Abstract TMP37: The Biomakers Expression Following Reperfusion After Carotid Artery Stenting

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fuqiang Guo

Objective: This study was to demonstrate the biomarkers (NSE,MMP9,S100B,HO-1,CO) in serum for their correlation with reperfusion after carotid artery stenting (CAS). Methods: In this study, a total of 44 patients who were diagnosed with carotid artery stenosis (symptomatic/ asymptomatic stenosis≥70%) by Digital Subtraction Angiography (DSA) and underwent CAS successfully, were selected as the operation groups. The patients’ blood samples were collected at three different time points: T1, prior to operation; T2, next morning after operation (24 hours); T3, three days after operation (72 hours); The second group of 30 patients, who were excluded for carotid artery stenosis by DSA, were assigned to be the control group; Blood samples of these patients were collected at T1. The concentrations of NSE, S100B, MMP9, HO-1 and CO in serum from patients of both groups were detected by ELISA. Results: (1) There was no significant difference between the control group and the operation group at T1 (P>0.05) on their concentrations of NSE, S100B, MMP9, HO-1 and CO in the serum. (2) All of the operations were implanted in stents successfully without complications and the reperfusion improved after CAS. The concentrations of NSE, S100B, MMP9 and CO in the serum decreased gradually.(T1: 378.53±187.74MU/ml, 20.04±9.27ng/ml, 3.28±1.62ng/ml, 2.21±1.98umol/l respectively; T2: 302.65±160.46MU/ml, 16.45±8.95ng/ml, 2.81±1.63ng/ml, 1.49±1.10umol/l respectively, T1 vs T2: P<0.01; T3: 280.60±159.22MU/ml, 12.62±8.32ng/ml, 2.59±1.55ng/ml, 1.22±1.04umol/l respectively,T1 vs T3: P<0.01). (3) The serum concentrations of HO-1 in the T2 increased when compared with T1 (P<0.05) and obviously increased in the T3 when compared with T1 (P<0.01). Conclusions: We concluded that the concentrations of NSE, S100B, MMP9 and CO in serum decreased with the improvement of cerebral reperfusion after CAS. NSE, S100B, MMP9 and CO can be used as biomarkers to evaluate the improvement of reperfusion after CAS. What’s more, the changes of HO-1 after CAS may be associated with hyper-perfusion syndrome. Key words: NSE; S100B; MMP9; CO; HO-1;reperfusion; carotid artery stenting

2019 ◽  
Vol 16 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Xiaofan Yuan ◽  
Jianhong Wang ◽  
Duozi Wang ◽  
Shu Yang ◽  
Nengwei Yu ◽  
...  

Objective: Previous studies have shown that the neuron-specific- enolase (NSE), S100B protein (S100B) and matrix metalloproteinase-9 (MMP9) are specific markers for studying cerebral injury. This study was aimed to demonstrate these biomarkers for their correlation with reperfusion after carotid artery stenting (CAS). Methods: In this study, a total of 44 patients who were diagnosed unilateral carotid artery stenosis by digital subtraction angiography (DSA) and underwent CAS, were selected as the operation groups. The patients' blood samples were collected at three different time points: T1, prior to operation; T2, next morning after operation (24 hours); T3, three days after operation (72 hours); All of the patients with the operation received computed tomography perfusion (CTP) at T1 and T3. The second group of 12 patients, who were excluded for carotid artery stenosis by DSA, were assigned to be the control group; Blood samples of these patients were collected at T1. The concentrations of NSE, S100B and MMP9 in serum from patients of both groups were detected by ELISA. Results: All of the operations were implanted in stents successfully without complications. (1) After CAS, rCBF increased while rMTT and rTTP decreased. (2) The concentrations of NSE, S100B and MMP9 in the serum decreased gradually (T1>T2>T3). There was no significant difference between the control group and the operation group at T1 (P>0.05) on their concentrations of NSE, S100B and MMP9 in the serum. When compared among the operation groups, the concentrations of NSE, S100B and MMP9 in the serum at T1 and T3 showed significant difference (P < 0.05). (3) Correlation analysis among the operation groups indicated that NSE, S100B, MMP9 and rCBF were positively correlated before operation (r = 0.69, 0.58 and 0.72, respectively, P < 0.05), as well as after operation (r = 0.75, 0.65 and 0.60, respectively, P < 0.05). Conclusion: We concluded that the concentrations of NSE, S100B and MMP9 in serum decreased with the improvement of cerebral reperfusion after CAS. NSE, S100B and MMP9 can be used as laboratory biochemical markers to evaluate the improvement of reperfusion after CAS. The results very well complement the imaging methods, such as CTP.


