatile flow conditions (Re = 220; flow 0.39 l/min; flow rate ratio ICA:ECA = 70:30) in hemodynamically relevant cross-sections. The hemodynamic changes were analyzed by comparing velocity fluctuations of corresponding flow profiles. Results. The flow rate ratio ICA:ECA shifted significantly from 70/30 to 73.9/26.1 in the MembraX and remained nearly unchanged in the SelfX and Wallstent. There were no changes in the flow patterns at the inflow proximal to the stents. In the stent no relevant changes were found in the SelfX. In the Wallstent the separation zone shifted from the orifice of the ICA to the distal end of the stent. Four millimeters distal to the SelfX and the Wallstent the flow profile returned to normal. In the MembraX an increase in the central slipstreams was found with creation of a flow separation distal to the stent. With a modification of the membrane this flow separation vanished. In the ECA flow disturbances were seen at the inner wall distal to the stent struts in the SelfX and the Wallstent. With the MembraX a calming of flow could be observed in the ECA with a slight loss of flow volume. Conclusions. Stent placement across the carotid artery bifurcation induces alterations of the physiologic flow

  10. The clinical application of 64-slice spiral CT angiography in carotid artery bifurcation disease

    International Nuclear Information System (INIS)

    Objective: To explore the clinical value of 64-slice spiral CT angiography (CTA) in carotid stenosis and atherosclerotic plaque. Methods: 40 patients (80 carotid arteries) underwent CTA and DSA. These two examinations within one week. The results of CTA were compared with that of DSA, the sensitivity and specificity of CTA and DSA were figured out. Results: CTA performed well in the detection of mild (0% to 29%) carotid stenosis, as well as carotid occlusion, with values for sensitivity and specificity both near 100%. In determining that a stenosis was >50% by DSA measurement, CTA with a sensitivity, specificity of 89% and 91% respectively. While CTA was quite specific in identifying degrees of stenoses in either the 50% to 69% or the 70% to 99% ranges, in this task it was much less sensitive: 65% and 73% respectively. CTA can detect all kinds of ulcers while DSA can not. Conclusions: 64-slice CTA and DSA were correctly identified in detecting carotid stenosis. CTA could demonstrate ulcers associated with the carotid stenosis, hut DSA only show stenosis. (authors)

  11. Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

    2009-01-01

    We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking. PMID:19875014

  12. Massive Hemorrhage from Internal Carotid Artery Pseudoaneurysm Successfully Treated by Transcatheter Arterial Embolization with Assessment of Regional Cerebral Oxygenation

    International Nuclear Information System (INIS)

    A 54-year-old male presented with intermittent massive hemorrhage from recurrent oropharyngeal cancer. The angiogram showed the encasements at the main trunk of the left internal carotid artery (ICA) and external carotid artery (ECA). Transcatheter arterial embolization (TAE) of the ECA with gelatin sponge particles and microcoils was performed. However, hemorrhage recurred several hours after the initial TAE. The second angiogram showed a large pseudoaneurysm of the ICA developing at the encasement on the initial angiogram. As a simple neurologic test, regional cerebral oxygenation (rSO2) was assessed with and without manual compression of the common carotid artery (CCA). With compression of the left CCA, the rSO2 did not change. We therefore performed isolation of the pseudoaneurysm. We embolized proximally and distally to the ICA pseudoaneurysm with microcoils and the pseudoaneurysm disappeared. No major complications occurred and no massive hemorrhage recurred until death from the cancer. TAE was an effective treatment for massive hemorrhage caused by tumor invasion to ICA. Assessment of rSO2 was a simple and useful neurologic test predicting the cerebral blood flow to prevent complications of TAE

  13. False aneurysms in carotid arteries of cattle and water buffalo during shechita and halal slaughter.

    Science.gov (United States)

    Gregory, Neville G; von Wenzlawowicz, Martin; Alam, Rashedul M; Anil, Haluk M; Yeşildere, Tahsin; Silva-Fletcher, Ayona

    2008-06-01

    It has previously been shown that the cattle brain is supplied with blood via a basi-occipital plexus, in addition to branches from the carotid and basilar arteries. In addition it has been shown during conventional stunning and slaughter that the carotid arteries in cattle can develop false aneurysms at their severed ends and this can curtail exsanguination. This investigation examined whether false aneurysms can occur during religious slaughter, and during bleeding following electrical stunning that simultaneously induced a cardiac arrest. The prevalence of large (>3cm outer diameter) false aneurysms in cattle carotid arteries was 10% for both shechita and halal slaughter. The prevalence of animals with bilateral false aneurysms (at least 2cm in one artery and at least 3cm diameter in the opposite artery) was 7% and 8% for shechita and halal slaughter, respectively. No false aneurysms occurred during bleeding in cattle that were electrically stunned and simultaneously developed a cardiac arrest. The combination of false aneurysms and collateral routes to the brain present a risk of sustained consciousness during religious slaughter in cattle. PMID:22062756

  14. Regional calcium distribution and ultrasound images of the vessel wall in human carotid arteries

    Science.gov (United States)

    Szikszai, Z.; Kertész, Zs.; Uzonyi, I.; Szíki, G. Á.; Magyar, M. T.; Molnár, S.; Ida, Y.; Csiba, L.

    2005-04-01

    Arterial calcification can take place at two sites in the vessel wall: the intima and the media. Intimal calcification occurs exclusively within atherosclerotic plaques, while medial calcification may develop independently. Extensive calcified plaques in the carotid arteries can be easily detected by B-mode ultrasonic imaging. The calcium content might correlate with the ultrasound reflectance of the vessel wall, and could be a surrogate marker for arteriosclerosis. In this study, segments of human carotid arteries collected at autopsy were examined by ultrasonography in vitro and calcium distributional maps of sections from the same segments were determined by particle induced X-ray emission. Our aim was to make a first step towards investigating the relationship between the calcium distributional maps and the respective ultrasound images.

  15. Carotid arterial blood pressure waveform monitoring using a portable ultrasound system.

    Science.gov (United States)

    Joohyun Seo; Pietrangelo, Sabino J; Hae-Seung Lee; Sodini, Charles G

    2015-08-01

    This work presents a non-invasive arterial blood pressure (ABP) waveform monitoring technique using ultrasound. A portable ultrasound system to excite ultrasound transducers and acquire data is designed with off-the-shelf components. The insonation angles are identified using a vector Doppler technique based on the cosine dependency of the Doppler signals. The pulse pressure of an estimated waveform at the left common carotid artery is compared to the standard sphygmomanometer measurement in a clinical test. The estimated carotid ABP waveform shows excellent agreement to the finger ABP waveform with expected discrepancy of the systolic peak shape due to different measurement sites. The proposed method also tracks slow blood pressure fluctuations. This validation on human subjects shows potential for a noninvasive blood pressure waveform monitoring device at central arterial sites. PMID:26737584

  16. External carotid artery embolization of dural arteriovenous malformations involving the cavernous sinus

    International Nuclear Information System (INIS)

    Nine patients with dural arteriovenous malformations (AVMs) in the region of the cavernous sinus were treated by means of external carotid artery (ECA) embolization using polyvinyl alcohol. All AVMs received vascular supply from both the ECA and the internal carotid artery. Seven cases were clinically cured after embolization, while 2 cases with cortical venous drainage and high flow through the shunt were not completely cured. Venous thrombosis was observed in 5 cases before and in 9 after embolization. In 6 cases the drainage pattern changed owing to venous thrombosis. Complete thrombosis of the cavernous sinus was found on a follow-up angiography in 2 cases. Formation of venous thrombosis and occlusion of feeding arteries are curcial factors for success of ECA embolization. Dural AVMs with cortical venous drainage and high flow cannot be relieved by ECA embolization alone owing to difficulty in obtaining thrombosis of the veins. (orig.)

