Hemodynamic Assessment of Carotid Artery Obstructive Lesions: Comparison of PET and SPECT

1992 ◽  
pp. 94-110 ◽  
Author(s):  
J. M. Derlon ◽  
G. Bouvard ◽  
M. C. Petit ◽  
F. Viader ◽  
B. Lechevalier ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Hemodynamic Assessment

scholarly journals Hemodynamics and oxygen extraction in chronic large artery steno-occlusive disease: Clinical applications for predicting stroke risk

2017 ◽  
Vol 38 (9) ◽  
pp. 1584-1597 ◽  
Author(s):  
Colin P Derdeyn
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Stroke Risk ◽  
Arterial Stenosis ◽  
Oxygen Extraction Fraction ◽  
Oxygen Extraction ◽  
Large Artery ◽  
Extraction Fraction ◽  
Hemodynamic Assessment

Depending on the adequacy of collateral sources of blood flow, arterial stenosis or occlusion may lead to reduced perfusion pressure and ultimately reduced blood flow in the distal territory supplied by that vessel. There are two well-defined compensatory mechanisms to reduced pressure or flow – autoregulatory vasodilation and increased oxygen extraction fraction. Other changes, such as metabolic downregulation, are likely. The positive identification of autoregulatory vasodilation and increased oxygen extraction fraction in humans is an established risk factor for future ischemic stroke in some disease states such as atherosclerotic carotid stenosis and occlusion. The mechanisms by which ischemic stroke may occur are not clear, and may include an increased vulnerability to embolic events. The use of hemodynamic assessment to identify patients with occlusive vasculopathy at an increased risk for stroke is very appealing for several different patient populations, such as those with symptomatic intracranial atherosclerotic disease, moyamoya phenomenon, complete internal carotid artery occlusion, and asymptomatic cervical carotid artery stenosis. While there is very good data for stroke risk prediction in some of these groups, no intervention based on these tools has been proven effective yet. In this manuscript, we will review these topics above and identify areas for future research.

scholarly journals Sonographic features of carotid artery dissection due to extension of aortic dissection: a case report

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Christian Boßelmann ◽  
Sven Poli
Keyword(s):  
Carotid Artery ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Point Of Care ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Carotid Ultrasound ◽  
Case Presentation ◽  
Retrosternal Pain ◽  
Hemodynamic Assessment

Abstract Background Carotid artery dissection due to extension of aortic dissection (CAEAD) is a severe complication of acute aortic dissection. The risk of ischemic stroke is increased. Early sonographic detection and repeat evaluation are necessary to guide clinical management. Case presentation A 58-year-old male patient presents with sudden, tearing retrosternal pain. Point-of-care carotid ultrasound is used to establish the diagnosis of CAEAD. We describe a number of sonographic features and compare ultrasound to other imaging modalities. Conclusions Bedside carotid ultrasound enables rapid, sensitive and safe hemodynamic assessment, especially in critically ill patients.

Urgent Carotid Artery Stenting for Carotid-Related Stroke-in-Evolution

2017 ◽  
Vol 14 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Nobuhiro Nakagawa ◽  
Norihito Fukawa ◽  
Kiyoshi Tsuji ◽  
Naoki Nakano ◽  
Saori Murakami ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
National Institutes Of Health ◽  
Severe Stenosis ◽  
Total Occlusion ◽  
Nihss Score ◽  
Hemodynamic Assessment ◽  
Hemodynamic Impairment ◽  
The Mean ◽  
Distal Protection

Abstract BACKGROUND Stroke-in-evolution (SIE) is a major outcome determinant in patients with acute ischemic stroke. The benefit of surgery for treatment of carotid artery-related SIE remains controversial. OBJECTIVE To retrospectively evaluate the use of carotid artery stenting (CAS) as a possible alternative treatment in patients with carotid-related SIE. METHODS Ten patients with carotid-related SIE were treated with CAS from May 2005 to December 2014. The mean initial National Institutes of Health Stroke Scale (NIHSS) score was 5.4 ± 4.4. Two patients had total occlusion of the internal carotid artery, and 8 had severe stenosis. The mean interval from symptom onset to clinical deterioration was 2.9 ± 2.9 d. The mean NIHSS score after deterioration was 14.3 ± 4.5. In the hemodynamic assessment using perfusion imaging, the ipsilateral cerebral hemodynamics was impaired in 7 of 8 patients. RESULTS All patients underwent urgent CAS in the acute phase of SIE. Seven patients underwent CAS using flow reversal with or without distal protection. No procedure-related complications occurred in any patients, although 1 patient developed aspiration pneumonia. The mean NIHSS score 7 d after CAS was 4.8 ± 2.3. Six patients (60%) had a modified Rankin scale score of 0 to 2 at discharge. CONCLUSION Urgent CAS for carotid-related SIE with hemodynamic impairment appears to be an effective method for achieving good clinical outcomes.

Hemodynamic Assessment and Surgical Correction of the Kinked Internal Carotid Artery

1981 ◽  
Vol 74 (11) ◽  
pp. 1348-1352 ◽  
Author(s):  
PAUL E. STANTON ◽  
DAVID ROSENTHAL ◽  
DAVID A. McCLUSKY ◽  
PANO A. LAMIS
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Surgical Correction ◽  
Hemodynamic Assessment

Endotoxin Alteration of the Mucopolysaccharide Blood Vessel Coating in Rats

1974 ◽  
Vol 32 ◽  
pp. 148-149
Author(s):  
D. E. Philpott ◽  
A. Takahashi
Keyword(s):  
Skeletal Muscle ◽  
Endothelial Cells ◽  
Salivary Gland ◽  
Carotid Artery ◽  
Basement Membrane ◽  
Coronary Vessels ◽  
Ruthenium Red ◽  
E Coli ◽  
Old Rats ◽  
The Brain

Two month, eight month and two year old rats were treated with 10 or 20 mg/kg of E. Coli endotoxin I. P. The eight month old rats proved most resistant to the endotoxin. During fixation the aorta, carotid artery, basil arartery of the brain, coronary vessels of the heart, inner surfaces of the heart chambers, heart and skeletal muscle, lung, liver, kidney, spleen, brain, retina, trachae, intestine, salivary gland, adrenal gland and gingiva were treated with ruthenium red or alcian blue to preserve the mucopolysaccharide (MPS) coating. Five, 8 and 24 hrs of endotoxin treatment produced increasingly marked capillary damage, disappearance of the MPS coating, edema, destruction of endothelial cells and damage to the basement membrane in the liver, kidney and lung.

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