scholarly journals Optimalus vidinės miego arterijos endarterektomijos laikas sergant insultu ir didelio laipsnio vidinės miego arterijos stenoze

2006 ◽  
Vol 4 (1) ◽  
pp. 0-0
Author(s):  
Auksė Meškauskienė ◽  
Egidijus Barkauskas ◽  
Artūras Mackevičius
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Group Iv ◽  
Operative Risk ◽  
Group Iii ◽  
The Third ◽  
Group I ◽  
Significant Difference

Optimalus vidinės miego arterijos endarterektomijos laikas sergant smegenų insultu ir didelio laipsnio vidinės miego arterijos stenoze Auksė Meškauskienė, Egidijus Barkauskas, Artūras MackevičiusVilniaus universiteto Neurologijos ir neurochirurgijos klinikosNeuroangiochirurgijos centras,Šiltnamių g. 26, LT-04130 VilniusEl paštas: [email protected] Įvadas / tikslas Miego arterijos endarterektomija yra veiksmingas gydymo būdas, padedantis išvengti insulto esant didelio laipsnio simptominei miego arterijos stenozei. Ankstyva, tuoj po insulto atlikta endarterektomija sukelia daug komplikacijų, todėl dauguma chirurgų siūlo operaciją atidėti 4–6 savaitėms. Tačiau operacijos atidėjimas didina insulto pasikartojimo riziką. Naujausios literatūros duomenimis, per 30 dienų nuo insulto pradžios atlikta endarterektomija nedidina komplikacijų skaičiaus, tačiau nėra vienodos nuomonės dėl tikslaus operacijos laiko. Darbo tikslas – nustatyti operacijos riziką ligoniams, kurie serga smegenų insultu ir didelio laipsnio vidinės miego arterijos stenoze, atsižvelgiant į atliekamos endarterektomijos laiką. Ligoniai ir metodai Į analizę įtraukti duomenys 243 ligonių (192 vyrų ir 51 moters, amžiaus vidurkis 65,4 metų), kurie sirgo išeminiu insultu ir jiems buvo operuota simptominė didelio laipsnio miego arterijos stenozė. Iki operacijos visų analizuotų ligonių neurologinė simptomatika buvo stabili arba gerėjanti. Atsižvelgdami į laiko trukmę nuo ligos pradžios iki operacijos, ligonius suskirstėme į keturias grupes: I grupę (n = 59) sudarė operuotieji pirmą savaitę, II grupę (n = 61) – antrą savaitę, III grupę (n = 67) trečią ar ketvirtą savaitę, IV grupę (n = 56) – po keturių savaičių nuo ligos pradžios. Rezultatai Po operacijos komplikacijų buvo 14 (5,6%) ligonių, pusei iš jų įvyko insultas ir tiek pat ligonių mirė. Komplikacijų pasireiškė 5 ir 59 (8,5%) pirmos grupės ligonių, 4 iš 61 (6,5%) – antros, 1 iš 67 (1,5%) – trečios ir 4 iš 56 (7,2%) – ketvirtos. Mažiausia komplikacijų ištiko ligonius, kuriems endarterektomija daryta trečią ar ketvirtą ligos savaitę, nors komplikacijų skirtumas tarp grupių nebuvo statistiškai reikšmingas. Išvados Mirties ir operacinio insulto rizika ligoniams, sergantiems insultu ir didelio laipsnio vidinės miego arterijos stenoze, tiesiogiai nepriklausė nuo endarterektomijos laiko, tačiau mažiausiai komplikacijų ištiko ligonius, operuotus trečią ar ketvirtą savaitę nuo insulto pradžios. Reikšminiai žodžiai: insultas, miego arterijos endarterektomija, laikas, operacinė rizika The optimal timing of carotid endarterectomy in patients with stroke and severe carotid artery stenosis Auksė Meškauskienė, Egidijus Barkauskas, Artūras MackevičiusVilnius University, Clinics of Neurology and Neurosurgery,Center of Neuroangiosurgery,Šiltnamių str. 26, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Background / objective Carotid endarterectomy is highly effective in preventing stroke in patients with recentl symptomatic severe stenosis. Some studies showed early carotid endarterectomy to carry a high risk. Therefore, many surgeons delay carotid endarterectomy for 4 to 6 weeks after stroke, but any delay leads to reduced benefit because of the risk of stroke before surgery. Recent data have suggested that the operative risk is not increased in patients operated on within 30 days of stroke; however, controversy remains regarding the timing of this intervention. The purpose of the current work was to determine the operative risk of death and stroke in patients with stroke and severe carotid stenosis in relation to the time of carotid endarterectomy. Patients and methods A retrospective study of 243 patients undergoing carotid endarterectomy after stroke is presented. All patients had either stable or improving neurological examinations. The patients were divided into four groups: group I (n = 59) patients who had carotid endarterectomy between 2–7 days after stroke, group II (n = 61) patients who had carotid endarterectomy during the second week, group III (n = 67) patients who were operated during the third–fourth week after stroke and group IV (n = 56) patients who were operated on later than 4 weeks. Results Of the 192 men and 51 women who underwent surgery, there were 7 strokes and 7 deaths, with the total rate of complications 5.6%. Postoperative stroke and mortality was respectively: group I – 8.5%, group II – 6.5%, group III – 1.5%, group IV – 7.2%. There was no statistically significant difference in operative risk among the groups; however, a trend toward a decreased operative risk was noticed in patients operated on during the third–fourth week after stroke. Division to early (<2 weeks) and late (>2 weeks) endarterectomy also did not reveal any significant difference in the operative risk. Conclusions The perioperative risk of stroke and death was unrelated to the timing of carotid endarterectomy in patients with stroke and severe carotid stenosis. Carotid endarterectomy can be performed safely after 2 weeks of ischemic stroke in patients with severe carotid artery stenosis. Key words: stroke, carotid endarterectomy, time, operative risk

