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Stroke Prevention: Little-Known and Neglected Aspects
Combining available therapies has the potential to reduce the risk of stroke by 80% or more. A comprehensive review of all aspects of stroke prevention would be very lengthy; in this narrative review, we focus on some aspects of stroke prevention that are little-known and/or neglected. These include the following: (1) implementation of a Mediterranean diet; (2) B vitamins to lower homocysteine; (3) coordinated approaches to smoking cessation; (4) intensive lipid-lowering therapy; (5) lipid lowering in the elderly; (6) physiologically individualized therapy for hypertension based on renin/aldosterone phenotyping; (7) avoidi...
Source: Cerebrovascular Diseases - May 27, 2021 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

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

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

CLOCK disruption aggravates carotid artery stenosis through endoplasmic reticulum stress-induced endothelial-mesenchymal transition.
In conclusion, the disruption of CLOCK function aggravates EndMT via the IRE1α-XBP1 axis, contributing to carotid artery stenosis. PMID: 33437367 [PubMed]
Source: American Journal of Translational Research - January 14, 2021 Category: Research Tags: Am J Transl Res Source Type: research

Imaging High-Risk Atherothrombosis Using a Novel Fibrin-Binding Positron Emission Tomography Probe
CONCLUSIONS: We demonstrated that molecular fibrin PET imaging using 68Ga-CM246 could be a useful tool to diagnose experimental and clinical atherothrombosis. Based on our initial results using human carotid plaque specimens, in vivo molecular imaging studies are warranted to test 68Ga-CM246 PET as a tool to stratify risk in atherosclerotic patients.PMID:34965737 | DOI:10.1161/STROKEAHA.121.035638
Source: Atherosclerosis - December 30, 2021 Category: Cardiology Authors: David Izquierdo-Garcia Himashinie Diyabalanage Ian A Ramsay Nicholas J Rotile Adam Mauskapf Ji-Kyung Choi Thomas Witzel Valerie Humblet Farouc A Jaffer Anna-Liisa Brownell Ahmed Tawakol Ciprian Catana Mark F Conrad Peter Caravan Ilknur Ay Source Type: research