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Correlation Between Intracranial Calcification and Extracranial Stenosis of the Internal Carotid Artery
We examined a population not selected for cerebral disease. This retrospective study contained 179 subjects aged 18 years and older from the Hawaii Diagnostic Radiology database. Extracranial internal carotid artery stenosis was determined using the absolute diameter, North American Symptomatic Carotid Endarterectomy Trial, and common carotid artery methods. Calcification was scored using the modified Woodcock method. A positive correlation between intracranial calcification and extracranial carotid stenosis was found using all three methods. Individuals with intracranial calcification were more likely to be older, have a ...
Source: Atherosclerosis - July 12, 2023 Category: Cardiology Authors: Julia R Jahansooz Andrew Ko Ryoko Hiroi Masako Matsunaga Enrique Carrazana Jason Viereck Source Type: research

The Impact of Full Collapse on the Risk of Ischaemic Stroke in Patients with Carotid Near Occlusion
Carotid near occlusion (CNO) is a severe carotid stenosis associated with a reduction in the calibre of the extracranial internal carotid artery distal to the stenosis.1 The risk of ipsilateral stroke in patients with CNO is a controversial issue. While a post hoc analysis of the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) reported a lower risk of ipsilateral stroke for medically treated patients with CNO compared with patients with severe (70 –99%) carotid stenosis2, more recent studies have shown that the CNO recurrence rate may be higher.
Source: European Journal of Vascular and Endovascular Surgery - April 20, 2023 Category: Surgery Authors: Andr és García-Pastor, Ana Iglesias-Mohedano, Antonio Gil-Núñez Tags: Editorial Source Type: research

Correspondence on "Unplanned readmission after carotid stenting versus endarterectomy: analysis of the United States Nationwide Readmissions Database" by Nazari et al
We read the article by Nazari et al1 comparing carotid endarterectomy and carotid artery stenting. Most of the patients in the article were asymptomatic patients. Asymptomatic carotid stenosis is considered one of the most significant causes of ischemic stroke. The management of asymptomatic carotid stenosis ranges from open surgical approaches to minimally invasive endovascular interventions and medical therapeutics.2 With the advances in the neurosurgical field within the last decade, various surgical interventions have emerged. However, to date, the evidence regarding the optimal interventional strategies for asymptomat...
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Azzam, A. Y., Ghozy, S., Kallmes, K. M., Dmytriw, A. A., Kadirvel, R., Kallmes, D. F. Tags: Letter Source Type: research

Unplanned readmission after carotid stenting versus endarterectomy: analysis of the United States Nationwide Readmissions Database
Conclusions Readmission is not uncommon after carotid revascularization, occurs more often after CAS, and is predicted by baseline factors and by preventable adverse events at initial admission.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Nazari, P., Golnari, P., Ansari, S. A., Cantrell, D. R., Potts, M. B., Jahromi, B. S. Tags: Open access, Ischemic stroke Source Type: research

Embolic protection devices for carotid artery stenting: A network meta-analysis
CONCLUSIONS: PB deployment during CAS is superior to DF and DB in preventing distal embolization phenomena. However, no statistically significant difference in TIA and stroke rate was found among any of the analyzed EPD groups. Further research is warranted to investigate the association of embolic phenomena on imaging after CAS with clinically significant neurologic deficits.PMID:36394946 | DOI:10.1177/17085381221140616
Source: Vascular - November 17, 2022 Category: Surgery Authors: Stefanos Giannopoulos Marios Sagris Spyridon Giannopoulos Andreas Tzoumas Damianos G Kokkinidis Pavlos Texakalidis George Koutsias Panagiotis Volteas Li Jing Rafael D Malgor Source Type: research

Correlation between intracranial vertebral artery stenosis diameter measured by digital subtraction angiography and cross-sectional area measured by optical coherence tomography
Conclusion Measurement of the narrowest diameter was not a reliable predictor of the cross-sectional area of V4 stenosis. Larger studies are therefore needed to develop a new evaluation system based on V4 stenosis.
Source: Journal of NeuroInterventional Surgery - October 15, 2021 Category: Neurosurgery Authors: Feng, Y., Wu, T., Wang, T., Li, Y., Li, M., Li, L., Yang, B., Bai, X., Zhang, X., Wang, Y., Gao, P., Chen, Y., Ma, Y., Jiao, L. Tags: Ischemic stroke Source Type: research

Significance of concurrent ipsilateral intracranial carotid artery stenosis in carotid revascularization
A 71-year-old male presenting with a transient ischemic attack was found to have an ipsilateral severe proximal right internal carotid artery (ICA) stenosis as graded per the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. He was subsequently treated with right internal carotid endarterectomy (CEA). The surgery was complicated by a right sided watershed infarction determined by magnetic resonance imaging (MRI) of the head. His post-surgery National Institutes of Health Stroke Scale score was 6 and the 90  days modified Rankin Scale score was 3.
Source: Journal of the Neurological Sciences - February 19, 2021 Category: Neurology Authors: Riwaj Bhagat, Allison Muha Tags: Letter to the Editor Source Type: research

Preliminary study about the relationship between degree of internal carotid artery stenosis, wall shear stress on MR angiography and 18F-FDG uptake on PET/CT
Conclusions: These preliminary results indicated that there were significant correlations between degree of internal carotid artery stenosis, WSS and 18F-FDG uptake in patients with carotid artery stenosis. Furthermore, the relationship between WSS and 18F-FDG uptake was higher than that between degree of internal carotid artery stenosis and 18F-FDG uptake.
Source: Journal of Nuclear Medicine - May 14, 2020 Category: Nuclear Medicine Authors: Takami, Y., Norikane, T., Yamamoto, Y., Fujimoto, K., Mitamura, K., Nishiyama, Y. Tags: Clinical Science (Poster Session) Source Type: research

Outcome Differences between Carotid artery stenting (CAS) and Carotid endarterectomy (CEA) in Postoperative Ventricular Arrhythmia, Neurological Complications and In-Hospital Mortality.
Conclusions: In short-term outcomes, CEA was associated with lower risk of postoperative ventricular arrhythmia, neurological complications, in-hospital mortality, and lower cost as compared with CAS. PMID: 32396028 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - May 14, 2020 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Reply
I am pleased Ross Naylor is of the opinion that I have built a convincing case with respect to the implications of increasing stenosis severity in asymptomatic patients with carotid stenosis. Furthermore, it is difficult to refute the statement that carotid interventions are not undertaken to prevent transient ischemic attack (TIA). Virtually all natural history studies (Asymptomatic Carotid Stenosis and Risk of Stroke [ACSRS], North American Symptomatic Carotid Endarterectomy Trial [NASCET]) including ours (see Conrad, reference 3) have indicated that the index neurologic event in previously asymptomatic patients is as li...
Source: Journal of Vascular Surgery - July 20, 2018 Category: Surgery Authors: Richard P. Cambria Tags: Letter to the Editor Source Type: research

The effects of centralisation of vascular surgical services in the Bath, Bristol and Weston area on the carotid endarterectomy pathway.
Conclusion Centralisation has not significantly impacted the overall efficiency of the carotid endarterectomy pathway. This study highlights areas where improvement across the vascular network is required. This includes addressing the 35% patients that are not currently meeting the 14-day target and standardising the provision of care to outlying communities. Further follow-up is required to assess the longer term effects of centralisation. PMID: 28682128 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - July 6, 2017 Category: Surgery Authors: Partridge E, Brooks M, Curd C, Davis V, Oates C, McGeeney D Tags: Ann R Coll Surg Engl Source Type: research