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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

E-107 Carotid artery stenting in patients with symptomatic non-stenotic carotid artery disease - a case series
ConclusionsIn this case series performed over a 10-year period at a high-volume stroke center we show that CAS is safe and efficient in patients with SyNC. Previous studies have established safety and effectiveness of CES in patients presenting with SyNC, however there is a paucity of reports in the literature regarding the effect of CAS in this patient population. Recent guidelines have brought specific attention to high-risk plaque characteristics which suggest that plaque instability plays a major role in the onset of ischemic events, regardless of lumen narrowing. Advanced imaging techniques, such as Optical Coherence ...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nedelcu, S., Kuhn, A., Singh, J., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Carotid artery disease: clinical features and management
Publication date: Available online 5 June 2015 Source:Surgery (Oxford) Author(s): A Ross Naylor The most common cause of ischaemic carotid territory stroke is thromboembolism from stenoses in the extracranial internal carotid artery (ICA). In the majority, embolism is preceded by an acute change in plaque morphology thereby predisposing the patient to overlying thrombus formation and embolization. The management of patients with carotid artery disease mandates risk factor modification, antiplatelet and statin therapy in everyone. There is grade A, level I evidence that recently symptomatic patients with 50–99% NASCET s...
Source: Surgery (Oxford) - June 6, 2015 Category: Surgery 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 artery disease: clinical features and management
The most common cause of ischaemic carotid territory stroke is thromboembolism from stenoses in the extracranial internal carotid artery (ICA). In the majority, embolism is preceded by an acute change in plaque morphology thereby predisposing the patient to overlying thrombus formation and embolization. The management of patients with carotid artery disease mandates risk factor modification, antiplatelet and statin therapy in everyone. There is grade A, level I evidence that recently symptomatic patients with 50–99% NASCET stenoses gain significant benefit from carotid endarterectomy (CEA), despite a small risk of perioperative stroke.
Source: Surgery (Medicine Publishing) - June 5, 2015 Category: Surgery Authors: A Ross Naylor Tags: Vascular surgery I Source Type: research