A Comparative Study of Carotid Magnetic Resonance Plaque Imaging in Predicting the Early Progression of Acute Anterior Circulation Mild Stroke

2021 ◽  
Vol 11 (6) ◽  
pp. 1113-1119
Author(s):  
Bo Wei ◽  
Yiqin Xu ◽  
Xiaohong Gui ◽  
Chenglong Wu ◽  
Liping Wang
Keyword(s):  
Carotid Arteries ◽  
Plaque Imaging ◽  
Plaque Composition ◽  
Anterior Circulation ◽  
Progressive Group ◽  
Bilateral Carotid ◽  
Early Progression ◽  
Before And After ◽  
3.0 T ◽  
Mild Stroke

To analyze the biological properties of carotid lumen stenosis and plaque before and after bifurcation of the bilateral carotid arteries in patients with acute anterior circulation mild stroke (AACMS) by 3.0 T high-resolution magnetic resonance imaging (HR-MRI) with the aim to clarify the predictive effect of 3.0 T HR-MRI on early progression and poor prognosis in patients with AACMS. Random division of 96 patients with AACMS into a stroke progression group and a non-progression group. The bilateral cervical vessels of the patients were detected by HR-MRI. The degree of carotid artery stenosis before and after bilateral carotid bifurcation was evaluated using a vascular plaque imaging diagnostic system. There were significant differences in the maximum and average wall standardization index, maximum wall thickness, maximum wall area, plaque composition, proportion of plaque fibrous cap rupture, and proportion of VI complex plaques in the progressive group. There was no significant difference in the related indexes of bilateral vessels in the non-progressive group (P >0.05). There are significant differences in MRI morphological characteristics of bilateral carotid plaques in patients with AACMS progression. Through a comparative analysis of the plaque load and plaque composition of bilateral carotid arteries using 3.0 T HR-MRI in patients with early-stage AACMS, the type and stability of complex plaques can be identified, which serve as prognostic factors in predicting the early progression of stroke and guiding clinical treatment.

scholarly journals Plasma Exosomal miRNA Levels after Radiotherapy Are Associated with Early Progression and Metastasis of Cervical Cancer: A Pilot Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2110
Author(s):  
Oyeon Cho ◽  
Do-Wan Kim ◽  
Jae-Youn Cheong
Keyword(s):  
Cervical Cancer ◽  
Pilot Study ◽  
Biological Functions ◽  
Patients With Cancer ◽  
Initial Stage ◽  
Exosomal Mirnas ◽  
Early Progression ◽  
Before And After ◽  
Microenvironmental Factors ◽  
Exosomal Mirna

Plasma exosomal miRNAs are key regulators of cell-cell interactions associated with several biological functions in patients with cancer. This pilot study aimed to investigate the log2 fold change (log2FC) of the expression of exosomal miRNAs and related mRNAs in the blood of patients with cervical cancer to identify prognostic markers better than those currently available. We sequenced plasma exosomal RNA from 56 blood samples collected from 28 patients with cervical cancer, who had been treated with concurrent chemoradiotherapy (CCRT). Changes in the expression of miRNAs and mRNAs before and after CCRT were represented as log2FC. Their biological functions were studied by miRNA-mRNA network analysis, using ingenuity pathway analysis, after the selection of two groups of miRNAs, each associated with early progression (EP) and metastasis, also described as initial stage. Seven patients experienced EP, three of whom died within four months after progression. Reduced levels of miR-1228-5p, miR-33a-5p, miR-3200-3p, and miR-6815-5p and increased levels of miR-146a-3p in patients with EP revealed unresolved inflammation, with accompanying increased expression of PCK1 and decreased expression of FCGR1A. Increased levels of miR-605-5p, miR-6791-5p, miR-6780a-5p, and miR-6826-5p and decreased levels of miR-16-1-3p (or 15a-3p) were associated with the degree of metastasis and led to the systemic activation of myeloid, endothelial, and epithelial cells, as well as neurons, phagocytes, and platelets. Log2FCs in the expression of miRNAs and mRNAs from plasma exosomes after CCRT are associated with EP and metastasis, reflecting unresolved inflammation and systemic microenvironmental factors, respectively. However, this study, supported by preliminary data insufficient to reach clear conclusions, should be verified in larger prospective cohorts.

