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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

Symptomatic Carotid Artery Stenosis: Surgery, Stenting, or Medical Therapy?
Opinion statementSymptomatic carotid artery disease is a significant cause of ischemic stroke, and these patients are at high risk for recurrent vascular events. Patients with symptoms of stroke or transient ischemic attack attributable to a significantly stenotic vessel (70 –99% luminal narrowing) should be treated with intensive medical therapy. Intensive medical therapy is a combination of pharmacologic and lifestyle interventions consistent with best-known practices as follows: initiation of antiplatelet agent or anticoagulation if medically indicated, high potenc y statin medication, blood pressure control with goal...
Source: Current Treatment Options in Cardiovascular Medicine - July 5, 2017 Category: Cardiology Source Type: research

Dual Antiplatelet Therapy Prior to Expedited Carotid Surgery Reduces Recurrent Events Prior to Surgery without Significantly Increasing Peri-operative Bleeding Complications.
CONCLUSION: Early introduction of dual antiplatelet therapy was associated with a significant reduction in recurrent neurological events and spontaneous embolization prior to CEA, without incurring a significant increase in major peri-operative bleeding complications. PMID: 26283034 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - August 14, 2015 Category: Surgery Authors: Batchelder A, Hunter J, Cairns V, Sandford R, Munshi A, Naylor AR Tags: Eur J Vasc Endovasc Surg Source Type: research

Comparative Review of the Treatment Methodologies of Carotid Stenosis
Int J AngiolDOI: 10.1055/s-0035-1545073The treatment of carotid stenosis entails three methodologies, namely, medical management, carotid angioplasty and stenting (CAS), as well as carotid endarterectomy (CEA). The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) have shown that symptomatic carotid stenosis greater than 70% is best treated with CEA. In asymptomatic patients with carotid stenosis greater than 60%, CEA was more beneficial than treatment with aspirin alone according to the Asymptomatic Carotid Atherosclerosis (ACAS) and Asymptomatic Carotid Stenosis Tr...
Source: International Journal of Angiology - May 18, 2015 Category: Cardiology Authors: Bae, ConeySzuchmacher, MauricioChang, John B. Tags: Review Article Source Type: research

Clinical Picture Ischaemic scalp ulceration and hair loss
A 46-year-old woman presented to our outpatient clinic in June, 2013, with frequent collapse, ischaemic scalp ulcerations, and hair loss (). She had undergone carotid endarterectomy in 2005, after a small right hemispheric stroke, and had no other medical history apart from hypercholesterolaemia. She had no previous dermatological or scalp problems. She took clopidogrel 75 mg, aspirin 80 mg, and simvastatin 40 mg daily.
Source: LANCET - October 11, 2014 Category: Journals (General) Authors: Çağdaş Ünlü, Jean-Paul P M de Vries Tags: Clinical Picture Source Type: research

Urgent Best Medical Therapy May Obviate the Need for Urgent Surgery in Patients With Symptomatic Carotid Stenosis Clinical Sciences
Conclusions— CEA can be performed in the subacute period without significantly increasing the operative risk. The urgent best medical treatment was associated with significant reduction in the risk of early NR in CEA patients. It seems that urgent aggressive best medical treatment may obviate the need for urgent CEA.
Source: Stroke - July 22, 2013 Category: Neurology Authors: Shahidi, S., Owen-Falkenberg, A., Hjerpsted, U., Rai, A., Ellemann, K. Tags: Secondary prevention, Antiplatelets, Carotid endarterectomy, Transient Ischemic Attacks Clinical Sciences Source Type: research