  17. Repeatability of in vivo quantification of atherosclerotic carotid artery plaque components by supervised multispectral classification

    OpenAIRE

    Gao, Shan; van ’t Klooster, Ronald; van Wijk, Diederik F.; Nederveen, Aart J.; Lelieveldt, Boudewijn P.F.; van der Geest, Rob J.

    2015-01-01

    Objective To evaluate the agreement and scan–rescan repeatability of automated and manual plaque segmentation for the quantification of in vivo carotid artery plaque components from multi-contrast MRI. Materials and methods Twenty-three patients with 30–70 % stenosis underwent two 3T MR carotid vessel wall exams within a 1 month interval. T1w, T2w, PDw and TOF images were acquired around the region of maximum vessel narrowing. Manual delineation of the vessel wall and plaque components (lipid...

  18. Cerebral haemodynamic and metabolic changes in carotid artery occlusion: a PET study

    International Nuclear Information System (INIS)

    Using the positron emission tomography, with the O15 inhalation technique, the cerebral blood flow (CBF), the oxygen extraction fraction (OEF) and the cerebral metabolic rate of oxygen (CMRO2) were studied in 37 patients with internal carotid artery (ICA) occlusion. In the territory of the occluded ICA, two pattern of focal anomaly have been observed: a CBF decrease with a ''compensatory'' OEF increase or a matched CBF and CMRO2 decrease. On the other hand, as compared to age matched control values, CMRO2 is significantly decreased in the territory of the occluded carotid only in patients with extensive neck vessels obstructive disease

  19. Intima-Media Thickness Does Not Differ between Two Common Carotid Artery Segments in Children

    OpenAIRE

    Heidi Weberruß; Raphael Pirzer; Robert Dalla Pozza; Heinrich Netz; Renate Oberhoffer

    2016-01-01

    Carotid intima-media thickness (cIMT) is a surrogate marker of early atherosclerotic changes in children. cIMT-studies are hard to compare, due to variations in ultrasound protocols, especially regarding the common carotid artery (CCA) segment measured in relation to the bulb. This study's purpose was therefore to compare two distinct CCA segments in children, to see if cIMT values differ substantially according to the site of measurement. cIMT was assessed after power calculation in 30 child...

  20. The efficacy of carotid ultrasonography in estimating coronary artery stenosis in patients receiving hemodialysis

    International Nuclear Information System (INIS)

    In patients with dialysis therapy, cardiovascular diseases have a great impact on morbidity and mortality. Because physicians have recently been encountering more patients with diabetes mellitus as well as more elderly patients, the importance of evaluating atherosclerosis has continuously increased. It has been reported that ischemic heart diseases or cerebrovascular diseases can be estimated using non-invasive ultrasonography. In addition, we can also diagnose coronary stenosis using computed tomography more easily than before. In this study, we in vestigated the efficacy of carotid ultrasonography in estimating coronary artery stenosis in patients with hemodialysis. One hundred and eight patients (58 men and 50 women with a mean age of 69±12 years, and a mean dialysis duration of 6.7±6.2 years) were enrolled in this study. We measured the maximum intima-media thickness (max-IMT), the distribution and the properties of plaque and plaque scores at carotid arteries using ultrasonography, and examined the degree of stenosis and the number of stenotic coronary arteries using computed tomography. As the max-IMT or plaque scores increased, the degree of stenosis became significantly more severe and multi-vessel disease was observed with significantly greater frequency. End stage renal disease is one of most significant cardiovascular risk factors. However, it is difficult to diagnose ischemic heart disease correctly in these patients because they sometimes have few symptoms due to diabetes and often show atypical electrocardiograms due to ventricular hypertrophy or electrolyte disorders. In this study, we clearly showed the correlation between atherosclerosis in the carotid arteries and stenosis in the coronary arteries. It is suggested that carotid ultrasonography is useful to estimate coronary artery stenosis, and effective for evaluating the risk of ischemic heart diseases non-invasively in patients with hemodialysis. (author)

  1. Impact of baseline characteristics on outcomes of carotid artery stenting in acute ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Yu CS

    2016-03-01

    Full Text Available Cheng-Sheng Yu,1,* Chih-Ming Lin,2,3,* Chi-Kuang Liu,4 Henry Horng-Shing Lu1 1Institute of Statistics and Big Data Research Center, National Chiao Tung University, Hsinchu, 2Stroke Centre and Department of Neurology, Chunghua Christian Hospital, Chunghua, 3Graduate Institute of Biological Science and Technology, National Chiao Tung University, Hsinchu, 4Department of Medical Imaging, Chunghua Christian Hospital, Chunghua, Taiwan, Republic of China *These authors contributed equally to this work Abstract: Carotid artery stenting is an effective treatment for ischemic stroke patients with moderate-to-severe carotid artery stenosis. However, the midterm outcome for patients undergoing this procedure varies considerably with baseline characteristics. To determine the impact of baseline characteristics on outcomes following carotid artery stenting, data from 107 eligible patients with a first episode of ischemic stroke were collected by retrospective chart review. A modified Rankin Scale (mRS was used to divide patients into two baseline groups, mRS ≤2 and mRS >2. A three-step decision-tree statistical analysis was conducted. After weighting the decision-tree parameters, the following impact hierarchy was obtained: admission low-density lipoprotein, gouty arthritis, chronic kidney disease, ipsilateral common carotid artery resistance index, contralateral ophthalmic artery resistance index, sex, and dyslipidemia. The finite-state machine model demonstrated that, in patients with baseline mRS ≤2, 46% had an improved mRS score at follow-up, whereas 54% had a stable mRS score. In patients with baseline mRS >2, a stable mRS score was observed in 75%, improved score in 23%, and a poorer score in 2%. Admission low-density lipoprotein was the strongest predictive factor influencing poststenting outcome. In addition, our study provides further evidence that carotid artery stenting can be of benefit in first-time ischemic stroke patients with baseline m

  2. Transcatheter Closure of a Chronic Iatrogenic Arteriovenous Fistula Between the Carotid Artery and the Brachiocephalic Vein with an Amplatzer Duct Occluder in Combination with a Carotid Stent

    International Nuclear Information System (INIS)

    We report an original method of transcatheter closure of an arteriovenous fistula using the combination of an Amplatzer PDA occluder and a carotid stent. The fistula was between the left carotid artery and the brachiocephalic vein. The patient had significant left-to-right shunt and was highly symptomatic. Due to the large orifice and pseudoaneurysmatic enlargement of the fistula, we had to use a large Amplatzer PDA occluder and the protruding part of the PDA device disk had to be covered with a carotid stent. The fistula was completely closed. The patient stopped having symptoms and, 2 years after the procedure, the effect persists.