Atorvastatin and Thrombogenicity of the Carotid Atherosclerotic Plaque: the ATROCAP Study

2002 ◽  
Vol 88 (07) ◽  
pp. 41-47 ◽  
Author(s):  
Elisabetta Cofrancesco ◽  
Eloisa Arbustini ◽  
Francesca Rossi ◽  
Andrea Negri ◽  
Elena Tremoli ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Atorvastatin Treatment ◽  
Beneficial Effects ◽  
Fibrous Cap ◽  
Cerebrovascular Events ◽  
Bilateral Carotid ◽  
Before And After ◽  
Tissue Factor Pathway ◽  
Immunohistochemical Analyses ◽  
Human Carotid

SummaryStatins appear to have beneficial effects on fibrous cap stabilisation but their effects on plaque thrombogenicity have not been reported. To evaluate the thrombogenicity of human carotid plaques before and after atorvastatin treatment, 59 patients with bilateral carotid stenosis eligible for two-step carotid endoarterectomy (CEA) were randomly assigned to atorvastatin, 20 mg/day, or placebo. Histological and immunohistochemical analyses, Tissue Factor (TF), Tissue Factor Pathway Inhibitor (TFPI) antigens (Ag) and TF activity were determined in endoarterectomy specimens obtained at baseline and after treatment. Mean TFAg and TFPIAg levels from plaques removed at the first CEA were 55 ± 56 and 32 ± 26 pg/mg. After placebo, TFAg and TFPIAg content was higher in the second than the first CEA. Plaques removed at the second CEA from atorvastatin-treated patients had a lower macrophage content than plaques at the first CEA. TFAg and TFPIAg levels, and TF activity in plaques after atorvastatin treatment were lower (respectively 29, 18% and 56%) than after placebo. These findings indicate that atorvastatin reduce the inflammatory/thrombotic phenotype of carotid plaque, suggesting that these drugs may indeed have a beneficial effect on cerebrovascular events.We are indebted to Pfizer Italia for providing atorvastatin, 20 mg, and placebo.

Central and peripheral chemoreceptor inputs to phrenic and hypoglossal motoneurons

1982 ◽  
Vol 53 (6) ◽  
pp. 1504-1511 ◽  
Author(s):  
E. N. Bruce ◽  
J. Mitra ◽  
N. S. Cherniack
Keyword(s):  
Opposite Effect ◽  
Carotid Sinus ◽  
Ventral Surface ◽  
Carotid Sinus Nerve ◽  
Peripheral Chemoreceptor ◽  
Hypoglossal Motoneurons ◽  
Nerve Response ◽  
Bilateral Carotid ◽  
Hypoglossal Motoneuron ◽  
Before And After

We tested the hypothesis that phrenic and hypoglossal responses to progressive hypercapnia differ qualitatively because the CO2-related drive inputs to their respective motoneuron pools are different. The relative contributions of carotid sinus and central chemoreceptor inputs to hypoglossal and phrenic responses during hyperoxic hypercapnia were determined by comparing the two nerve activities during rebreathing runs done either before and after bilateral carotid sinus nerve (CSN) section, or without and with cooling of the intermediate, I(s), area on the ventral surface of the medulla. The studies were performed on chloralose-anesthetized, vagotomized, paralyzed cats. Cooling of the I(s) area impaired phrenic responsiveness to hypercapnia more than hypoglossal responsiveness, whereas CSN section had the opposite effect. Thus phrenic nerve response was more dependent on central chemoreceptor input than was the hypoglossal response, but hypoglossal response was more dependent on carotid sinus chemoreceptor input. We conclude that the phrenic and hypoglossal motoneuron pools each receive a different functional input from both the medullary and the carotid sinus chemoreceptors.

scholarly journals Variations in the Presence of Carotid Intraplaque Hemorrhage Across Age Categories: What Age Groups Are Most Likely to Benefit From Plaque Imaging?

