scholarly journals Carotid Artery Disease in Diabetic Patients

PRILOZI ◽  
2014 ◽  
Vol 35 (3) ◽  
pp. 149-161 ◽  
Author(s):  
Marijan Bosevski
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diabetic Patients ◽  
Symptomatic Carotid ◽  
Main Determinants ◽  
Artery Disease

AbstractThere are two points of view on the interplay between carotid artery disease and diabetes mellitus: Diabetes mellitus has been recognized as one of the main determinants for the presence and progression of asymptomatic and symptomatic carotid artery disease; and carotid intima-media thickness has been defined as a useful tool for risk stratification of this population.Hyperglycaemia, duration of diabetes, arterial hypertension, cholesterol and inflammatory markers have previously been determined as independent factors for carotid atherosclerosis in diabetes, and aging as its predictor in this population by our own results. This paper focuses on the particularities of risk factors in diabetic patients (especially in type 2) and evidence-based guidelines for the management and risk reduction of these patients with stroke and/or carotid artery disease.At present, carotid ultrasound is recommended in diabetic patients with cerebrovascular symptoms. Since the prevalence of diabetes increases constantly, we attempt to address refreshment of criteria for screening of carotid artery disease in the diabetic population. It could be recommended for diabetic patients with at least one more risk factors and for diabetic patients above 60 years of age.

scholarly journals Carotid Intima-Media Thickness and Cardiovascular Risk Factors

2020 ◽  
Author(s):  
Vitorino Modesto dos Santos ◽  
Laura Campos Modesto
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Traditional Risk Factors ◽  
Artery Disease

Albers SS et al. reviewed carotid artery variation in the development of atherosclerotic carotid artery disease (Int J Med Students. 2019 Sep-Dec;7(3):82-91) commenting on changes from birth to older ages that can contribute to disorders of intramural elastin even in absence of disease. Considering the coexistence of traditional risk factors of atherosclerosis, additional comments are posed about measurements of carotid intima-media thickness in patients with obesity, chronic renal failure, and secondary hyperparathyroidism. The authors emphasized the need for further research to validate preventive procedures initiating since prenatal.

Correlation between SYNTAX score and carotid intima-media thickness in patients with chronic coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Djuric ◽  
S Obradovic ◽  
M Spasic ◽  
D.J Prokic ◽  
Z Mladenovic ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Factor Viii ◽  
Carotid Artery Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Group Iii ◽  
Coronary Syndrome ◽  
Group I ◽  
Artery Disease ◽  
Pai 1

