scholarly journals Carotid Plaque Characterization Using Digital Image Processing and its Potential in Future Studies of Carotid Endarterectomy and Angioplasty

1998 ◽  
Vol 5 (3) ◽  
pp. 240-246 ◽  
Author(s):  
Giorgio M. Biasi ◽  
Paolo M. Mingazzini ◽  
Lucia Baronio ◽  
Maria Rosa Piglionica ◽  
Stefano A. Ferrari ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Carotid Endarterectomy ◽  
Carotid Plaque ◽  
Screening Tool ◽  
Brain Infarction ◽  
Carotid Stent ◽  
Plaque Characterization ◽  
Duplex Scan ◽  
Future Studies ◽  
The Mean

Purpose: To corroborate the validity of a computerized methodology for evaluating carotid lesions at risk for stroke based on plaque echogenicity. Methods: The records of 96 carotid endarterectomy patients (59 men; median age 69.5 years, range 52 to 83) with stenoses > 50% were studied retrospectively. Forty-one patients (43%) had been symptomatic preoperatively. All patients had undergone computed tomography (CT) to detect infarction in the carotid territory and a duplex scan to measure carotid stenosis. Plaque echogenicity was analyzed by computer, expressing the echodensity in terms of the gray scale median (GSM). The incidence of CT-documented cerebral infarction was analyzed in relation to symptomatology, percent stenosis, and echodensity. Results: Symptoms correlated well with CT evidence of brain infarction: 32% of symptomatic patients had a positive CT scan versus 16% for asymptomatic plaques (p = 0.076). The mean GSM value was 56 ± 14 for plaques associated with negative CT scans and 38 ± 13 for plaques from patients with positive scans (p < 0.0001). However, there was no difference in the GSM value between plaques with > or < 70% stenosis. Furthermore, the incidence of CT infarction was 40% in the cerebral territory of carotid plaques with a GSM value < 50 and only 9% in those with a GSM > 50 (p < 0.001). Conclusions: Computerized analysis of plaque echogenicity appears to provide clinically useful data that correlates with the incidence of cerebral infarction and symptoms. This method of analyzing plaque echolucency could be used as a screening tool for carotid stent studies to identify high-risk lesions better suited to conventional surgical treatment.

Restenosis After Carotid Endarterectomy Performed With Routine Intraoperative Duplex Ultrasonography and Arterial Patch Closure: A Contemporary Series

2007 ◽  
Vol 41 (3) ◽  
pp. 200-205 ◽  
Author(s):  
Andres Schanzer ◽  
Andrew Hoel ◽  
Christopher D. Owens ◽  
Nicole Wake ◽  
Louis L. Nguyen ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Carotid Endarterectomy ◽  
Duplex Ultrasound ◽  
Duplex Ultrasonography ◽  
Routine Practice ◽  
Single Institution ◽  
Duplex Scan ◽  
Patch Closure ◽  
The Mean

The restenosis rates of 5% to 15% have been reported after carotid endarterectomy (CEA). We undertook this investigation to determine whether the routine practice of carotid artery patch closure and intraoperative completion duplex ultrasonography would result in lower rates of carotid restenosis after CEA. All consecutive carotid endarterectomies performed between 2000 and 2004 at a single institution were reviewed retrospectively. Patients underwent CEA using a longitudinal arteriotomy, followed by routine patching and intraoperative completion duplex ultrasonography. Only patients with at least one postoperative duplex scan performed at a minimum of 180 days after CEA were included. During the 5-year study period, 407 consecutive carotid endarterectomies were performed, with a combined 30-day stroke and mortality rate of 2.5%; 217 patients (53%) had one or more duplex ultrasound examinations performed at least 180 days after CEA. The mean follow-up duration was 692 days. Of the patients who underwent intraoperative intervention based on the results of the completion duplex study, none experienced restenosis, stroke, or death. CEA that is performed with routine patching and intraoperative duplex completion ultrasonography is a safe, durable operation with restenosis rates below those commonly reported.

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.

