A Combined TCD and MRA Screening for Significant Siphon Portion of Internal Carotid Artery (S-ICA) Stenosis

2011 ◽  
Vol 22 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Junya Aoki ◽  
Kazumi Kimura ◽  
Yasuyuki Iguchi ◽  
Kensaku Shibazaki ◽  
Kazuto Kobayashi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Ica Stenosis

scholarly journals Optimization of duplex velocity criteria for diagnosis of internal carotid artery (ICA) stenosis: A report of the Intersocietal Accreditation Commission (IAC) Vascular Testing Division Carotid Diagnostic Criteria Committee

2021 ◽  
pp. 1358863X2110112
Author(s):  
Heather L Gornik ◽  
Tatjana Rundek ◽  
Hannah Gardener ◽  
James F Benenati ◽  
Nirvikar Dahiya ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Diagnostic Criteria ◽  
Internal Carotid ◽  
Peak Systolic Velocity ◽  
Duplex Ultrasound ◽  
Additional Parameter ◽  
Characteristic Analysis ◽  
Carotid Duplex ◽  
Ica Stenosis

Diagnostic criteria to classify severity of internal carotid artery (ICA) stenosis vary across vascular laboratories. Consensus-based criteria, proposed by the Society of Radiologists in Ultrasound in 2003 (SRUCC), have been broadly implemented but have not been adequately validated. We conducted a multicentered, retrospective correlative imaging study of duplex ultrasound versus catheter angiography for evaluation of severity of ICA stenosis. Velocity data were abstracted from bilateral duplex studies performed between 1/1/2009 and 12/31/2015 and studies were interpreted using SRUCC. Percentage ICA stenosis was determined using North American Symptomatic Carotid Endarterectomy Trial (NASCET) methodology. Receiver operating characteristic analysis evaluated the performance of SRUCC parameters compared with angiography. Of 448 ICA sides (from 224 patients), 299 ICA sides (from 167 patients) were included. Agreement between duplex ultrasound and angiography was moderate (κ = 0.42), with overestimation of degree of stenosis for both moderate (50–69%) and severe (⩾ 70%) ICA lesions. The primary SRUCC parameter for ⩾ 50% ICA stenosis of peak-systolic velocity (PSV) of ⩾ 125 cm/sec did not meet prespecified thresholds for adequate sensitivity, specificity, and accuracy (sensitivity 97.8%, specificity 64.2%, accuracy 74.5%). Test performance was improved by raising the PSV threshold to ⩾ 180 cm/sec (sensitivity 93.3%, specificity 81.6%, accuracy 85.2%) or by adding the additional parameter of ICA/common carotid artery (CCA) PSV ratio ⩾ 2.0 (sensitivity 94.3%, specificity 84.3%, accuracy 87.4%). For ⩾ 70% ICA stenosis, analysis was limited by a low number of cases with angiographically severe disease. Interpretation of carotid duplex examinations using SRUCC resulted in significant overestimation of severity of ICA stenosis when compared with angiography; raising the PSV threshold for ⩾ 50% ICA stenosis to ⩾ 180 cm/sec as a single parameter or requiring the ICA/CCA PSV ratio ⩾ 2.0 in addition to PSV of ⩾ 125 cm/sec for laboratories using the SRUCC is recommended to improve the accuracy of carotid duplex examinations.

Hybrid Repair of a Common Carotid Pseudoaneurysm and Concomitant Internal Carotid Stenosis With Retrograde Stenting and Carotid Endarterectomy

2021 ◽  
pp. 153857442199293
Author(s):  
Constantinos Zarmakoupis ◽  
George Galyfos ◽  
Grigorios Tsoukalos ◽  
Panagiota Dalla ◽  
Alexandra Triantafyllou ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Common Carotid Artery ◽  
Rare Case ◽  
Internal Carotid ◽  
Covered Stent ◽  
Hybrid Technique ◽  
Hybrid Repair ◽  
Ica Stenosis

This report aims to present a rare case of a common carotid artery (CCA) pseudoaneurysm with a concomitant internal carotid artery (ICA) stenosis that were treated with a hybrid technique. This strategy included the retrograde placement of a CCA covered stent under ICA clamping followed by standardized carotid endarterectomy. The technique will be discussed and compared with other possible treatments.

