The role of hemodynamic disturbance on extracranial carotid artery on the occurrence of brain aneurysm

Introduction: Stroke is life threatening & debilitating neurological disease, defined as focal neurological deficit of sudden onset lasting >24 hours & vascular in origin. Significant association between ischemic type of stroke with carotid artery disease seen, more prevalent with carotid artery stenosis. Objectives: This study was done to show association between extracranial carotid artery disease & cerebrovascular accidents (CVAs) with the help of Color Doppler Sonography (CDS). The association between carotid artery disease with associated risk factors were also assessed. Methodology: In this ethically approved prospective study, carotid CDS was done in 79 consecutive patients with diagnosis of acute ischemic stroke (AIS). The various parameters studied included peak systolic velocity (PSV) of internal carotid artery (ICA) & common carotid artery (CCA), ICA/CCA PSV ratio & plaque characteristics. The data collected was analyzed with appropriate statistical test of significance was calculated. Results: Total 79 patients with AIS included out of which 53 were males & 26 were females. The most common presenting complains were hemiparesis (30.4%) & most commonly associated risk factors included hypertension (62.02%). Right sided strokes were most common (44.3%) & middle cerebral artery was most commonly involved vascular territory. Significant stenosis (≥50%) of carotid artery was seen in 27 patients with ICA most common site (45.8%) for plaque formation. Bilateral carotid artery involvement (52.1%) with hypoechoic echotexture of atheromatous plaques (46.6%) was most responsible for significant stenosis & increased intima media thickness. Increased value of PSV & EDV was seen in the stenotic area in the proportion of stenosis with increased PSV ICA/CCA ratio of more than three indicates >60% stenosis. Conclusion: The present study showed well documented role of carotid doppler in detection of site & extent of carotid artery stenosis due to atheromatous plaques of various characteristics playing critical role in thromboembolic phenomenon responsible for development of stroke.

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The role of intravenous digital subtraction angiography in the evaluation of extracranial carotid artery disease

Journal of Vascular Surgery ◽

10.1067/mva.1986.avs0040157 ◽

1986 ◽

Vol 4 (2) ◽

pp. 157-163 ◽

Cited By ~ 1

Author(s):

Edward F. Crocker ◽

Roger H. Tutton ◽

John C. Bowen

Keyword(s):

Carotid Artery ◽

Digital Subtraction Angiography ◽

Carotid Artery Disease ◽

Digital Subtraction ◽

Extracranial Carotid Artery ◽

Intravenous Digital Subtraction Angiography ◽

Artery Disease

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The role of intravenous digital subtraction angiography in the evaluation of extracranial carotid artery disease

Journal of Vascular Surgery ◽

10.1016/0741-5214(86)90416-7 ◽

1986 ◽

Vol 4 (2) ◽

pp. 157-163 ◽

Cited By ~ 7

Author(s):

Edward F. Crocker ◽

Roger H. Tutton ◽

John C. Bowen

Keyword(s):

Carotid Artery ◽

Digital Subtraction Angiography ◽

Carotid Artery Disease ◽

Digital Subtraction ◽

Extracranial Carotid Artery ◽

Intravenous Digital Subtraction Angiography ◽

Artery Disease

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M.540 The role of adamts-1 in atherosclerosis: Remodeling of carotid artery, immunohistochemistry, and proteolysis of versican

Atherosclerosis ◽

10.1016/s0021-9150(04)90538-2 ◽

2004 ◽

Vol 5 (1) ◽

pp. 125

Author(s):

A JONSSONRYLANDER

Keyword(s):

Carotid Artery

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Surgical management of extracranial carotid artery aneurysms

VASA ◽

10.1024/0301-1526/a000528 ◽

2016 ◽

Vol 45 (3) ◽

pp. 223-228 ◽

Cited By ~ 2

Author(s):

Jan Paweł Skóra ◽

Jacek Kurcz ◽

Krzysztof Korta ◽

Przemysław Szyber ◽

Tadeusz Andrzej Dorobisz ◽

...

Keyword(s):

Carotid Artery ◽

Surgical Management ◽

Minor Stroke ◽

Stroke Rate ◽

Extracranial Carotid Artery ◽

Long Term Follow Up ◽

End To End ◽

Dacron Patch ◽

Major Stroke

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

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