2020 ◽  
Vol 11 ◽  
Author(s):  
Anthony S. Larson ◽  
John C. Benson ◽  
Waleed Brinjikji ◽  
Luis Savastano ◽  
Giuseppe Lanzino ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Age Groups ◽  
Intraplaque Hemorrhage ◽  
Plaque Imaging ◽  
Anterior Circulation ◽  
The Mean ◽  
Artery Disease ◽  
Cerebral Ischemic ◽  
Ischemic Events

Although carotid artery intraplaque hemorrhage (IPH) is a known risk-factor for cerebral ischemic events in patients of advanced age, its prevalence in younger cohorts is less certain. The purpose of this study was to assess the prevalence of carotid artery IPH across the age spectrum. A retrospective review was completed of all adult patients from our institution who underwent neck MRA with high-resolution carotid plaque imaging between 2017 and 2020. The mean ages of patients with and without IPH were calculated. The prevalence of IPH was compared between patients that were categorized into age groups. Patients with and without a cerebral ischemic event (e.g., stroke, retinal ischemia) were included. Unilateral anterior circulation ischemic events in patients without atrial fibrillation were presumed to be likely related to ipsilateral carotid artery disease. Multiple regression analysis was performed to determine independent associations with IPH. 634 patients were included (1,268 carotid arteries). Increasing age (OR: 1.04; 95% CI: 1.02–1.06; P = 0.001) was independently associated with IPH. 211 patients had unilateral anterior circulation ischemic events. The mean age of patients with carotid IPH was 71.4 years (SD = 9.9), compared to 62.8 years (SD = 15.8) of those without (P ≤ 0.0001). The prevalence of IPH increased with age in all patients (P = 0.0002). Among patients with ipsilateral anterior circulation ischemic events, each age category above 50 years had a significantly higher prevalence of IPH when compared to patients 18–50 years (P ≤ 0.05 for all comparisons). The prevalence of carotid IPH increases with age and is rare in patients under 50 years. The approximate threshold age for IPH development is likely around 50 years.

Role of the descending pressor pathway in the conscious and pentobarbital-anesthetized dog

1978 ◽  
Vol 234 (2) ◽  
pp. H152-H156
Author(s):  
G. S. Geis ◽  
G. Barratt ◽  
R. D. Wurster
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular Control ◽  
Conscious Dogs ◽  
Cardiovascular Parameters ◽  
Bilateral Carotid ◽  
Before And After ◽  
Anesthetized Dogs ◽  
Conscious Animals

Resting cardiovascular parameters and the responses to bilateral carotid occlusions (BCO) were monitored in pentobarbital-anesthetized and conscious dogs before and after placing lesions in the dorsolateral funiculi at C7-C8 and after spinal transections at C7. Pre- and postlesion blood pressure (BP) and heart rate (HR) responses to exercise were also monitored. The lesions significantly attenuated the responses to BCO and decreased resting BP in anesthetized dogs. Yet neither resting HR in anesthetized or conscious dogs nor the resting BP in conscious dogs was affected by the lesions. Subsequent spinal transections significantly decreased resting HR and BP and the responses to BCO but did not affect the BP response to BCO in anesthetized dogs as compared with corresponding postlesion parameters. BP responses to exercise were significantly attenuated by the lesions, but HR responses were not affected. Since stimulation and BP studies indicated that the descending pressor pathway had been ablated, the data suggest that the pathway mediates BP and HR responses to BCO in pentobarbital-anesthetized and conscious dogs. It does not maintain resting HR in anesthetized or conscious animals, and the resting BP in conscious dogs. This pathway is important for BP responses to exercise but is not necessary for HR responses. Finally, other spinal pathways are involved in cardiovascular control.

Bilateral Carotid Siphon Involvement in Giant Cell Arteritis

Neurosurgery ◽  
1986 ◽  
Vol 18 (6) ◽  
pp. 773-776 ◽  
Author(s):  
Frederick M. Vincent ◽  
Tish Vincent
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
High Dose ◽  
Ischemic Optic Neuropathy ◽  
Vascular Changes ◽  
Bilateral Carotid ◽  
Internal Carotid Arteries ◽  
Bilateral Carotid Artery

Abstract A 60-year-old woman with inadequately treated giant cell arteritis developed an acute unilateral ischemic optic neuropathy associated with bilateral carotid artery and orbital bruits. Angiography demonstrated vascular changes compatible with arteritis localized to the cavernous and petrous segments of both internal carotid arteries. After treatment with high dose steroids, the bruits disappeared.