  3. Complications of ENT infections: pseudoaneurysm of the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Brochu, Bernard [Department of Radiology, Laval University, Quebec (Canada); Dubois, Josee; Garel, Laurent [Department of Medical Imaging, Sainte-Justine Hospital, 3175, Cote Ste-Catherine, H3T 1C5, Montreal, Quebec (Canada); Quintal, Marie-Claude [Department of Otorhinolaryngology, Sainte-Justine Hospital, Montreal, Quebec (Canada); Roy, Daniel [Department of Radiology, CHUM, Montreal, Quebec (Canada)

    2004-05-01

    Ear, nose and throat infections are common, especially in children and young adults. Since the advent of antibiotics, complications from tonsillitis and pharyngeal abscess are rare, but potentially lethal. Vascular complications can be imaged with Doppler ultrasound and CT scan. The treatment of infectious vascular complications represents a significant challenge. We describe the case of a young girl presenting with a pseudoaneurysm of the internal carotid and thrombosis of the internal jugular vein. Endovascular therapy was utilized to treat the patient. (orig.)

  4. MRI and ultrasonography of atherosclerosis of the thoracic aorta and carotid arteries in elderly hypercholesterolemic patients

    International Nuclear Information System (INIS)

    In 53 elderly participants aged more than 60 the thoracic aorta and bilateral carotid arteries were observed with noninvasive techniques, MRI and ultrasonography, in order to elucidate the relationship between hypercholesterolemia and atherosclerosis in the elderly. Hypercholesterolemic subjects were classified as group H (serum total cholesterol (TC)>220 mg/dl), group H-I (220 mg/dl< TC<250 mg/dl) and group H-II (TC≥250 mg/dl). Atherosclerotic changes of the thoracic aorta were observed in 46% of group H, 27% of group H-I, 60% of group H-II and 37% of normolipidemic subjects (group NL). Carotid atherosclerotic changes were observed in 19% of group H, 9% of group H-I, 27% of group H-II and 18% of group NL. In group H-I, the percentages of atherosclerotic changes in both thoracic aorta and carotid arteries were lower than those in group NL. However, atherosclerotic changes of thoracic aorta and carotid arteries were detected in 43% and 29% of the subjects showing higher apo B/Apo A1 ratio than 1.0 among group H-I+NL (TC<250 mg/dl). These changes occurred in 32% and 13% of the subjects showing lower apo B/Apo A1 ratio than 1.0 among the same groups. Namely, atherosclerotic changes of the thoracic aorta and carotid arteries were observed more frequently in the subjects showing a higher apo B/Apo A1 ratio than 1.0 even if their serum cholesterol values were not higher than 250 mg/dl. We should use not only the serum cholesterol value but also the apo B/Apo A1 ratio as an indicator to evaluate the roles of lipids in the development of atherosclerosis. (author)

  5. Prospective study of screening for blunt intracranial carotid arterial injuries following basilar skull fractures

    International Nuclear Information System (INIS)

    Blunt intracranial carotid arterial injuries (BCIs) are considered rare, but have the potential for a devastating outcome. Early diagnosis of intracranial vascular injuries is extremely difficult, owing to the preferential use of computed tomographic (CT) scanning on its own as a method for the evaluation of head trauma cases. Patients are commonly referred for angiographies only when their clinical conditions become obvious. To diagnose BCIs at an early stage, we performed cerebral angiographies aggressively when initial head CT scanning revealed basilar skull fractures in the proximity to the carotid artery. From November 2000 to September 2002, 202 patients with blunt head trauma were admitted to the Nakakawachi Medical Center of Acute Medicine, a certified Level I trauma center. We investigated a total of 16 blunt head trauma patients with basilar skull fractures to determine the existence of BCIs. A total of 16 patients were angiographically examined, with 7 patients (44%) being identified as having BCIs. Five patients had unilateral BCIs, while 2 patients were found to have bilateral BCIs. We observed various types of BCIs, including 3 stenotic lesions of stenosis due to dissection, 3 cases of carotid-cavernous fistulas, 3 aneurysmal dilatation lesions and one case of occlusion, which were found at initial angiography. Two patients underwent endovascular surgery. One patient underwent craniotomy (wrapping). Both endovascular surgery and craniotomy (trapping with anastomosis) were performed on one patient. The other 3 patients managed conservatively. After the performance of initial angiographies, neurologically deteriorated patients were not observed. BCI is rare, but lethal, particularly when the diagnosis is delayed, thus aggressive screening is necessary to prevent deterioration. Basilar skull fractures near the carotid artery are the most important risk factor for BCI. When initial head CT scanning reveals basilar skull fracture near the carotid artery in

  6. Carotid Artery Stenting: Retrospective Evaluation of Experience of an Invasive Tertiary Center

    Directory of Open Access Journals (Sweden)

    Faruk Ertaş

    2016-03-01

    Full Text Available Objective: Carotid artery stenting (CAS is being applied more frequently as an alternative mode of treatment to carotid endarterectomy. We aimed to present the short-term clinical outcomes of the patients admitted to our clinic with a diagnosis of carotid artery disease and revas­cularized by CAS. Methods: The study was retrospective and a single-centered study. Between June 2013-January 2016 the patients with an indication for carotid artery intervention and accepted CAS procedure were included in the study. Clinical characteristics and procedural data of the patients were obtained by scanning patient files. After discharge, hospital records were scanned and patients were called to learn whether or not patients were alive and that they have suffered a recent stroke. Results: We included 82 patients that meet the inclusion criteria in the study. 59% of patients were male with a mean age of 68±9 years. 56% of patients were symp­tomatic. In all patients, stents were used. 85% of patients distal embolic protection devices and 15% MOMA were used. 64 right, 18 left, and two bilateral carotid arteries were stented with a total of 82 patient of 84 successful CAS. Due to residual stenosis a second stent was im­planted only in one patient. One patient experienced a partial muscle weakening in upper extremity due to an air embolism and 2 patients received opac material which recovered spontaneously in 24 hours. Conclusion: CAS is being successfully applied with a very low risk of complications in experienced centers. Short-term clinical results of CAS are quite satisfactory.