Association between obstructive sleep apnea and persistent-postural perceptual dizziness

2021 ◽  
pp. 1-6
Author(s):  
Anand K. Bery ◽  
Jayson Lee Azzi ◽  
Andre Le ◽  
Naomi S. Spitale ◽  
Judith Leech ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sensitivity And Specificity ◽  
Berlin Questionnaire ◽  
Future Studies ◽  
Obstructive Sleep ◽  
Chronic Dizziness ◽  
Patients At Risk ◽  
The Mean ◽  
The Relationship

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to vestibular dysfunction, but no prior studies have investigated the relationship between Persistent Postural Perceptual Dizziness (PPPD), a common cause of chronic dizziness, and OSA. OBJECTIVE AND METHODS: We determined the frequency of OSA in an uncontrolled group of PPPD patients from a tertiary dizziness clinic based on polysomnogram (PSG). We then assessed the sensitivity and specificity of common OSA questionnaires in this population. RESULTS: Twenty-five patients with PPPD underwent PSG (mean age 47, 60% female, mean BMI 29.5). A majority, or 56%, of patients were diagnosed with OSA, and in most, the OSA was severe. OSA patients were older (56 years versus 40 years, p = 0.0006) and had higher BMI (32 versus 26, p = 0.0078), but there was no clear gender bias (56% versus 64% female, p = 1.00). The mean sensitivity and specificity of the STOP BANG questionnaire for detecting OSA was 86% and 55%, respectively. Sensitivity and specificity of the Berlin Questionnaire was 79% and 45%, respectively. CONCLUSIONS: The prevalence of OSA was much higher in our small PPPD group than in the general population. Screening questionnaires appear to demonstrate good sensitivity to detect PPPD patients at risk of OSA in this small study. Future studies should confirm these findings and determine whether treatment of OSA improves symptoms in PPPD.

scholarly journals Preliminaryin vivoatherosclerotic carotid plaque characterization using the accumulated axial strain and relative lateral shift strain indices

2008 ◽  
Vol 53 (22) ◽  
pp. 6377-6394 ◽  
Author(s):  
Hairong Shi ◽  
Carol C Mitchell ◽  
Matthew McCormick ◽  
Mark A Kliewer ◽  
Robert J Dempsey ◽  
...  
Keyword(s):  
Carotid Plaque ◽  
Axial Strain ◽  
Lateral Shift ◽  
Plaque Characterization

scholarly journals Intravenous Administration of Human Amniotic Mesenchymal Stem Cells in the Subacute Phase of Cerebral Infarction in a Mouse Model Ameliorates Neurological Disturbance by Suppressing Blood Brain Barrier Disruption and Apoptosis via Immunomodulation

2021 ◽  
Vol 30 ◽  
pp. 096368972110241
Author(s):  
Yasunori Yoshida ◽  
Toshinori Takagi ◽  
Yoji Kuramoto ◽  
Kotaro Tatebayashi ◽  
Manabu Shirakawa ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Mouse Model ◽  
Cerebral Infarction ◽  
Blood Brain Barrier ◽  
Brain Infarction ◽  
Brain Barrier ◽  
Neurological Deficits ◽  
Immunomodulatory Effects ◽  
Amniotic Mesenchymal Stem Cells

Neuro-inflammation plays a key role in the pathophysiology of brain infarction. Cell therapy offers a novel therapeutic option due to its effect on immunomodulatory effects. Amniotic stem cells, in particular, show promise owing to their low immunogenicity, tumorigenicity, and easy availability from amniotic membranes discarded following birth. We have successfully isolated and expanded human amniotic mesenchymal stem cells (hAMSCs). Herein, we evaluated the therapeutic effect of hAMSCs on neurological deficits after brain infarction as well as their immunomodulatory effects in a mouse model in order to understand their mechanisms of action. One day after permanent occlusion of the middle cerebral artery (MCAO), hAMSCs were intravenously administered. RT-qPCR for TNFα, iNOS, MMP2, and MMP9, immunofluorescence staining for iNOS and CD11b/c, and a TUNEL assay were performed 8 days following MCAO. An Evans Blue assay and behavioral tests were performed 2 days and several months following MCAO, respectively. The results suggest that the neurological deficits caused by cerebral infarction are improved in dose-dependent manner by the administration of hAMSCs. The mechanism appears to be through a reduction in disruption of the blood brain barrier and apoptosis in the peri-infarct region through the suppression of pro-inflammatory cytokines and the M2-to-M1 phenotype shift.