Endovascular Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S92-S101 ◽  
Author(s):  
Jorge L. Eller ◽  
Travis M. Dumont ◽  
Grant C. Sorkin ◽  
Maxim Mokin ◽  
Elad I. Levy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Stenting ◽  
Historical Background ◽  
Treatment Modalities ◽  
Endovascular Management ◽  
The Past

Abstract Carotid artery stenting has become a viable alternative to carotid endarterectomy in the management of carotid stenosis. Over the past 20 years, many trials have attempted to compare both treatment modalities and establish the indications for each one, depending on clinical and anatomic features presented by patients. Concurrently, carotid stenting techniques and devices have evolved and made endovascular management of carotid stenosis safe and effective. Among the most important innovations are devices for distal and proximal embolic protection and new stent designs. This paper reviews these advances in the endovascular management of carotid artery stenosis within the context of the historical background.

scholarly journals Assessment of Outcome of Intrathecal Analgesia in Multiparous Women Undergoing Vaginal Delivery

2020 ◽  
Vol 5 (1) ◽  
pp. 153-155
Author(s):  
Sanjay Melville Masih ◽  
Rakesh Kumar Gupta
Keyword(s):  
Vaginal Delivery ◽  
Group Iv ◽  
Normal Vaginal Delivery ◽  
Secondary Outcome ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Multiparous Women ◽  
Group Ii ◽  
Intrathecal Analgesia

Background: The present study was conducted to assess the outcome of intrathecal analgesia in multiparous women undergoing vaginal delivery. Subjects and Methods: The present study was conducted among 80 multiparous women ages ranged 18- 40 years. All patients received 0.5 ml of intrathecal injection of 2.5 mg bupivacaine 0.5% and 1 ml dexamethasone 4 mg plus a 0.5 ml adjuvant. The adjuvants in group I patients were 100 μg morphine, 25 μg fentanyl in group II, 5 μg dexmedetomidine in group III and normal saline in group IV (control group). The primary and secondary outcome was the duration of pain relief, the analgesia onset time, the maximum level of sensory block, the visual analogue scale (VAS) was recorded. Results: The mean duration of analgesia in group I was 182.4 minutes, in group II was 170.5 minutes, in group III was 200.4 minutes and in group, IV was 140.2 minutes. The onset of analgesia was 3.9 minutes, 2.8 minutes, 2.7 minutes and 4.5 minutes in group I, II, III and IV respectively. S1 sensory regression time (minutes) was 181.4, 157.4, 185.3 and 130.6 in group I, II, III and IV respectively. Modified Bromage scale 5 minutes, 15 minutes and 30 minutes after IT in all groups was 0.0. VAS was 1.3, 1.6, 1.6 and 3.1 with significant differences in all groups (P< 0.05). There was non- significant difference in mean age, weight, height and gestational age between all groups (P> 0.05). There was a non- significant difference in APGAR 1, 5, umbilical pH immediately after delivery, neonatal HR after 5minute, 15 minutes and 30 minutes in all groups (P> 0.05). Conclusion: The authors found that dexmedetomidine is a safe and effective adjuvant to intrathecal bupivacaine-dexamethasone in multiparous women undergoing normal vaginal delivery.