Neurosurgery ◽  
2009 ◽  
Vol 65 (2) ◽  
pp. 325-330 ◽  
Author(s):  
John G. Gaudet ◽  
Philip M. Meyers ◽  
James F. McKinsey ◽  
Sean D. Lavine ◽  
William Gray ◽  
...  

Abstract OBJECTIVE Approximately 25% of patients with carotid artery stenosis treated with carotid endarterectomy develop cognitive dysfunction (CD) between 1 day and 1 month after surgery compared with a control group. We hypothesized that patients with carotid artery stenosis treated with carotid artery stenting (CAS) performed under cerebral embolic protection also develop CD at similar time points compared with a control group. METHODS Twenty-four patients scheduled for elective CAS were enrolled in a prospective institutional review board–approved study to evaluate cognitive function with a battery of 6 neuropsychometric tests before, and 1 day and 1 month after, CAS. Test performance was compared with 23 patients undergoing coronary artery procedures (control group). The mean and standard deviation of the difference scores in the control group were used to generate Z scores. We used a previously described point system to transform negative Z scores into injury points for each neuropsychometric test. Global performance is presented as average deficit score (sum of injury points divided by the number of completed tests). All patients underwent the procedures with mild sedation. Results were analyzed in 2 ways: group-rate and event-rate analysis. Outcome was dichotomized by defining moderate to severe CD as average deficit score at least 1.5 standard deviations worse than the control group. Fisher tests and multivariate logistic regression models were used to analyze group performance. RESULTS Control patients tended to be younger and had a lower incidence of stroke or previous transient ischemic attack. One day after surgery, 41% of patients (10 of 24) treated with CAS developed moderate to severe CD (P = 0.0422). Average deficit score was also significantly higher in the CAS group at 1 day (P = 0.0265). These differences were independent of age and history of stroke/transient ischemic attack. Interestingly, we found that the absence of oral statin medication may increase the probability of CD. By 1 month, 9% of patients (1 of 11) treated with CAS presented with CD. Other patients were lost to follow-up. CONCLUSION CAS is associated with a decline in cognitive performance that is at least moderate 1 day after surgery.


2020 ◽  
Vol 5 (3) ◽  
pp. 1-6
Author(s):  
Noemi Cifani ◽  

Background: The aim of this study was to evaluate miRNA-33 and miRNA-155 expression in Peripheral Blood Mononuclear Cells (PBMC) and carotid specimens of patients affected by Critical Carotid Artery Stenosis (CAS). Material and Methods: We selected 17 asymptomatic (CAS-A group) and 10 symptomatic (CAS-S group) patients with CAS. Ten patients with traditional cardiovascular risk factors (RF group), matched for age and sex, were used as control group. Results: A significant increase in miRNA-33 expression was observed both in peripheral blood and in carotid specimens of CAS-A patients (p 0.04) in comparison with CAS-S and RF, whereas no significant difference were found among the groups regarding miRNA-155 expression both in peripheral blood and in carotid specimens. Conclusions: This is to our knowledge the first report on miRNAs expression in human PBMCs from CAS patients. Results of this study suggest that miRNA-33 in involved in the process underling plaque formation and growth, but not in plaque instability and ischemic brain damage, whereas miRNA-155 is expressed during all the phases of atherosclerotic disease.


2019 ◽  
Author(s):  
Xiaofan Yuan ◽  
Shu Yang ◽  
Duozi Wang ◽  
Lei Guo ◽  
Jianhong Wang ◽  
...  