scholarly journals Diurnal Body Temperature and Rate of Passage of Loggers in Lions

Animals ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1388
Author(s):  
Ted Friend ◽  
Giulia Corsini ◽  
Vincent Manero ◽  
Raffaella Cocco
Keyword(s):  
Body Temperature ◽  
Time Frame ◽  
Heat Lamp ◽  
Future Studies ◽  
Ambient Temperatures ◽  
Diurnal Patterns ◽  
Data Loggers ◽  
The Mean ◽  
African Lions ◽  
Circadian Patterns

The documentation of diurnal patterns in body temperature in lions could be important because disruption of circadian patterns can be a useful measure of distress. This study quantified changes in body temperature of seven African lions (Panthera leo) at 5 min intervals during cold conditions from noon until the ingested body temperature loggers were expelled the next day. Thirteen loggers were fed to 11 lions during their daily noon feeding, while ambient temperatures were also recorded using six data loggers. The lions had continuous access to their dens and exercise pens during the day but were restricted to their heavily bedded dens that also contained a heat lamp from 23:00 until 08:00 the next day. Body temperatures averaged 37.95 ± 0.42 °C at 15:50, and 36.81 ± 0.17 °C at 06:50 the next day, 30 min before the first loggers passed from a lion, and were significantly different (t-test, t = 8.09, df = 6, p < 0.0003). The mean duration for the time of passage was 22 ± 2.69 (h ± SD), so future studies using the noninvasive feeding of temperature loggers need to consider that time frame.

Repeat Revascularization over 10 Years Following Carotid Endarterectomy or Carotid Stent Placement: An Analysis of CREST

2021 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Wei Huang ◽  
Iryna Lobanova ◽  
M. Fawad Ishfaq ◽  
Brandi R. French ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Stent Placement ◽  
Carotid Stent ◽  
Repeat Revascularization

Carotid plaque characterization using CT and MRI scans for synergistic image analysis

2014 ◽  
Author(s):  
Matthew Getzin ◽  
Yiqin Xu ◽  
Arhant Rao ◽  
Saaussan Madi ◽  
Ali Bahadur ◽  
...  
Keyword(s):  
Image Analysis ◽  
Carotid Plaque ◽  
Plaque Characterization ◽  
Mri Scans ◽  
Ct And Mri

scholarly journals Comparing Sudden Stratospheric Warming Definitions in Reanalysis Data*

2015 ◽  
Vol 28 (17) ◽  
pp. 6823-6840 ◽  
Author(s):  
Froila M. Palmeiro ◽  
David Barriopedro ◽  
Ricardo García-Herrera ◽  
Natalia Calvo
Keyword(s):  
Seasonal Cycle ◽  
Winter Season ◽  
Reanalysis Data ◽  
Sudden Stratospheric Warming ◽  
Pronounced Increase ◽  
Future Studies ◽  
Common Peak ◽  
Before And After ◽  
The Mean ◽  
Large Case

Abstract Sudden stratospheric warmings (SSWs) are characterized by a pronounced increase of the stratospheric polar temperature during the winter season. Different definitions have been used in the literature to diagnose the occurrence of SSWs, yielding discrepancies in the detected events. The aim of this paper is to compare the SSW climatologies obtained by different methods using reanalysis data. The occurrences of Northern Hemisphere SSWs during the extended-winter season and the 1958–2014 period have been identified for a suite of eight representative definitions and three different reanalyses. Overall, and despite the differences in the number and exact dates of occurrence of SSWs, the main climatological signatures of SSWs are not sensitive to the considered reanalysis. The mean frequency of SSWs is 6.7 events decade−1, but it ranges from 4 to 10 events, depending on the method. The seasonal cycle of events is statistically indistinguishable across definitions, with a common peak in January. However, the multidecadal variability is method dependent, with only two definitions displaying minimum frequencies in the 1990s. An analysis of the mean signatures of SSWs in the stratosphere revealed negligible differences among methods compared to the large case-to-case variability within a given definition. The stronger and more coherent tropospheric signals before and after SSWs are associated with major events, which are detected by most methods. The tropospheric signals of minor SSWs are less robust, representing the largest source of discrepancy across definitions. Therefore, to obtain robust results, future studies on stratosphere–troposphere coupling should aim to minimize the detection of minor warmings.

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