scholarly journals Silent Brain Infarction in Patients With Asymptomatic Carotid Artery Atherosclerotic Disease

2016 ◽  
Vol 64 (2) ◽  
pp. 534-535 ◽  
Author(s):  
H. Baradaran ◽  
G. Gialdini ◽  
E. Mtui
Keyword(s):  
Carotid Artery ◽  
Brain Infarction ◽  
Atherosclerotic Disease ◽  
Asymptomatic Carotid ◽  
Silent Brain Infarction

scholarly journals Silent Brain Infarction in Patients With Asymptomatic Carotid Artery Atherosclerotic Disease

Stroke ◽  
2016 ◽  
Vol 47 (5) ◽  
pp. 1368-1370 ◽  
Author(s):  
Hediyeh Baradaran ◽  
Gino Gialdini ◽  
Edward Mtui ◽  
Gulce Askin ◽  
Hooman Kamel ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Brain Infarction ◽  
Atherosclerotic Disease ◽  
Asymptomatic Carotid ◽  
Silent Brain Infarction

scholarly journals The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

2013 ◽  
Vol 70 (11) ◽  
pp. 993-998 ◽  
Author(s):  
Djordje Milosevic ◽  
Janko Pasternak ◽  
Vladan Popovic ◽  
Dragan Nikolic ◽  
Pavle Milosevic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Brain Infarction ◽  
Statistical Significance ◽  
Brain Parenchyma ◽  
Plaque Morphology ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Silent Brain Infarction

Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the manifestation of silent brain infarction, and to analyze the influence of risk factors for cardiovascular diseases on the occurrence of silent brain infarction and the morphology of carotid plaque. Methods. This retrospective study included patients who had been operated for high grade (> 70%) extracranial atherosclerotic carotid stenosis at the Clinic for Vascular and Transplantation Surgery of the Clinical Center of Vojvodina over a period of 5 years. The patients analyzed had no clinical manifestation of cerebrovascular insufficiency of the carotid artery territory up to the time of operation. The classification of carotid plaque morphology was carried out according to the Gray-Weale classification, after which all the types were subcategorized into two groups: stable and unstable. Brain lesions were verified using preoperative imaging of the brain parenchyma by magnetic resonance. We analyzed ipsilateral lesions of the size > or = 3 mm. Results. Out of a 201 patients 78% had stable plaque and 22% unstable one. Unstable plaque was prevalent in the male patients (male/female ratio = 24.8% : 17.8%), but without a statistically significant difference (p > 0.05). The risk factors (hypertension, nicotinism, hyperlipoproteinemia, and diabetes mellitus) showed no statistically significant impact on carotid plaque morphology and the occurrence of silent brain infarction. Silent brain infarction was detected in 30.8% of the patients. Unstable carotid plaque was found in a larger percentage of patients with silent brain infarction (36.4% : 29.3%) but without a significant statistical difference (p > 0.05). Conclusions. Even though silent brain infarction is more frequent in patients with unstable plaque of carotid bifurication, the difference is of no statistical significance. The effects of the number and type of risk factors bear no statistical significance on the incidence of morphological asymptomatic carotid plaque.

scholarly journals Endovascular revascularization of carotid artery stenosis

2020 ◽  
Vol 73 (11-12) ◽  
pp. 351-356
Author(s):  
Slavko Budinski ◽  
Vladimir Manojlovic ◽  
Nebojsa Budakov ◽  
Nikola Batinic ◽  
Milica Pejakovic-Budinski ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Atherosclerotic Disease ◽  
Asymptomatic Carotid ◽  
Endovascular Revascularization ◽  
Early Results ◽  
Disease Therapy ◽  
Significant Difference ◽  
Male Patients ◽  
Artery Disease