Abstract In this study we monitored the concentration change of the cerebral biomarkers Glial fibrillary acidic protein (GFAP) and S100B Protein (S100B) in serum of the patients, who were performed with carotid artery stenosis before and after carotid artery stent implantation. In total, thirty patients with unilateral carotid stenosis who underwent carotid artery stenting and had no complications were enrolled in the carotid artery stenting (CAS) group. The blood samples of operation patients were collected on three different time points: T1: the day before operation; T2: one day after operation (24 hours); T3, three days after operation (72 hours). Thirty patients who were excluded for carotid artery stenosis by Digital Subtraction Angiography (DSA) were selected as the control group. The blood samples of patients in control group were collected at D1 (before DSA) and D2 (24 hours after DSA). The concentrations of GFAP and S100B in serum from patients of both groups were measured with ELISA. The results showed that the serum concentrations of GFAP and S100B in control group did not change significantly before and after DSA (P>0.05); while the serum concentrations of GFAP and S100B was higher in the CAS group before operation than those in DSA group(P<0.05). In the operation group, GFAP and S100B increased significantly on the first day after operation (T2) and decreased gradually on the third day after operation (T3) but increased compared with that before operation (T1) with statistical significance (P < 0.05). For patients with symptomatic stenosis before operation, the concentrations of GFAP and S100B in serum were higher than those in patients without symptomatic stenosis, and there was statistical difference between them (P < 0.05), but there was no statistical significance between them after operation (P > 0.05). So we confirm the cerebral biochemical markers GFAP and S100B have a certain change trend after CAS, which can be used as the cerebral biochemical markers in the pre-operative evaluation and post-operative efficacy in monitoring of carotid stent implantation.


2008 ◽  
Vol 29 (2) ◽  
pp. 265-268 ◽  
Author(s):  
A.S. Turk ◽  
I. Chaudry ◽  
V.M. Haughton ◽  
B.P. Hermann ◽  
H.A. Rowley ◽  
...  

Author(s):  
James Hu ◽  
◽  
Andy Sohn ◽  
Justin George ◽  
Rajesh Malik ◽  
...  

Carotid artery atherosclerotic disease impacts over 2 million Americans annually. Since the advent of the carotid endarterectomy by Debakey in 1953, the surgical management of carotid artery stenosis has prevented cerebrovascular accidents. The technology utilized to manage carotid artery stenosis continued to evolve with the utilization of carotid artery stenting in 1989 and more recently transcarotid artery revascularization (TCAR). This review discusses the modern management of carotid artery stenosis with an emphasis on transcarotid artery revascularization (TCAR) and reversal of flow for reversal of flow for embolic protection.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Aditya Singh ◽  
Tom Stys ◽  
Valerie Bares ◽  
Jeffrey Wilson ◽  
Adam Stys

Introduction: Coronary artery calcium (CAC) has been found to be associated with coronary artery plaque burden and is a major predictor of coronary heart disease (CHD) events. The data on its role in predicting carotid artery stenosis (CAS) is limited. Methods: Participants age ≥ 18 years with heart screen done from Nov 2008- Feb 2019 were selected and were assessed for documented diagnosis of carotid artery stenosis after their heart screen. Only the most recent heart screen per person and earliest documented CAS was considered. The chi-squared test and Welch’s 2-sample t-test was used to test for significant association between CAS and the nominal variables and mean calcium score respectively. Results: A total of 35,084 patient were screened for CAC score and 1439 (4.1%), were recorded to have a diagnosis of carotid artery stenosis. 53.5% being females and mean age of 63.69±9.31 years. The mean time between heart screen and documented diagnosis of CAS was 1529.4 ± 1211.0 days. The presence of CAS was significantly higher in patients ≥ 60 years (8.5%) as compared to those age <60 years (2%). There was a significant difference in mean CAC score between those with CAS as compared to non- carotid stenosis group (324.2, vs 107.27, p<.0001). In patient with elevated CAC ≥ 100, 9.98% had diagnosis of CAS, as compared to 2.82% in patients with CAC <100, however among patients with diagnosis of CAS 46.6% had elevated CAC ≥ 100. Conclusions: The presence of carotid artery stenosis (CAS) was significantly associated with elevated coronary artery calcium score (≥100) and was significantly higher in patients with age ≥ 60 years, which in correct clinical context is helpful in suspecting CAS.


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