Abstract 16464: Coronary Artery Calcium Score and Incidence of Clinically Significant Carotid Stenosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Aditya Singh ◽  
Tom Stys ◽  
Valerie Bares ◽  
Jeffrey Wilson ◽  
Adam Stys
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Coronary Artery Calcium ◽  
Carotid Artery Stenosis ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Artery Stenosis ◽  
Plaque Burden ◽  
Significant Difference

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.

Is there a difference in prevalence of anxiety and depression symptoms among patients with different stages of hypertension?

2017 ◽  
Vol 41 (S1) ◽  
pp. S414-S414 ◽  
Author(s):  
A. Mermerelis ◽  
S.M. Kyvelou ◽  
V. Akke ◽  
C. Papageorgiou ◽  
C. Stefanadis ◽  
...  
Keyword(s):  
Depression Scale ◽  
Group Iv ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Study Cohort ◽  
Hypertensive Patients ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

IntroductionWhether anxiety and depression are associated with hypertension and to what extent is not clear.AimsThe aim of the present study was to assess any differences in the prevalence of anxiety and depression among different groups of hypertensive patients.MethodsThe study cohort comprised of 127 patients (75 male, mean age 54 ± 14) who underwent assessment of their blood pressure levels and were divided in four groups: group I (normotensives, n = 34), group II (stage 1 HTN, n = 33), group III (stage 2 HTN, n = 30) and group IV (stage 3 HTN, n = 30). The evaluation of anxiety disorder was made by means of Hospital Anxiety Depression Scale (HADS), while the evaluation of depression was made with the Beck Depression Inventory (BDI). Statistical analysis was done with SPSS for windows. P-value was set at 0.05 for differences to be considered significant.ResultsComparing the four groups of patients there was a significant difference both in BDI (8.6 ± 7.0 vs. 11.6 ± 10.4 vs. 27.1 ± 5.8 vs. 32.4 ± 3.9, P < 0.0001) and HADS (10.2 ± 7.2 vs. 9.7 ± 7.0 vs. 16 ± 4.7 vs. 27 ± 5.1, P < 0.0001). We proceeded to comparison among the 4 groups and there was a significant rise in the BDI and HADS in three of the four groups group II > group III > group IV, P < 0.0001.ConclusionThese data suggest that there is a clear burden of anxiety and depression as the levels of BP increase. This finding is of important clinical significance as it could contribute to a different approach of hypertensive patients. A larger cohort study could enlightened the mechanisms involved.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Shear bond strength of bulk-fill and nano-restorative materials to dentin

2016 ◽  
Vol 10 (01) ◽  
pp. 040-045 ◽  
Author(s):  
Hakan Colak ◽  
Ertugrul Ercan ◽  
Mehmet Mustafa Hamidi
Keyword(s):  
Bond Strength ◽  
Shear Bond Strength ◽  
Clinical Success ◽  
Testing Machine ◽  
Group Iv ◽  
Composite Resins ◽  
Group Iii ◽  
Bonding System ◽  
Group I ◽  
Significant Difference

ABSTRACT Objectives: Bulk-fill composite materials are being developed for preparation depths of up to 4 mm in an effort to simplify and improve the placement of direct composite posterior restorations. The aim of our study was to compare shear-bond strength of bulk-fill and conventional posterior composite resins. Materials and Methods: In this study, 60 caries free extracted human molars were used and sectioned parallel to occlusal surface to expose midcoronal dentin. The specimens were randomly divided into four groups. Total-etch dentine bonding system (Adper Scotchbond 1XT, 3M ESPE) was applied to dentin surface in all the groups to reduce variability in results. Then, dentine surfaces covered by following materials. Group I: SonicFill Bulk-Fill, Group II: Tetric EvoCeram (TBF), Group III: Herculite XRV Ultra, and Group IV: TBF Bulk-Fill, 2 mm × 3 mm cylindrical restorations were prepared by using application apparatus. Shear bond testing was measured by using a universal testing machine. Kruskal–Wallis and Mann–Whitney U-tests were performed to evaluate the data. Results: The highest value was observed in Group III (14.42 ± 4.34) and the lowest value was observed in Group IV (11.16 ± 2.76) and there is a statistically significant difference between these groups (P = 0.046). However, there is no statistically significant difference between the values of other groups. In this study, Group III was showed higher strength values. Conclusion: There is a need for future studies about long-term bond strength and clinical success of these adhesive and bulk-fill systems.