  7. The role of completion imaging following carotid artery endarterectomy.

    Science.gov (United States)

    Ricco, Jean-Baptiste; Schneider, Fabrice; Illuminati, Giulio; Samson, Russell H

    2013-05-01

    A variety of completion imaging methods can be used during carotid endarterectomy to recognize technical errors or intrinsic abnormalities such as mural thrombus or platelet aggregation, but none of these methods has achieved wide acceptance, and their ability to improve the outcome of the operation remains a matter of controversy. It is unclear if completion imaging is routinely necessary and which abnormalities require re-exploration. Proponents of routine completion imaging argue that identification of these abnormalities will allow their immediate correction and avoid a perioperative stroke. However, much of the evidence in favor of this argument is incidental, and many experienced vascular surgeons who perform carotid endarterectomy do not use any completion imaging technique and report equally good outcomes using a careful surgical protocol. Furthermore, certain postoperative strokes, including intracerebral hemorrhage and hyperperfusion syndrome, are unrelated to the surgical technique and cannot be prevented by completion imaging. This controversial subject is now open to discussion, and our debaters have been given the task to clarify the evidence to justify their preferred option for completion imaging during carotid endarterectomy. PMID:23601598

  8. Mycotic aneurysm of the extracranial internal carotid artery - report of a case and review of the literature

    International Nuclear Information System (INIS)

    The authors report a case of mycotic aneurysm of the extracranial internal carotid artery in a 4-year-old- male child, resulting from tonsillar infection. The authors relate the difficulties to initially suggest the diagnosis, stress the importance of the differential diagnosis particularly in children and describe the findings on conventional films, US colour-Doppler, CT and carotid digital subtraction angiography. (author)

  9. The application of subintimal recanalization in percutaneous transluminal angioplasty for chronic long-segment occlusion of femoropopliteal artery

    International Nuclear Information System (INIS)

    Objective: To discuss the technical points and clinical efficacy of subintimal recanalization technique in treating chronic long-segment total occlusion of femoropoliteal artery. Methods: Forty-two patients with chronic long-segment total occlusion of femoropoliteal artery underwent subintimal recanalization treatment. The basic procedure of subintimal recanalization was as follows. First, a subintimal path in the wall of the occluded artery was created by inserting a super-slip guide wire and the guide wire was then pushed into the true lumen of the outflow tract, which was followed by balloon angioplasty and stent placement to insure the patency of the re-canalized path. The technical points were discussed and the clinical results were evaluated. Results: The subintimal recanalization of occluded arterial segment was successfully achieved in 39 patients. The clinical symptoms were promptly and remarkably relieved after the procedure. The technical success rate was 92.9% (39/42). Technical failure occurred in three patients because the guide wire could not be managed into the true lumen of the outflow tract. Conclusion: The subintimal recanalization is an effective and safe technique for the treatment of chronic long-segment total occlusion of femoropoliteal artery. (authors)

  10. The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions

  11. Estimation of Carotid Artery Pulse Wave Velocity by Doppler Ultrasonography

    OpenAIRE

    Mehdi Maerefat; Manijhe Mokhtari Dizaji; Saeed Rahgozar

    2009-01-01

    Background: Pulse wave velocity (PWV) is widely used for estimating the stiffness of an artery. Various invasive and non-invasive methods have been developed to determine PWV over the years. In the present research, the non-invasive estimation of the PWV of large arteries was used as an index for arterial stiffness. Methods: A dynamic model based on the Navier-Stokes equations coupled to elasticity equations was introduced for the PWV in arteries with elastic walls. This system of equations w...

  12. Wiktor stent implantation in patients with restenosis following balloon angioplasty of a native coronary artery

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); M.E. Bertrand (Michel); V. Wiegand; G. Kober; J.F. Marquis; B. Valeix; R. Uebis; J. Piessen; P.P.T. de Jaegere (Peter)

    1992-01-01

    textabstractIntracoronary stenting has been introduced as an adjunct to balloon angioplasty aimed at overcoming its limitations, namely acute vessel closure and late restenosis. This study reports the first experience with the Wiktor stent implanted in the first 50 consecutive patients. All patients

  13. Percutaneous transluminal angioplasty of iliac and femoral arteries in severe lower-limb ischaemia

    DEFF Research Database (Denmark)

    Jørgensen, B; Henriksen, L O; Karle, A;

    1988-01-01

    Percutaneous transluminal angioplasty was performed 92 times in 86 patients with severe lower-limb ischaemia (40% occlusion), giving rise to rest pain and/or gangrene. The patients were thereafter observed for periods up to 5 years. Criteria for success were appearance of normal groin pulse (iliac...

  14. A rare variant of persistent trigeminal artery: cavernous carotid-cerebellar artery anastomosis--a case report and a systematic review.

    Science.gov (United States)

    Raphaeli, Guy; Bandeira, Alexandra; Mine, Benjamin; Brisbois, Denis; Lubicz, Boris

    2009-12-01

    We report a very rare anomalous anatomic variant of the cavernous internal carotid artery supplying directly the posterior inferior cerebellar artery, with no basilar artery opacification. A systematic review as well as a description of other variants of trigeminal-cerebellar anastomosis is given. PMID:19517204

  15. Cerebral blood flow volume measurements of the carotid artery and ipsilateral branches using two-dimensional phase-contrast magnetic resonance angiography

    Institute of Scientific and Technical Information of China (English)

    Gang Guo; Yonggui Yang; Weiqun Yang

    2011-01-01

    The optimal velocity encoding of phase-contrast magnetic resonance angiography (PC MRA) in measuring cerebral blood flow volume (BFV) ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional (2D) PC MRA, the present study localized the region of interest at blood vessels of the neck using PC MRA based on three-dimensional time-of-flight sequences, and the velocity encodingwas set to 80 cm/s. Results of the measurements showed that the error rate was 7.0 ± 6.0%in the estimation of BFV in the internal carotid artery, the external carotid artery and the ipsilateralcommon carotid artery. There was no significant difference, and a significant correlation in BFV between internal carotid artery + external carotid artery and ipsilateral common carotid artery. Inaddition, the BFV of the common carotid artery was correlated with that of the ipsilateral internal carotid artery. The main error was attributed to the external carotid artery and its branches. Therefore,after selecting the appropriate scanning parameters and protocols, 2D PC MRA is more accuratein the determination of BFV in the carotid arteries.

  16. Prevalence of carotid artery calcifications detected on panoramic radiographs and confirmed by Doppler ultrasonography: Their relationship with systemic conditions

    Directory of Open Access Journals (Sweden)

    Thalita Queiroz Abreu

    2015-01-01

    Conclusions: CACs can be detected in PRJs, and are more frequent in common carotid arteries. No significant associations were detected between the presence of unilateral or bilateral CAC in PRJ and hypertension, diabetes, or obesity.

  17. Automatic segmentation of the internal carotid arteries through the skull base

    Science.gov (United States)

    Manniesing, Rashindra; Niessen, Wiro J.

    2007-03-01

    An automatic method is presented to segment the internal carotid arteries through the difficult part of the skull base in CT angiography. The method uses the entropy per slice to select a cross sectional plane below the skull base. In this plane 2D circular structures are detected by the Hough transform. The center points are used to initialize a level set which evolves with a prior shape constraint on its topology. In contrast with some related vessel segmentation methods, our approach does not require the acquisition of an additional CT scan for bone masking. Experiments on twenty internal carotids in ten patients show that 19 seed points are correctly identified (95%) and 18 carotids (90%) are successfully segmented without any human interaction.