Abstract Background In most cases coronary artery disease (CAD) and carotid artery disease exist at the same time and both represent the most serious manifestation of systemic atherosclerosis. Chronic coronary syndrome (CSS) includes six different clinical scenarious, and patients with stable angina symptoms and/or dyspnoea were comprised in our study. A previous studies have demonstrated that patients with myocardial infarction have more severe carotid artery disease, but there are no available data regarding association between SYNTAX I score (SS) and carotid intima-media thickness (CIMT) in patients with CSS. SS is known as universal angiographic scoring system, entirely based on coronary anatomy and lesion characteristics. CIMT measurement is a non-invasive tool to diagnose early atherosclerosis. Purpose The aim of this study was to determine the correlation between SS and CIMT in patients with with CSS. Methods A total of 82 CSS patients (average age 61±12 years, 28.9% females) underwent exercise ECG or stress echocardiography. Coronary angiography and ultrasonography of internal carotid artery were performed and patients were divided into three groups according to SS: Group I (<22, n=42), Group II (23–32, n=20), Group III (>33, n=20). We also estimate the severity of CAD according to clinical SYNTAX. Simultaneously, we evaluate whether biomarkers of hemostasis and thrombosis, such as fibrinogen, plasminogen activator inhibitor (PAI-1), D dimer, coagulation factor VIII and von Willebrand factor (VWF), as well as homocysteine and C reactive protein (hs CRP) were associated with CAD complexity. Results There were significant correlation between severity of CAD according to SYNTAX I score and CIMT (Group I: 1.23±0.27, II: 1.56±0.43, III 1.43±0.21, Kruskal Wallis p=0.000). In order to estimate the impact of atherosclerosis burden on CAD complexity, patients were divided into 3 groups according to CIMT: low (<0.90 mm), intermediate (0.91–1.30 mm) and high (≥1.31 mm). SS according to the CIMT were: Group I: 12.57±5.71, Group II: 21.20±11.36, Group III: 28.38±10.92, KW, p=0.004. We demonstrated significant correlation between SS and values of fibrinogen (I: 3.53±0.70, II: 3.59±0.62, III 3.93±0.56, p=0.018), VWF (I: 1.16±0.59, II: 1.52±0.62, III 1.49±0.80, p=0.040), factor VIII (I: 2.25±0.75, II: 2.21±0.53, III 2.97±0.95, p=0.009), homocysteine (I: 11.21±3.78, II: 13.66±4.61, III 13.87±5.34, p=0.019) and CRP (I: 3.75±4.10, II: 3.82±4.86, III 7.28±5.75, p=0.013), but not with PAI-1 and D dimer (p>0.05). We didn't find positive association between clinical SYNTAX I score and CIMT (p>0.05). Conclusion Patients with chronic coronary syndrome and severe carotid artery disease according to CIMT (≥1.31) had higher SS and more complex CAD. Elevated biomarkers of hemostasis and thrombosis such as fibrinogen, VWF and factor VIII, as well as homocysteine and CRP may be a mutual casual factors for associated polyvascular disease. Correlation between CIMT and SS Funding Acknowledgement Type of funding source: None

scholarly journals Flip-Flop Phenomenon: Swallowing-Induced Arterial Displacement as an Indicator of Carotid Artery Disease

2018 ◽  
Vol 45 (5-6) ◽  
pp. 258-262 ◽  
Author(s):  
Naoto Kinoshita ◽  
Kozue Saito ◽  
Yoshitaka Yamaguchi ◽  
Soichiro Abe ◽  
Shinichi Wada ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Neurological Diseases ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cerebrovascular Diseases ◽  
Internal Carotid Artery Stenosis ◽  
Flip Flop ◽  
Neurological Patients ◽  
Artery Disease

Background and purpose: The dynamic displacement of the carotid arteries with interference of the hyoid bone during swallowing, named as “flip-flop” phenomenon (FFP), may be associated with ischemic stroke. However, the extent to which FFP is prevalent in carotid artery disease remains unknown. We aimed to investigate its exact prevalence to explore the relationship between FFP and carotid artery disease. Methods: We examined 202 consecutive patients who were affected by neurological diseases including cerebrovascular diseases. Using carotid ultrasound, we evaluated carotid intima-media thickness, internal carotid artery stenosis (ICS), and FFP during swallowing with neck rotation. Results: FFP was observed in 39 of the 202 patients (19.3%). Patients with FFP showed significantly higher prevalence of ICS than those without FFP (12/39 [30.8] vs. 21/163 [12.9%]; p = 0.007). Among those with ICS (n = 33; 36 vessels), FFP was associated with symptomatic ICS more frequently than with asymptomatic ICS (6/11 [54.5] vs. 5/25 [20.0%]; p = 0.038). Among those with unilateral FFP (n = 37), the prevalence of ipsilateral ICS was higher than that of contralateral ICS (9/37 [24.3] vs. 2/37 [5.4%]; p = 0.035). Conclusions: FFP accompanies the swallowing movement in some neurological patients, and more frequently in patients with ICS. FFP may thus be a novel indicator of stroke.

