The role of atheromatous plaque of the internal carotid artery in carotid sinus hypersensitivity

1998 ◽  
Vol 5 ◽  
pp. 45
Author(s):  
V. Bérczi ◽  
F. Solti ◽  
L. Entz ◽  
K. Hüttl ◽  
Zs. Járányi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Sinus ◽  
Atheromatous Plaque ◽  
Carotid Sinus Hypersensitivity

Abstract WMP40: Cervical Internal Carotid Artery Tortuosity as a Marker of Non-Atherosclerotic Aging: Results From the Northern Manhattan Study (NOMAS)

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Farid Khasiyev ◽  
Tatjana Rundek ◽  
Chensy Marquez ◽  
Clinton B. Wright ◽  
Ralph Sacco ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Genetic Disorders ◽  
Matrix Remodeling ◽  
Plaque Area ◽  
Blood Pressures ◽  
The Right ◽  
Cervical Internal Carotid Artery

Background: Cervical internal carotid artery (ICA) tortuosity has been associated with vascular risk and stroke as well as genetic disorders related to abnormal extracellular matrix remodeling. It is plausible that dystrophic or aberrant arterial remodeling may therefore relate to cervical ICA tortuosity. We hypothesized that cervical ICA tortuosity relates to carotid dilatation, but not to traditional ultrasound (US) markers of atherosclerosis. Methods: Subjects of the NOMAS with available time-of-flight MRA were included in our study. Cervical ICA tortuosity was defined as a bend in the distal cervical ICA of > 90° as seen on MRA. We excluded subjects with < 5 cm of the cervical ICA visualized. Distensibility was calculated as the percentage excursion of the right CCA diastolic diameter during systole, which was assessed by high-resolution B-mode US of the right common carotid artery (CCA). We used multivariable logistic regression analyses to estimate odds ratios for the association of cervical ICA tortuosity and Doppler measures of carotid wall aging. Results: We visualized cervical ICA tortuosity in 468 NOMAS participants (mean age 64±8 years, 70% women, 70% Hispanic). It was present in 23% of subjects. In unadjusted models, cervical ICA tortuosity was more common in women (OR 2.34, 95% CI 1.34-4.11), Hispanics (OR 1.85, 95%CI 1.06-3.25) and those with higher diastolic blood pressures (OR per mm Hg 1.04, 95%CI 1.01-1.06), and less common among smokers (OR 0.23, 95%CI 0.07-0.78). In models adjusted for demographic and vascular risks, right CCA tortuosity was associated with ipsilateral larger CCA DD (OR 1.42, 95%CI 1.02-1.96) and borderline associated with lower distensibility (OR 0.94, 95%CI 0.87-1.01, P=0.06) but not with ipsilateral ICA IMT (OR 0.26, 95%CI 0.14-4.77), number of plaques (OR 1.08, 95%CI 0.76-1.53), maximum plaque thickness (OR 0.96, 95%CI 0.73-1.27), or plaque area (1.00, 95%CI 0.97-1.05). Conclusions: Cervical ICA tortuosity associates with ipsilateral cervical ICA dilatation and lower distensibility, but not with traditional US markers of atherosclerosis. The association with diastolic blood pressure suggests a role of steady, rather than pulsatile, hemodynamics in aberrant cervical ICA remodeling.

Atheromatous pseudo-occlusion of the internal carotid artery

1980 ◽  
Vol 52 (6) ◽  
pp. 782-789 ◽  
Author(s):  
Laligam N. Sekhar ◽  
Roberto C. Heros ◽  
Preston R. Lotz ◽  
Arthur E. Rosenbaum
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Contrast Medium ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Contrast Material ◽  
Atheromatous Plaque ◽  
Content Type ◽  
Specialized Technique ◽  
Logical Treatment

✓ In the past year, three patients were referred for microvascular bypass surgery for relief of symptoms secondary to an apparently occluded internal carotid artery (ICA). Careful review of the late films of their initial arteriographic series or repeat arteriography with a specialized technique revealed a thin trickle of contrast medium flowing antegrade through a region of extreme stenosis. This thin line of contrast material ascended slowly to meet the column of contrast medium in the cavernous carotid segment that was filling by collateral circulation. Surgical exploration of the neck in these patients revealed a patent but collapsed ICA distal to a localized atheromatous plaque. These patients have been asymptomatic following carotid endarterectomy. This distinctive angiographic appearance may be described as “atheromatous pseudo-occlusion.” Once recognized, carotid endarterectomy is the logical treatment of choice.

Surgical Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S83-S91 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Akshal Patel
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Carotid Angioplasty ◽  
Artery Disease ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Abstract Carotid endarterectomy is a commonly performed operation to prevent stroke in patients who have asymptomatic or symptomatic internal carotid artery atherosclerotic stenosis. Carotid angioplasty and stenting has also been advocated for treatment of these patients. In this article, we address a number of questions for which a review of available data will advance our understanding of the role of carotid endarterectomy in stroke prevention. These include the following: Are carotid endarterectomy and carotid angioplasty and stenting equivalent procedures for the treatment of carotid artery disease? Which patients should be deemed at high risk for carotid endarterectomy? Should carotid endarterectomy be an urgent procedure in symptomatic patients with severe internal carotid artery stenosis? Finally, what is the role of carotid endarterectomy in asymptomatic patients? We also review the senior author's personal experience with &gt;2000 consecutive carotid endarterectomies, with special attention to his present approach to this operation. We believe that carotid endarterectomy, in experienced hands, is a minimally invasive operation that remains the procedure of choice for most patients with carotid artery disease who will benefit from invasive treatment.

Optic Nerve and Chiasma Compression by a Dolichoectatic Internal Carotid Artery

1998 ◽  
Vol 11 (2) ◽  
pp. 199-201
Author(s):  
A. Blandino ◽  
M. Longo ◽  
F.M. Salpietro ◽  
C. Alafaci ◽  
C. Narbone ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Mr Angiography ◽  
Internal Carotid ◽  
Neurovascular Conflict ◽  
Unusual Type

We describe an unusual type of neurovascular conflict between an elongated internal carotid artery and the optic nerve-chiasma complex. The fundamental role of conventional MR and MR angiography in the demonstration of the neurovascular conflict is illustrated.

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