  18. Emergency placement of stent-graft for symptomatic acute carotid artery occlusion after endarterectomy.

    Science.gov (United States)

    Ko, Jun Kyeung; Choi, Chang Hwa; Lee, Sang Weon; Lee, Tae Hong

    2016-03-01

    A patient underwent a left-sided carotid endarterectomy (CEA) for an asymptomatic 80% carotid artery (CA) stenosis. There were no signs of intolerance during the carotid cross-clamping and an initially uneventful awakening was observed. However, in the third postoperative hour he experienced left amaurosis and dysarthria. An urgent MRI showed an occluded internal CA on the operated site without evidence of acute infarction. To recanalize the occluded internal CA and minimize leakage from the arteriotomy site, a self-expandable stent-graft was placed, covering the dissection and the distal atherosclerotic lesions. Complete recanalization of the left internal CA was achieved and the patient showed a dramatic improvement of his preoperative deficits. To our knowledge, this is the first case of stent-graft implantation for a symptomatic acute CA occlusion following CEA. Stent-graft placement should be considered as an alternative method of treatment for acute CA occlusion or dissection following CEA. PMID:25653229

  19. Subintimal angioplasty for below-the-ankle arterial occlusion in diabetic patients with chronic critical limb ischemia

    International Nuclear Information System (INIS)

    Objective: To assess the feasibility and efficacy of subintimal angioplasty (SA) for the treatment of below-the-arterial occlusion in diabetic patients with chronic critical limb ischemia (CLI). Methods: SA was adopted for 57 diseased lower limbs in 37 diabetic patients with chronic CLI and occlusive disease of the dorsalis pedis artery (DPA) and/or planter artery (PA), who were not suitable candidates for intraluminal angioplasty or bypass surgery. Of the total 57 diseased lower limbs, tissue loss was seen in 31 (54.4%) and pain was reported in 51 (89.5%). SA was carried out to create continuous arterial flow to the foot for limb salvage. Both before and after the procedure the clinical symptoms, DPA or PA pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the healing of the wound, the salvage of the diseased limb and the re-stenosis occurrence of the target vessels were evaluated. Kaplan-Meier curves were constructed to evaluate limb salvage, survival rate and freedom from amputation. Results: A total of 66 below-the-ankle arterial lesions were detected in 57 affected limbs. Of the 66 lesions, SA was successfully performed in 55 (83.3%). Before SA the median pulse volume scores and ABIs were 0.33±0.54 and 0.31±0.19 respectively, which became 2.04±1.05 and 0.80±0.14 respectively after SA, the differences in both median pulse volume scores and ABI were statistically significant (P<0.01 for both). One patient (2.7%) died within 30 days after the procedure. Mild complications, such as bleeding, thrombosis or angiospasm etc. occurred in five patents (13.5%). Twelve months after SA. Kaplan-Meier analysis showed that the limb salvage rate was 94.6%, the freedom from amputation was 89.2% and the survival rate was 97.3%. Conclusion: SA of the dorsalis pedis artery and/or planter artery is an effective technique for lower limb salvage in diabetic

  20. Diagnosis of atherosclerosis in human carotid artery by FT-Raman spectroscopy: Principal Components Analysis algorithm

    Science.gov (United States)

    Nogueira, Grazielle V.; Silveira, Landulfo, Jr.; Martin, Airton A.; Zangaro, Renato A.; Pacheco, Marcos T.; Chavantes, Maria C.; Zampieri, Marcelo; Pasqualucci, Carlos A. G.

    2004-07-01

    FT- Raman Spectroscopy (FT-Raman) could allow identification and evaluation of human atherosclerotic lesions. A Raman spectrum can provide biochemical information of arteries which can help identifying the disease status and evolution. In this study, it is shown the results of FT-Raman for identification of human carotid arteries in vitro. Fragments of human carotid arteries were analyzed using a FT-Raman spectrometer with a Nd:YAG laser at 1064nm operating at an excitation power of 300mW. Spectra were obtained with 250 scans and spectral resolution of 4 cm-1. Each collection time was approximately 8 min. A total of 75 carotid fragments were spectroscopically scanned and FT-Raman results were compared with histopathology. Principal Components Analysis (PCA) was used to model an algorithm for tissue classification into three categories: normal, atherosclerotic plaque without calcification and atherosclerotic plaque with calcification. Non-atherosclerotic (normal) artery, atherosclerotic plaque and calcified plaque exhibit different spectral signatures related to biochemicals presented in each tissue type, such as, bands of collagen and elastin (proteins), cholesterol and its esters and calcium hydroxyapatite and carbonate apatite respectively. Results show that there is 96% match between classifications based on PCA algorithm and histopathology. The diagnostic applied over all 75 samples had sensitivity and specificity of about 89% and 100%, respectively, for atherosclerotic plaque and 100% and 98% for calcified plaque.

  1. Acute ischaemic stroke secondary to a mobile thrombus in the common carotid artery - case report

    Directory of Open Access Journals (Sweden)

    Bajkó Zoltán

    2015-04-01

    Full Text Available A mobile thrombus in the carotid arteries is a very rare ultrasonographic finding and is usually diagnosed after a neurological emergency, such as a transient ischemic attack or cerebral infarction. We present the case of a 54-year-old man with vascular risk factors (a heavy smoker, untreated hypertension who was admitted to the emergency unit with right sided hemiparesis and aphasia. A cerebral CT scan showed a left middle cerebral artery territory infarction. The duplex ultrasound examination revealed mild atherosclerotic changes in the right common and internal carotid arteries, right-sided complete subclavian steal phenomenon and a complicated hypoechoic atherosclerotic plaque in the left common carotid artery with a large mobile thrombus. Due to the high embolization risk, the patient was hospitalised and prescribed Aspirin together with low molecular weight Heparin. We recorded an improvement in the patient’s neurological status and the control duplex scan revealed disappearance of the thrombus. The presence of floating thrombus in a patient with clinical and imagistic evidence of stroke is a major therapheutic challenge for the neurologist. The treatment strategies are not standardized and must be individualized, however in our case parenteral anticoagulation proved to be successful.

  2. Intramural location and size of arterial calcification are associated with stenosis at carotid bifurcation

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Shigeki, E-mail: shigekiyamada3@gmail.com [Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Otowachinji-cho 2, Yamashina-ku, Kyoto 607-8602 (Japan); Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan); Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 (Japan); Oshima, Marie, E-mail: marie@iis.u-tokyo.ac.jp [Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 (Japan); Watanabe, Yoshihiko, E-mail: ynabe@magic.odn.ne.jp [Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan); Ogata, Hideki, E-mail: hidogata@gmail.com [Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan); Hashimoto, Kenji, E-mail: hashiken8022@yahoo.co.jp [Department of Neurosurgery, Kishiwada Municipal Hospital, 1001 Gakuhara-cho, Kishiwada city, Osaka 596-8501 (Japan); Miyake, Hidenori, E-mail: hi-miyake@hamamatsuh.rofuku.go.jp [Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka 430-8525 (Japan)