Carotid Artery Disease

2019 ◽  
pp. 555-562
Author(s):  
Nnenna Mbabuike ◽  
Rabih G. Tawk
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Disease Risk ◽  
Carotid Artery Disease ◽  
Management Approach ◽  
Common Source ◽  
Transient Ischemic Attacks ◽  
Management Options ◽  
Symptomatic Carotid ◽  
Artery Disease

Carotid artery disease is a common source of ischemic stroke due to ulcerated or hemorrhagic plaque. Risk factors for carotid artery disease include typical atherosclerotic disease risk factors, such as smoking, hyperlipidemia, and diabetes mellitus. This chapter reviews the diagnostic approach to symptomatic carotid artery disease (including stroke and transient ischemic attacks), the overall management approach for symptomatic carotid artery disease (including endovascular and open carotid endartectomy), and medical management options for asymptomatic carotid artery disease. Perioperative management after carotid artery intervention is discussed.

scholarly journals Ultrasound evaluation of carotid artery intima-media thickness in patients with risk factors for cardiovascular disease

2017 ◽  
Vol 4 (2) ◽  
pp. 16 ◽  
Author(s):  
Ibrahim A. Awad ◽  
Hanan Y. Abbas
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Cardiovascular Risk Factors ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Ultrasound Evaluation ◽  
And Gender

Objective: The study purpose was to assess the change of carotid artery intima-media thickness (CAIMT) in patients with cardiovascular risk factors (CVRF), and determine the main factor that causing the abnormal IMT.Methods: We collected the data of 89 patients who underwent a carotid artery ultrasound between February 2011 and November 2012 (43 men and 46 women aged between 20-80 years old). All patients included in the study had one of the following cardiovascular risk factors: smoking (n = 40), arterial hypertension (n = 25) or diabetes mellitus (n = 24). The IMT of the common carotid artery was measured and the results were correlated with the recorded risk factor. Correlation with the patient’s age and gender was also performed.Results: The study revealed abnormal IMT (> 1 mm) in a total of 71 (79.8%) patients. These included 22 (88%) patients with hypertension, 19 (79.2%) patients with diabetes mellitus and 30 (75%) patients who were smokers (p < .05 for all 3 risk factors). While aging was also associated with increased IMT (p < .05), no gender differences were noted (p > .05).Conclusions: The present study showed that ultrasound is an excellent, noninvasive method for evaluation of carotid intima-media thickness. The main risk factors associated with abnormal carotid IMT were hypertension, diabetes mellitus, smoking andpatient’s age.

Concomitant Surgical Treatment of Symptomatic Carotid Artery Disease With a Coexisting Shamblin I Carotid Body Tumor

2017 ◽  
Vol 51 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Carlos A. Hinojosa ◽  
Javier E. Anaya-Ayala ◽  
Hugo Laparra-Escareno ◽  
Adriana Torres-Machorro ◽  
Rene Lizola ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Body ◽  
Carotid Artery Disease ◽  
Duplex Ultrasound ◽  
Neurological Deficits ◽  
Symptomatic Carotid ◽  
Carotid Body Tumors ◽  
Carotid Artery Endarterectomy ◽  
Artery Disease ◽  
Dissection Technique

Symptomatic carotid artery atherosclerotic disease is an indication for carotid artery endarterectomy. The coexistence of carotid body tumors (CBTs) with symptomatic carotid disease is rarely encountered and adds significant challenges to vascular surgeons, with a reported overall mortality for patients who undergo endarterectomy and tumor excision of 8.8%, as opposed to the 2% for those who had CBT excision only. We describe the case of a 79-year-old female who experienced an acute cerebrovascular accident in the left hemisphere; duplex ultrasound revealed high-grade carotid stenosis in the left side and the presence of a Shamblin I CBT. The risks and benefits of the planned operation were reviewed, and the decision was made to proceed with early carotid endarterectomy and concomitant surgical resection of the tumor using the retrocarotid dissection technique. The patient recovered well, and at 11 months from the combined procedure, her neurological deficits improved significantly.

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