From embolization to remodeling: the need for early carotid endarterectomy in symptomatic carotid plaques

Vascular ◽  
2011 ◽  
Vol 19 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Laura Capoccia ◽  
Caterina Pelonara ◽  
Cesira Imondi ◽  
Enrico Sbarigia ◽  
Francesco Speziale
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Duplex Ultrasound ◽  
Left Carotid Artery ◽  
Symptomatic Carotid ◽  
Atheromatous Plaques ◽  
Dynamic Structures ◽  
Arterial Stenoses

Atheromatous plaques are dynamic structures undergoing continuous remodeling. Duplex ultrasound is now an accepted technique to classify the severity of arterial stenoses. It gives information about the ultrasonic echogenicity of tissue, the plaque surface and the velocity of blood flowing through vessels with the latest equipment. We report the case of a 59-year-old male patient with left hemispheric stroke and a 50% left carotid artery stenosis whose remodeling and reabsorption developed throughout three months from the onset of symptoms. Plaque surface and structural echomorphology assessment and standardization, along with the degree of carotid stenosis, might be helpful in identifying patients most likely to benefit from carotid endarterectomy.

scholarly journals Establishment and Evaluation of Gvhd Mouse Model for Allogeneic Hematopoietic Stem Cell Transplantation

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5681-5681
Author(s):  
Mei Xie ◽  
Weihong Chen ◽  
Qiaoxia Zhang ◽  
Xin Du
Keyword(s):  
Bone Marrow ◽  
Conditioning Regimen ◽  
Group Iv ◽  
Spleen Cells ◽  
Hematopoietic Stem ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Leukocyte Counts ◽  
Group Ii

Abstract Objective: To study the feasibility of using cyclophosphamide alone without total body irradiation (TBI) as conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and establish a graft-versus-host disease (GVHD) mouse model. Methods: Single cell suspension of spleen and bone marrow were prepared from donor C57/BL/6 mice (B6 mice) . The recipient B6D2F1 mice (F1 mice) were signed into 4 groups with 12 mice per each group. Groups I~III mice were conditioned with peritoneal injection of cyclophosphamide (300 mg/m 2/d) on day -5, -4 and -3 of allo-HSCT, and group IV mice were used as control with saline injection. On day 0, group I mice were injected through tail vein with a mixture of 2×107 spleen cells, 5×106 bone marrow cells and 1×104 P815 cells; group II with 5×106 bone marrow cells and 1×104 P815 cells; group III with 1×104 P815 cells and group IV with RPMI1640 culture medium. The blood leukocyte counts were analyzed, GVHD score and the pathological leukemia infiltration of skin, liver and colon were evaluated and compared on day 30 after allo-HSCT. Results: (1) The GVHD scores of group I mice were 2 to 4 on day 14 post allo-HSCT, and mice started to die on day 15, eight (8) mice survived and the GVHD scores of them were 1 to 6 with a survival rate of 66.7% on day 30. Group II mice began to die on day 6 and only one survived on day 30 with a survival rate of 8.3%. All of group III mice died on day 18. Group IV mice survived (Figure 1). (2) The leukocyte counts in group I and group II were significantly increased on day 7 post allo-HSCT(p<0.05). There was also a significant difference in total leukocyte counts between groups I/II and group IV (p<0.05). The leukocyte counts in mice of groups I~III were significantly decreased, and there were a significant difference between group I and groups II/III/IV respectively (p<0.05) on day 14 post allo-HSCT. On day 21 after allo-HSCT, the leukocyte count of Group I and II mice were ≥1×109/L, which means that allo-HSCT were successful. The leukocyte counts in group I mice were again increased on day 28 post allo-HSCT. There was no significant difference between Group I and Group IV (p>0.05). (3) Pathological observation: The cell atrophy and necrosis in the hepatic portal area and slight infiltration of the leukemia cells in central vein were observed in group I recipient mice. The number of hepatocytes of the mice decreased, and the infiltration of the leukemia cells in the liver sinus were observed in group II. The liver was heavily infiltrated by leukemic cells in group III mice. The mouse livers were normal in group IV mice. Conclusion: It is feasible to establish GVHD model of the leukemia mice with cyclophosphamide conditioning regimen of allo-HSCT, and simple to operate. This is less harmful to people, animals and the environment. Discussion: The traditional animal model of GVHD is based on TBI conditioning regimen prior to allo-HSCT. However, the process can lead to systemic adverse reactions such as myelosuppression, radiation gastroenteritis, endocrine disorders and systemic function disorders, etc. in both the operators and animals. Therefore, the radiotherapy doses have to be low. At the same time, it is difficult to establish animal models of GVHD due to the uneven distribution of the doses. Cyclophosphamide was selected for the conditioning regimen of allo-HSCT in the study. Cyclophosphamide had the effect direct on killing tumor cells, induced recipients to tolerate the immune of donors, enabled to implant donor cells into recipients smoothly. The stable chimeras were obtained. There are a large number of T and B lymphocytes in donor's spleen cells. By injecting donor spleen cells and active immune cells derived from proliferation and differentiation of hematopoietic stem cells, the effects of graft-anti-leukemia are availably activated in recipients. Acknowledgments We thank Dr Zhifu Xiang very much for his great helpful revisions. Disclosures No relevant conflicts of interest to declare.