    2014-06-15

    Purpose: The purpose of this study was to investigate the association between internal carotid artery (ICA) stenosis and intramural location and size of calcification at the ICA origins and the origins of the cervical arteries proximal to the ICA. Method: A total of 1139 ICAs were evaluated stenosis and calcification on the multi-detector row CT angiography. The intramural location was categorized into none, outside and inside location. The calcification size was evaluated on the 4-point grading scale. The multivariate analyses were adjusted for age, serum creatinine level, hypertension, hyperlipidemia, diabetes mellitus, smoking and alcohol habits. Results: Outside calcification at the ICA origins showed the highest multivariate odds ratio (OR) for the presence of ICA stenosis (30.0) and severe calcification (a semicircle or more of calcification at the arterial cross-sectional surfaces) did the second (14.3). In the subgroups of >70% ICA stenosis, the multivariate OR of outside location increased to 44.8 and that of severe calcification also increased to 32.7. Four of 5 calcified carotid plaque specimens extracted by carotid endarterectomy were histologically confirmed to be calcified burdens located outside the internal elastic lamia which were defined as arterial medial calcification. Conclusions: ICA stenosis was strongly associated with severe calcification located mainly outside the carotid plaque. Outside calcification at the ICA origins should be evaluated separately from inside calcification, as a marker for the ICA stenosis. Additionally, we found that calcification at the origins of the cervical arteries proximal to the ICA was significantly associated with the ICA stenosis.

  3. Intramural location and size of arterial calcification are associated with stenosis at carotid bifurcation

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to investigate the association between internal carotid artery (ICA) stenosis and intramural location and size of calcification at the ICA origins and the origins of the cervical arteries proximal to the ICA. Method: A total of 1139 ICAs were evaluated stenosis and calcification on the multi-detector row CT angiography. The intramural location was categorized into none, outside and inside location. The calcification size was evaluated on the 4-point grading scale. The multivariate analyses were adjusted for age, serum creatinine level, hypertension, hyperlipidemia, diabetes mellitus, smoking and alcohol habits. Results: Outside calcification at the ICA origins showed the highest multivariate odds ratio (OR) for the presence of ICA stenosis (30.0) and severe calcification (a semicircle or more of calcification at the arterial cross-sectional surfaces) did the second (14.3). In the subgroups of >70% ICA stenosis, the multivariate OR of outside location increased to 44.8 and that of severe calcification also increased to 32.7. Four of 5 calcified carotid plaque specimens extracted by carotid endarterectomy were histologically confirmed to be calcified burdens located outside the internal elastic lamia which were defined as arterial medial calcification. Conclusions: ICA stenosis was strongly associated with severe calcification located mainly outside the carotid plaque. Outside calcification at the ICA origins should be evaluated separately from inside calcification, as a marker for the ICA stenosis. Additionally, we found that calcification at the origins of the cervical arteries proximal to the ICA was significantly associated with the ICA stenosis

  4. Segmentation of the common carotid artery with active shape models from 3D ultrasound images

    Science.gov (United States)

    Yang, Xin; Jin, Jiaoying; He, Wanji; Yuchi, Ming; Ding, Mingyue

    2012-03-01

    Carotid atherosclerosis is a major cause of stroke, a leading cause of death and disability. In this paper, we develop and evaluate a new segmentation method for outlining both lumen and adventitia (inner and outer walls) of common carotid artery (CCA) from three-dimensional ultrasound (3D US) images for carotid atherosclerosis diagnosis and evaluation. The data set consists of sixty-eight, 17× 2× 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80mg atorvastain and nine with placebo), who had carotid stenosis of 60% or more, at baseline and after three months of treatment. We investigate the use of Active Shape Models (ASMs) to segment CCA inner and outer walls after statin therapy. The proposed method was evaluated with respect to expert manually outlined boundaries as a surrogate for ground truth. For the lumen and adventitia segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC) of 93.6%+/- 2.6%, 91.8%+/- 3.5%, mean absolute distances (MAD) of 0.28+/- 0.17mm and 0.34 +/- 0.19mm, maximum absolute distances (MAXD) of 0.87 +/- 0.37mm and 0.74 +/- 0.49mm. The proposed algorithm took 4.4 +/- 0.6min to segment a single 3D US images, compared to 11.7+/-1.2min for manual segmentation. Therefore, the method would promote the translation of carotid 3D US to clinical care for the fast, safety and economical monitoring of the atherosclerotic disease progression and regression during therapy.

  5. Segmentation of common carotid artery with active appearance models from ultrasound images

    Science.gov (United States)

    Yang, Xin; He, Wanji; Fenster, Aaron; Yuchi, Ming; Ding, Mingyue

    2013-02-01

    Carotid atherosclerosis is a major cause of stroke, a leading cause of death and disability. In this paper, a new segmentation method is proposed and evaluated for outlining the common carotid artery (CCA) from transverse view images, which were sliced from three-dimensional ultrasound (3D US) of 1mm inter-slice distance (ISD), to support the monitoring and assessment of carotid atherosclerosis. The data set consists of forty-eight 3D US images acquired from both left and right carotid arteries of twelve patients in two time points who had carotid stenosis of 60% or more at the baseline. The 3D US data were collected at baseline and three-month follow-up, where seven treated with 80mg atorvastatin and five with placebo. The baseline manual boundaries were used for Active Appearance Models (AAM) training; while the treatment data for segmentation testing and evaluation. The segmentation results were compared with experts manually outlined boundaries, as a surrogate for ground truth, for further evaluation. For the adventitia and lumen segmentations, the algorithm yielded Dice Coefficients (DC) of 92.06%+/-2.73% and 89.67%+/-3.66%, mean absolute distances (MAD) of 0.28+/-0.18 mm and 0.22+/-0.16 mm, maximum absolute distances (MAXD) of 0.71+/-0.28 mm and 0.59+/-0.21 mm, respectively. The segmentation results were also evaluated via Pratt's figure of merit (FOM) with the value of 0.61+/-0.06 and 0.66+/-0.05, which provides a quantitative measure for judging the similarity. Experimental results indicate that the proposed method can promote the carotid 3D US usage for a fast, safe and economical monitoring of the atherosclerotic disease progression and regression during therapy.

  6. 18F-FDG accumulation in atherosclerosis: use of CT and MR co-registration of thoracic and carotid arteries

    International Nuclear Information System (INIS)

    The purpose of this study was to depict18F-fluoro-2-deoxy-D-glucose (FDG) accumulation in atherosclerotic lesions of the thoracic and carotid arteries on CT and MR images by means of automatic co-registration software. Fifteen hospitalised men suffering cerebral infarction or severe carotid stenosis requiring surgical treatment participated in this study. Automatic co-registration of neck MR images and FDG-PET images and of contrast-enhanced CT images and FDG-PET images was achieved with co-registration software. We calculated the count ratio, which was standardised to the blood pool count of the superior vena cava, for three arteries that branch from the aorta, i.e. the brachial artery, the left common carotid artery and the subclavian artery (n=15), for atherosclerotic plaques in the thoracic aorta (n=10) and for internal carotid arteries with and without plaque (n=13). FDG accumulated to a significantly higher level in the brachial artery, left common carotid artery and left subclavian artery at their sites of origin than in the superior vena cava (p=0.000, p=0.000 and p=0.002, respectively). Chest CT showed no atherosclerotic plaque at these sites. Furthermore, the average count ratio of thoracic aortic atherosclerotic plaques was not higher than that of the superior vena cava. The maximum count ratio of carotid atherosclerotic plaques was significantly higher than that of the superior vena cava but was not significantly different from that of the carotid artery without plaque. The results of our study suggest that not all atherosclerotic plaques show high FDG accumulation. FDG-PET studies of plaques with the use of fused images can potentially provide detailed information about atherosclerosis. (orig.)