Introduction. Endovascular revascularization is a peripheral artery disease therapy used to improve blood flow in blood vessels. The objective of this study was to analyze the types and prevalence of comorbidities in patients with indications for carotid artery revascularization, as well as early results of endovascular carotid artery revascularization in relation to periprocedural complications. Material and Methods. This retrospective study was conducted from October 2014 to October 2019 and included 96 patients. Descriptive and comparative statistical analysis was performed in all patients, male and female, and those with both symptomatic and asymptomatic carotid diseases. Results. The study included 96 patients, of whom 69.8% were male and 30.2% were female. A successful endovascular procedure was performed in 89.6% of patients, while in 10.4% of patients the procedure failed. The distribution of patients by sex, age and the duration of procedure, showed a statistically significant difference (p < 0.05) in the age (p = 0.0003) and duration of the procedure (p = 0.022). The comparison of two groups of patients, with symptomatic and asymptomatic carotid atherosclerotic disease, hyperlipoproteinemia (p = 0.015) showed a statistically significant difference (p < 0.05) between the two groups. Conclusion. Endovascular revascularization has a high success rate in the treatment of atherosclerotic disease of the carotid arteries as well as low periprocedural morbidity and mortality. The analysis of gender-related differences, we concluded that endovascular revascularization lasts significantly longer in female patients, and that the average age is significantly higher in male patients compared to females. We also concluded that hyperlipoproteinemia is a major risk factor for carotid artery disease.

scholarly journals Screening Recommendations for Asymptomatic Carotid Artery Disease and Role of Carotid Intima-Media Thickness Evaluation: A Literature Review

2021 ◽  
Vol 2 (1) ◽  
pp. 34-40
Author(s):  
Dedy Pratama ◽  
Fajar Satria Rahmaditya
Keyword(s):  
Carotid Artery ◽  
Literature Review ◽  
Carotid Artery Disease ◽  
Intima Media Thickness ◽  
Atherosclerotic Disease ◽  
Asymptomatic Carotid ◽  
Media Thickness ◽  
Ultrasound Evaluation ◽  
Artery Disease ◽  
Current Guidelines

Background: Asymptomatic carotid artery disease should be treated as soon as possible before the atherosclerotic disease progressed into ischaemic stroke. Diagnostic screening by measuring intima-media thickness (IMT) of carotid artery using ultrasound is one possible way to evaluate earlier the progression compared to standard stenosis evaluation. Not only the necessity of carotid screening is still questioned by some experts, current guidelines also show conflicting results in certainty whether we should perform the carotid screening or not. It is necessary to conduct a literature review of relevant recommendations from the latest clinical practice guidelines (CPGs). Method: The CPGs on the management of asymptomatic carotid artery disease published before October 2020 were retrieved from online databases and the rigor of guideline development assesed by using the Appraisal of Guidelines Research and Evaluation II (AGREE-II) instrument. The quality of CPGs was assessed and categorized, and their reported evidences were also evaluated. Results: Six eligible CPGs were included. Five of the CPGs recommends carotid screening for highly selective patient who has morbidity regarding atherosclerotic disease manifested in other organs. One CPG against the screening as further treatment considered cause more harms, although the recommendations mainly based on hypothetical outcomes and the CPG itself categorized into moderate quality. Conclusion: Our critical review on those CPGs showed that screening for asymptomatic carotid artery disease should be performed for specific high-risk populations of atherosclerotic disease. Although IMT evaluation could be a promising technique, current guidelines didn’t show any recommendation regarding the usage comparing standard ultrasound evaluation.

Predictors and Consequences of Silent Brain Infarction in Patients with Asymptomatic Carotid Stenosis

2020 ◽  
Vol 29 (10) ◽  
pp. 105108
Author(s):  
Rodolfo Pini ◽  
Gianluca Faggioli ◽  
Giuseppe Indelicato ◽  
Sergio Palermo ◽  
Andrea Vacirca ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Brain Infarction ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Silent Brain Infarction

Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 268-274
Author(s):  
Erhan Saraçoğlu ◽  
Ertan Vuruşkan ◽  
Yusuf Çekici ◽  
Salih Kiliç ◽  
Halil Ay ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carotid Artery ◽  
Oxidative Damage ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Oxidative Stress Marker ◽  
Asymptomatic Carotid ◽  
Imaging Methods ◽  
Neurological Findings ◽  
Asymptomatic Carotid Artery Stenosis

Abstract. Background: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis. Patients and methods: We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. Results: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). Conclusions: We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.

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