scholarly journals Posterior cerebral artery stenosis and posterior circulation revascularization surgery in pediatric patients with moyamoya disease

2018 ◽  
Vol 21 (6) ◽  
pp. 632-638 ◽  
Author(s):  
Tomomi Kimiwada ◽  
Toshiaki Hayashi ◽  
Reizo Shirane ◽  
Teiji Tominaga
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Pediatric Patients ◽  
Posterior Cerebral Artery ◽  
Posterior Circulation ◽  
Initial Diagnosis ◽  
Occipital Artery ◽  
Anterior Circulation ◽  
Before And After ◽  
Revascularization Surgery

OBJECTIVESome pediatric patients with moyamoya disease (MMD) present with posterior cerebral artery (PCA) stenosis before and after anterior circulation revascularization surgery and require posterior circulation revascularization surgery. This study evaluated the factors associated with PCA stenosis and assessed the efficacy of posterior circulation revascularization surgery, including occipital artery (OA)–PCA bypass, in pediatric patients with MMD.METHODSThe presence of PCA stenosis before and after anterior circulation revascularization surgery and its clinical characteristics were investigated in 62 pediatric patients (< 16 years of age) with MMD.RESULTSTwenty-three pediatric patients (37%) with MMD presented with PCA stenosis at the time of the initial diagnosis. A strong correlation between the presence of infarction and PCA stenosis before anterior revascularization was observed (p < 0.001). In addition, progressive PCA stenosis was observed in 12 patients (19.4%) after anterior revascularization. The presence of infarction and a younger age at the time of initial diagnosis were risk factors for progressive PCA stenosis after anterior revascularization (p < 0.001 and p = 0.002, respectively). Posterior circulation revascularization surgery, including OA-PCA bypass, was performed in 9 of the 12 patients with progressive PCA stenosis, all of whom showed symptomatic and/or radiological improvement.CONCLUSIONSPCA stenosis is an important clinical factor related to poor prognosis in pediatric MMD. One should be aware of the possibility of progressive PCA stenosis during the postoperative follow-up period and consider performing posterior circulation revascularization surgery.

scholarly journals Antegrade transapical branch deployment for endovascular aortic-arch repair by in situ fenestration

2019 ◽  
Author(s):  
Takashi Murakami ◽  
Noriaki Kishimoto ◽  
Etsuji Sohgawa ◽  
Toshihiko Shibata
Keyword(s):  
Aortic Arch ◽  
Carotid Arteries ◽  
Stent Grafts ◽  
Descending Aorta ◽  
Bilateral Carotid ◽  
Aortic Arch Repair ◽  
Sheath Insertion ◽  
Arch Aneurysm ◽  
Transapical Access

Abstract A 76-year-old man presented with an aortic arch aneurysm and was considered a candidate for endovascular aortic arch repair by in situ fenestration. Alternative access routes were explored because of atherosclerotic disease of the descending aorta and bilateral carotid arteries. Transapical deployment of both an aortic and a branched stent grafts was successfully conducted without cerebral complications. The transapical access might have the potential to reduce the risks of complications related to large bore-sheath insertion to the carotid arteries.

scholarly journals Morphologic and Haemodynamic Changes after Stent Placement for Experimental Carotid Aneurysm

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 153-154 ◽  
Author(s):  
H. Tenjin
Keyword(s):  
Blood Flow ◽  
Digital Subtraction Angiography ◽  
Stent Placement ◽  
Carotid Arteries ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Thin Slices ◽  
Before And After ◽  
Haemodynamic Changes ◽  
Plastic Resin

We investigated and compared the morphologic and haemodynamic changes between before and after stent placement when several different kinds of stents were applied to experimental aneurysms. Experimental aneurysms in eight pig carotid arteries were used. Stents were placed covering the aneurysm orifice. Five Cordis stents (coil stent), two GFXs (multilink stent), and one Multilink (tube stent) were used in this study. After stent placement, the arteries were perfused with 70% ethanol, the specimens were embedded in polyester plastic resin and thin slices were stained with hemtoxilin-eosin. Blood flow in the aneurysm was measured using digital subtraction angiography. The parent artery was stretched in multilink stent (GFX) cases, and was most markedly stretched by use of the tube stent (Multilink). Stent placement with any type of stent decreased intra-aneurysmal blood flow.

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