scholarly journals Ocular Image and Haemodynamic Features Associated with Different Gradings of Ipsilateral Internal Carotid Artery Stenosis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Hui Wang ◽  
Hongyang Li ◽  
Xiaojie Zhang ◽  
Lanyan Qiu ◽  
Zhenchang Wang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Layer Thickness ◽  
Internal Carotid ◽  
Peak Systolic Velocity ◽  
Central Retinal Artery ◽  
Chinese Patients ◽  
Retinal Layer ◽  
Retinal Artery ◽  
Ica Stenosis

Objectives. To analyse the changes of ocular haemodynamics and morphology in Chinese patients with internal carotid artery (ICA) stenosis in the current study. Methods. A retrospective case-control study was conducted with 219 patients. The haemodynamic characteristics, the calibre of retinal vessels, and the subfoveal choroidal thickness (SFChT) were compared. We analysed the correlations with the degree of ipsilateral ICA stenosis. Results. There were no significant differences among the groups in the central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and AVR (p=0.073, p=0.188, and p=0.738, resp.). The peak systolic velocity (PSV) and end diastolic velocity (EDV) in the central retinal artery (CRA) and the posterior ciliary artery (PCA) were significantly lower than normal eyes (p<0.001). The outer retinal layer thickness and SFChT values of the ICA stenosis groups were significantly lower than normal eyes (p=0.030 and p<0.001, resp.). Conclusion. The PSV and EDV in CRA and PCA and the SFChT and outer retinal layer thickness of ICA eyes were significantly lower than normal eyes. ICA stenosis may impact choroidal haemodynamics, and decreased choroidal circulation might affect the discordance of the SFChT and the outer retinal layer thickness.

scholarly journals Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Betül İlkay Sezgin Akçay ◽  
Esra Kardeş ◽  
Sultan Maçin ◽  
Cihan Ünlü ◽  
Engin Bilge Özgürhan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
The Mean ◽  
Group 2 ◽  
Ica Stenosis ◽  
Group 1

Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population.Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique.Results. The mean age of the patients was71.9±10.8years. The mean percentage of ICA stenosis was74±4.9% in Group 1 and47.5±7.7% in Group 2. The mean SFCT was231.9±44.6 μm in Group 1 and216.2±46.8 μm in Group 2, which was significantly lower (P=0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r=0896,P=0.001).Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%.

scholarly journals Retriever wire supported carotid artery revascularization (ReWiSed CARe) in acute ischemic stroke with underlying tandem occlusion caused by an internal carotid artery dissection: Technical note

2017 ◽  
Vol 23 (3) ◽  
pp. 289-292 ◽  
Author(s):  
Daniel Behme ◽  
Michael Knauth ◽  
Marios-Nikos Psychogios
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Technical Note ◽  
Stent Retriever ◽  
Artery Dissection ◽  
Technical Approach ◽  
Tandem Occlusion ◽  
Ica Stenosis

We hereby report a novel technical approach for the treatment of acute stroke with underlying tandem occlusion. The so-called retriever wire supported carotid artery revascularization (ReWiSed CARe) technique, utilizing the wire of a stent-retriever as a guiding wire for carotid artery stenting, is technically feasible in tandem occlusions caused by an internal carotid artery (ICA) dissection or high grade ICA stenosis. This technique eliminates the need to use a long microwire in order to maintain the position inside the true lumen of a dissection. Additionally, it leads to anterograde perfusion through the released stent-retriever during the time of ICA stenting, which is favorable in all tandem occlusion cases.

High Spatial Inhomogeneity in the Intima-Media Thickness of the Common Carotid Artery is Associated with a Larger Degree of Stenosis in the Internal Carotid Artery: The PARISK Study

2016 ◽  
Vol 38 (05) ◽  
pp. 523-529 ◽  
Author(s):  
Jeire Steinbuch ◽  
Anouk van Dijk ◽  
Floris Schreuder ◽  
Martine Truijman ◽  
Alexandra de Rotte ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
Common Risk Factors ◽  
The Common ◽  
Ica Stenosis

