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Contemporary carotid imaging: from degree of stenosis to plaque vulnerability.
Abstract Carotid artery stenosis is a well-established risk factor of ischemic stroke, contributing to up to 10%-20% of strokes or transient ischemic attacks. Many clinical trials over the last 20 years have used measurements of carotid artery stenosis as a means to risk stratify patients. However, with improvements in vascular imaging techniques such as CT angiography and MR angiography, ultrasonography, and PET/CT, it is now possible to risk stratify patients, not just on the degree of carotid artery stenosis but also on how vulnerable the plaque is to rupture, resulting in ischemic stroke. These imaging techniq...
Source: Journal of Neurosurgery - July 31, 2015 Category: Neurosurgery Authors: Brinjikji W, Huston J, Rabinstein AA, Kim GM, Lerman A, Lanzino G Tags: J Neurosurg Source Type: research

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture.
Abstract Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were eval...
Source: Journal of Neurosurgery - January 9, 2015 Category: Neurosurgery Authors: Hasegawa H, Inoue T, Tamura A, Saito I Tags: J Neurosurg Source Type: research

Carotid artery stenosis with a high-intensity signal plaque on time-of-flight magnetic resonance angiography and association with evidence of intraplaque hypoxia.
CONCLUSIONS Plaques with high-intensity signals on TOF MRA were associated with IPH and evidence of intraplaque hypoxia. This fact may represent an opportunity to establish novel therapeutic agents targeting intraplaque hypoxia. PMID: 27367236 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - June 30, 2016 Category: Neurosurgery Authors: Ogata A, Kawashima M, Wakamiya T, Nishihara M, Masuoka J, Nakahara Y, Ebashi R, Inoue K, Takase Y, Irie H, Abe T Tags: J Neurosurg Source Type: research