  7. Doppler Sonography Confirmation in Patients Showing Calcified Carotid Artery Atheroma in Panoramic Radiography and Evaluation of Related Risk Factors

    OpenAIRE

    2012-01-01

    Background and aims The purpose of this study was to identify patients at the risk of cerebrovascular attack (CVA) by detecting calcified carotid artery atheroma (CCAA) in panoramic radiography and evaluating their risk factors. Materials and methods A total of 960 panoramic radiographs of patients above 40 years old were evaluated. Doppler Sonography (DS) was performed for patients who showed calcified carotid artery atheroma (CCAA) in panoramic radiogra-phy in order to determine the presenc...

  8. Angioplasty of a persistent sciatic artery: case report Angioplastia de artéria isquiática persistente: relato de caso

    OpenAIRE

    Denis Szejnfeld; Sergio Quilici Belczak; Igor Rafael Sincos; Ricardo Aun

    2011-01-01

    Transluminal balloon angioplasty is a good choice for the treatment of lower limb arterial occlusion. Although there are some guidelines addressing its indications, some situations are so unusual that there is no consensus on their management. The presence of a persistent sciatic artery is a rare congenital anomaly of the circulatory system and may be associated with early atheromatous degeneration and occlusion. The authors describe the case of an 81-year-old woman that presented with a hist...

  9. Aorta-LITA Bypass Grafting with Saphenous Vein in a Patient Undergoing Coronary Artery Surgery with Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı

    2011-12-01

    Full Text Available The internal thoracic artery (ITA is the primary graft for coronary artery bypass grafting and can not be used if there is subclavian artery stenosis (SAS. Aorto-axillary, carotid-subclavian bypass and also angioplasty with stenting or other interventional treatments are acceptable procedures for SAS treatment. Aorta-ITA bypass with saphenous vein can be alternative and simple technique for SAS to save Winslow pathway for patients with peripheral artery disease.

  10. Carotid artery blowout producing massive hematemesis in the emergency department

    Institute of Scientific and Technical Information of China (English)

    Harrison K Borno; Richard J Menendez; John C Chaloupka; Michael T Dalley; David A Farcy

    2016-01-01

    Carotid blowout syndrome (CBS) is a rare and fatal complication which arises from patients who have been treated for head and neck cancer. The incidence of CBS is rare and not commonly seen by emergency physicians. We review a case of a 68-year-old woman with a history of laryngectomy and chemo-radiation therapy presenting with massive oral bleeding and hypotension. Her course and treatments are highlighted, literature referring to CBS are described and we reintroduce the approach of managing such a patient in the emergency department.

  11. Differences in carotid arterial morphology and composition between individuals with and without obstructive coronary artery disease: A cardiovascular magnetic resonance study

    OpenAIRE

    Takaya Norihide; Oikawa Minako; Yu Wei; Chu Baocheng; Saam Tobias; Hatsukami Thomas S; Espeland Mark A; Chen Haiying; Terry James G; Yuan Chun; Underhill Hunter R; Yarnykh Vasily L; Kraft Robert; Carr J Jeffrey; Maldjian Joseph

    2008-01-01

    Abstract Objective We sought to determine differences with cardiovascular magnetic resonance (CMR) in the morphology and composition of the carotid arteries between individuals with angiographically-defined obstructive coronary artery disease (CAD, ≥ 50% stenosis, cases) and those with angiographically normal coronaries (no lumen irregularities, controls). Methods and results 191 participants (50.3% female; 50.8% CAD cases) were imaged with a multi-sequence, carotid CMR protocol at 1.5T. For ...

  12. MR coil sensitivity inhomogeneity correction for plaque characterization in carotid arteries

    Science.gov (United States)

    Salvado, Olivier; Hillenbrand, Claudia; Suri, Jasjit; Wilson, David L.

    2004-05-01

    We are involved in a comprehensive program to characterize atherosclerotic disease using multiple MR images having different contrast mechanisms (T1W, T2W, PDW, magnetization transfer, etc.) of human carotid and animal model arteries. We use specially designed intravascular and surface array coils that give high signal-to-noise but suffer from sensitivity inhomogeneity. With carotid surface coils, challenges include: (1) a steep bias field with an 80% change; (2) presence of nearby muscular structures lacking high frequency information to distinguish bias from anatomical features; (3) many confounding zero-valued voxels subject to fat suppression, blood flow cancellation, or air, which are not subject to coil sensitivity; and (4) substantial noise. Bias was corrected using a modification of the adaptive fuzzy c-mean method reported by Pham et al. (IEEE TMI, 18:738-752), whereby a bias field modeled as a mechanical membrane was iteratively improved until cluster means no longer changed. Because our images were noisy, we added a noise reduction filtering step between iterations and used about 5 classes. In a digital phantom having a bias field measured from our MR system, variations across an area comparable to a carotid artery were reduced from 50% to carotid images were qualitatively improved and large regions of skeletal muscle were relatively flat. Other commonly applied techniques failed to segment the images or introduced strong edge artifacts. Current evaluations include comparisons to bias as measured by a body coil in human MR images.

  13. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics.

    Science.gov (United States)

    Birchall, Daniel; Zaman, Azfar; Hacker, Jacob; Davies, Gavin; Mendelow, David

    2006-05-01

    Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. PMID:16402252

  14. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics

    International Nuclear Information System (INIS)

    Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. (orig.)

  15. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Birchall, Daniel [Newcastle General Hospital, Division of Neuroradiology, Regional Neurosciences Centre, Newcastle-upon-Tyne (United Kingdom); Zaman, Azfar [Regional Cardiothoracic Centre, Division of Cardiology, Newcastle-upon-Tyne (United Kingdom); Hacker, Jacob; Davies, Gavin [Arup Research and Development, London (United Kingdom); Mendelow, David [Regional Neurosciences Centre, Divisions of Neurosurgery, Newcastle-upon-Tyne (United Kingdom)

    2006-05-15

    Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. (orig.)

