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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

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

Modern Treatment of Asymptomatic Carotid Stenosis —The Importance of Both Medical Therapy and Carotid Endarterectomy
Each year there are approximately 700  000 new ischemic strokes in the US, and 10% to 15% of them are caused by thromboembolism from a previously asymptomatic carotid stenosis (ACS). Three large randomized clinical trials, published in the 1990s and early 2000s, have demonstrated a significant benefit of carotid endarterectomy (CEA) i n preventing stroke in patients with severe ACS compared with medical therapy alone. They showed a 50% relative risk reduction in 5-year stroke rate and an approximately 1% per year absolute stroke risk reduction. Over the course of the past 2 decades, there has been significant improvement...
Source: JAMA Surgery - June 8, 2022 Category: Sports Medicine Source Type: research

Carotid endarterectomy for symptomatic low-grade carotid stenosis
Conclusions: This study shows that CEA is a safe, effective, and durable treatment for patients with symptomatic low-grade carotid stenosis associated with unstable plaque. Patients had excellent protection against further ischemic events and survived long enough to justify the initial surgical risk. Plaque instability seems to play a major part in the onset of ischemic events, regardless the entity of lumen narrowing.
Source: Journal of Vascular Surgery - August 19, 2013 Category: Surgery Authors: Enzo Ballotta, Annalisa Angelini, Franco Mazzalai, Giacomo Piatto, Antonio Toniato, Claudio Baracchini Tags: Clinical research studies Source Type: research

Carotid Atherosclerosis and Cerebral Microbleeds: The Framingham Heart Study Epidemiology
Conclusions Cumulative vascular risk factor exposure may increase the risk of CMB, especially in deep regions. The apparent paradoxical association of carotid intima–media thickness progression with lower risk of CMB may reflect benefits of intensive vascular risk factor treatment among persons with higher cardiovascular risk and deserves further investigation. If replicated, the results may have potential implications for assessment of preventive and therapeutic interventions for subclinical cerebral hemorrhage.
Source: JAHA:Journal of the American Heart Association - March 17, 2016 Category: Cardiology Authors: Romero, J. R., Preis, S. R., Beiser, A., DeCarli, C., D'Agostino, R. B., Wolf, P. A., Vasan, R. S., Polak, J. F., Seshadri, S. Tags: Epidemiology, Magnetic Resonance Imaging (MRI), Ultrasound, Cerebrovascular Disease/Stroke, Atherosclerosis Source Type: research

Statin Na ïve Patients with Myocardial Infarction have more Echolucent Plaques Compared to Long-term Statin Treated Chronic Atherosclerotic Patients – A 3D Ultrasound Study
Introduction: Size and morphology of carotid atherosclerotic plaques can be quantified by ultrasound (US) imaging. Carotid artery plaque size and gray-scale median (GSM) have been identified as risk markers for both cardiovascular events and stroke ADDIN EN.CITE ADDIN EN.CITE.DATA (1, 2). Unstable plaques have a thin fibrotic cap and a lipid or hemorrhagic core ADDIN EN.CITE ADDIN EN.CITE.DATA (3-6). A higher amount of lipid and hemorrhage have been observed in echolucent carotid plaques presenting as lower GSM compared to echogenic carotid plaques containing fibrotic tissue and calcification ADDIN EN.CITE ADDIN EN.CITE.DATA (7-10).
Source: European Journal of Vascular and Endovascular Surgery - November 30, 2019 Category: Surgery Authors: L ærke Urbak, Benjamin Sandholt, Martin Graebe, Lia E. Bang, Henning Bundgaard, Henrik Sillesen Source Type: research