Abstract Purpose Inhomogeneity of arterial wall thickness may be indicative of distal plaques. This study investigates the intra-subject association between relative spatial intima-media thickness (IMT) inhomogeneity of the common carotid artery (CCA) and the degree of stenosis of plaques in the internal carotid artery (ICA). Materials and Methods We included 240 patients with a recent ischemic stroke or transient ischemic attack and mild-to-moderate stenosis in the ipsilateral ICA. IMT inhomogeneity was extracted from B-mode ultrasound recordings. The degree of ICA stenosis was assessed on CT angiography according to the European Carotid Surgery Trial method. Patients were divided into groups with a low (≤ 2 %) and a high (> 2 %) IMT inhomogeneity scaled with respect to the local end-diastolic diameter. Results 182 patients had suitable CT and ultrasound measurements. Relative CCA-IMT inhomogeneity was similar for the symptomatic and asymptomatic side (difference: 0.02 %, p = 0.85). High relative IMT inhomogeneity was associated with a larger IMT (difference: 235 µm, p < 0.001) and larger degree of ICA stenosis (difference: 5 %, p = 0.023) which remained significant (p = 0.016) after adjustment for common risk factors. Conclusion Regardless of common risk factors, high relative CCA-IMT inhomogeneity is associated with a greater degree of ICA stenosis and is therefore indicative of atherosclerotic disease. The predictive value of CCA-IMT inhomogeneity for plaque progression and recurrence of cerebrovascular symptoms will be determined in the follow-up phase of PARISK.

scholarly journals RNF213 c.14576G>A Is Associated with Intracranial Internal Carotid Artery Saccular Aneurysms

Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1468
Author(s):  
Yasuo Murai ◽  
Eitaro Ishisaka ◽  
Atsushi Watanabe ◽  
Tetsuro Sekine ◽  
Kazutaka Shirokane ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Vascular Diseases ◽  
History Of ◽  
Ica Stenosis ◽  
The Relationship ◽  
Selection Of

A mutation in RNF213 (c.14576G>A), a gene associated with moyamoya disease (>80%), plays a role in terminal internal carotid artery (ICA) stenosis (>15%) (ICS). Studies on RNF213 and cerebral aneurysms (AN), which did not focus on the site of origin or morphology, could not elucidate the relationship between the two. However, a report suggested a relationship between RNF213 and AN in French-Canadians. Here, we investigated the relationship between ICA saccular aneurysm (ICA-AN) and RNF213. We analyzed RNF213 expression in subjects with ICA-AN and atherosclerotic ICS. Cases with a family history of moyamoya disease were excluded. AN smaller than 4 mm were confirmed as AN only by surgical or angiographic findings. RNF213 was detected in 12.2% of patients with ICA-AN and 13.6% of patients with ICS; patients with ICA-AN and ICS had a similar risk of RNF213 mutation expression (odds ratio, 0.884; 95% confidence interval, 0.199–3.91; p = 0.871). The relationship between ICA-AN and RNF213 (c.14576G>A) was not correlated with the location of the ICA and bifurcation, presence of rupture, or multiplicity. When the etiology and location of AN were more restricted, the incidence of RNF213 mutations in ICA-AN was higher than that reported in previous studies. Our results suggest that strict maternal vessel selection and pathological selection of AN morphology may reveal an association between genetic mutations and ICA-AN development. The results of this study may form a basis for further research on systemic vascular diseases, in which the RNF213 (c.14576G>A) mutation has been implicated.

scholarly journals Different causes and diverse outcomes of extremely rare septic cavernous sinus thrombosis complicated with internal carotid artery stenosis

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Bo-An Chen ◽  
Zhuo-Hao Liu ◽  
Chi-Cheng Chuang ◽  
Cheng-Chi Lee
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Fungal Infection ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Sinus Thrombosis ◽  
Surgical Debridement ◽  
Neurological Deficits ◽  
Special Cases ◽  
Ica Stenosis

Abstract Background Cases of acute sphenoid sinusitis complicated by septic cavernous sinus (CS) thrombosis and internal carotid artery (ICA) stenosis are rarely reported. Different causative pathogens have been reported for this condition. We present two extremely rare and special cases with diverse clinical presentations and outcomes. Case 1 involved a female patient with less extensive sinusitis, but critical ICA occlusion. Case 2 involved a male patient with extensive pansinusitis, meningitis, cerebritis, and vasculitis due to fungal infection, but less stenosis of the ICA lumen. Both patients underwent surgical debridement and received broad-spectrum antibiotics. Additional anti-fungal medication was also administered in Case 2. However, outcomes differed considerably between cases. Discussion Case 1 recovered with minimal neurological deficits and had Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) scores of 5 and 2, respectively; however, the Case 2 had GOS and mRS scores of 3 and 4, respectively. Although rare, septic CS thrombosis with ICA stenosis can lead to unexpected and severe neurological sequelae. Fungal infection can result in catastrophic complications and poorer prognosis. Conclusion In addition to early detection, aggressive surgical debridement and adequate antimicrobial treatment are crucial to satisfactory outcomes in patients with septic CS thrombosis complicated with ICA stenosis.

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