  16. Outcomes of emergent carotid artery stenting within 6 hours of symptom onset in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    To investigate clinical outcomes following the emergent carotid artery stenting for treatment of acute ischemic stroke. Twenty-eight consecutive patients with acute stroke due to atherosclerotic steno-occlusive diseases of extracranial internal carotid artery underwent emergent carotid artery stenting. Of these, 23 patients had tandem intracranial arterial occlusions. Extracranial carotid stenting was successful in all patients. From the 13 patients who underwent intracranial recanalization procedures, successful recanalization occurred in 84.6% (11/13). 57% of patients (16/28) had a good clinical outcome (modified Rankin Scale 0-2) after 3 months. Patients with successful intracranial/extracranial recanalization had a significantly higher rate of good outcome than those without recanalization after 3 months (75% vs. 33%, p = 0.027). Patients without intracranial tandem occlusions had a more favorable clinical outcome than those with intracranial tandem occlusions (100% vs. 48%, p = 0.033). Symptomatic intracerebral hemorrhage occurred in one patient (3.6%). Mortality rate was 0% (0/28) after 3 months. Emergent carotid artery stenting in setting of acute stroke was a safe and effective treatment modality. Successful recanalization (extracranial and intracranial) and absence of intracranial tandem occlusion are significantly associated with a good outcome for our cohort of patients whom undergone emergent carotid artery stenting.

  17. Occlusive lesions of carotid and intracranial arteries in patients with symptomatic lacunar infarction. Evaluation by MR angiography

    International Nuclear Information System (INIS)

    The purpose of this study is to elucidate the prevalence and degree of occlusive lesions of carotid and intracranial arteries in patients with symptomatic lacunar infarction. We performed carotid and intracranial MR angiography, and T2-weighted MRI on 65 patients with symptomatic lacunar infarction. Stenosis of more than 25% narrowing of the diameter was found in 12 patients (18.5%) in the extracranial carotid arteries and in 14 patients (21.5%) in the intracranial arteries. Most of the stenotic lesions were mild. Multiple logistic regression analysis showed that age was significant and independent predictor for carotid artery stenosis, and that diabetes mellitus was predictor for intracranial artery stenosis. The incidence of intracranial artery stenosis was statistically higher in patients with a symptomatic lacunar infarctions in subcortical white matter area on T2-weighted MRI than in patients without such lesions. Coexistence of carotid artery stenosis should be suspected in aged patients with symptomatic lacunar infarction, and the possibility of intracranial artery stenosis should be considered in patients with diabetes mellitus or asymptomatic lacunar infarctions in subcortical white matter area. (author)

  18. Lateral abdominal wall hematoma as a rare complication after carotid artery stenting: a case report

    Directory of Open Access Journals (Sweden)

    Satomi Jyunichiro

    2009-11-01

    Full Text Available Abstract Abdominal wall hematoma is a rare and life-threatening complication after carotid artery stenting (CAS, but it can occur when activated clotting time is prolonged. We report a right lateral abdominal wall hematoma caused by rupture of the superficial circumflex iliac artery after CAS in a 72-year-old man with severe stenosis of the origin of the right internal carotid artery. We performed CAS for the targeted lesion while activated clotting time exceeded 300 seconds. After 2 hours, he complained of right lateral abdominal pain. Abdominal computed tomography revealed an extensive hematoma in the right lateral abdominal wall. Activated clotting time was 180 seconds at this point. Seven hours later, he developed hypotension and hemoglobin level dropped to 11.3 g/dl. Subsequent computed tomography showed enlargement of the hematoma. Emergent selective angiography of the external iliac artery revealed active bleeding from the right superficial circumflex iliac artery. Transcatheter arterial embolization with Gelfoam and microcoils was performed successfully. With more CAS procedures being performed, it is important for endovascular surgeons and radiologists to consider the possibility of abdominal wall hematoma in this situation.

  19. Usefulness of thin axial images of computerized tomography angiography for surgery on paraclinoid carotid artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Nagasawa, Shiro; Deguchi, Jun; Arai, Motohiro; Tanaka, Hideo; Ohta, Tomio [Osaka Medical Coll., Takatsuki (Japan)

    1995-08-01

    Ten cases involving a total of 13 aneurysms located in the clinoid portion of the carotid artery were included in this study according to Al-Radham`s classification. Non-ionic, iodinated contrast solution, a total of 2 ml/ kg, was intravenously infused at a rate of 2 ml/sec. Helical scanning was begun 30 seconds after initiating the infusion, 1 mm pitch/1.5 second/rotation. 3-D images and original images of axial slices were compared to conventional angiography, DSA and surgical findings. The 3-D images of 3-D-CT-A were able to demonstrate both aneurysms located in the C2 segment of the carotid artery (groups I and II), and five of nine carotid cave aneurysms (group III). The aneurysms located more proximally (group IV or V) could not be visualized. Original axial images of 3-D-CT-A, on the other hand, clearly demonstrated the C2, C3 and C4 segment of the carotid artery, dome and neck of the aneurysm and bone structures such as the anterior clinoid process (ACP) and sella turcica in all cases. 3-D-CT-A is known to have several advantages in cases involving common locations around the Willis ring: multiple aneurysms on a single approach line, a giant aneurysm whose neck is not clearly demonstrated, or bony structures disturbing the access to aneurysms. However, it has been generally regarded that 3-D-CT-A is of little value for diagnosing paraclinoid internal carotid artery aneurysms. This study demonstrated that a series of original axial images of 3-D-CT-A provides excellent information regarding surgical anatomy; each segment of the carotid artery, neck and dome of the aneurysms, the ACP and its topographic relations to the aneurysm, calcification, and so forth. Since aneurysms can be visualized even in the presence of clips applied to adjacent aneurysms, original images are useful for the follow-up of these specific untreated aneurysms. (J.P.N.).

  20. Usefulness of thin axial images of computerized tomography angiography for surgery on paraclinoid carotid artery aneurysms

    International Nuclear Information System (INIS)

    Ten cases involving a total of 13 aneurysms located in the clinoid portion of the carotid artery were included in this study according to Al-Radham's classification. Non-ionic, iodinated contrast solution, a total of 2 ml/ kg, was intravenously infused at a rate of 2 ml/sec. Helical scanning was begun 30 seconds after initiating the infusion, 1 mm pitch/1.5 second/rotation. 3-D images and original images of axial slices were compared to conventional angiography, DSA and surgical findings. The 3-D images of 3-D-CT-A were able to demonstrate both aneurysms located in the C2 segment of the carotid artery (groups I and II), and five of nine carotid cave aneurysms (group III). The aneurysms located more proximally (group IV or V) could not be visualized. Original axial images of 3-D-CT-A, on the other hand, clearly demonstrated the C2, C3 and C4 segment of the carotid artery, dome and neck of the aneurysm and bone structures such as the anterior clinoid process (ACP) and sella turcica in all cases. 3-D-CT-A is known to have several advantages in cases involving common locations around the Willis ring: multiple aneurysms on a single approach line, a giant aneurysm whose neck is not clearly demonstrated, or bony structures disturbing the access to aneurysms. However, it has been generally regarded that 3-D-CT-A is of little value for diagnosing paraclinoid internal carotid artery aneurysms. This study demonstrated that a series of original axial images of 3-D-CT-A provides excellent information regarding surgical anatomy; each segment of the carotid artery, neck and dome of the aneurysms, the ACP and its topographic relations to the aneurysm, calcification, and so forth. Since aneurysms can be visualized even in the presence of clips applied to adjacent aneurysms, original images are useful for the follow-up of these specific untreated aneurysms. (J.P.N.)