scholarly journals Mid-and Long-term Clinical Efficacy Analysis of Carotid Artery Stenosis Treated With Carotid Endarterectomy

2020 ◽  
Author(s):  
Yanhua Wan ◽  
Yiran Li ◽  
Jiasheng Xu ◽  
Shasha Wan ◽  
Riwei Wang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Clinical Efficacy ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Cerebral Stroke ◽  
Improvement Rate ◽  
Efficacy Analysis ◽  
Significant Difference

Abstract Objective: To explore the mid-and long-term clinical efficacy analysis of carotid artery stenosis treated with carotid endarterectomy.Methods: Retrospective analysis of 89 cases of patients with carotid artery stenosisundergoing carotid endarterectomy from our center from Jan,2013 to June,2017. To gather the hospitalization data of patients including the general information, the past medical history, preoperative conditions, the situation during surgery, postoperative situations. All the patients were followed up from 16 months to 63 months, and to make survival analysis on the follow-up status.Results：Among the 89 cases, 22cases of mild stenosis ,67cases of severe stenosis. 5 cases had postoperation wound hemorrhage or hematoma, 2 cases of cranial nerve injury, 2cases of cerebral stroke. Among the 62 cases of symptomatic carotid artery stenosis,48cases have been improved in term of their clinical symptoms with improvement rate of 77.4%. The Nonparametric test of mRS scores before and after surgery showed that there was significant difference in the preoperative and postoperative scores（P<0.05）.Conclusion: The mid-and long-term clinical efficacy of carotid artery stenosis treated with carotid endarterectomy is good. The previous history of coronary heart disease and peripheral vascular diseases are the influence factors for the mid- and long-term adverse outcomes after carotid endarterectomy.

scholarly journals An in vitro comparative Evaluation of Fracture Strength of Roots Instrumentated with Self-adjusting File and Reciproc Reciprocating File, with and without Obturation

2017 ◽  
Vol 1 (1) ◽  
pp. 20-25
Author(s):  
Pooja Kabra
Keyword(s):  
Fracture Strength ◽  
Comparative Evaluation ◽  
Group Iv ◽  
Control Group ◽  
Group V ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

ABSTRACT Aim The purpose of this study was to evaluate the fracture strength of roots instrumented with the self-adjusting file (SAF; ReDent-Nova, Ra'anana, Israel) and the Reciproc reciprocating file and that were and were not obturated using the warm vertical lateral compaction technique. Materials and methods In total, 75 mandibular premolar teeth were sectioned at or below the cementoenamel junction to obtain roots 13 mm in length. The roots were balanced with respect to buccolingual and mesiodistal diameters and weight. They were distributed into four experimental groups and one control group (n = 15): No instrumentation (group I), instrumentation with SAF files but no obturation (group II), instrumentation with SAF files and obturated with warm vertical lateral compaction (group III), instrumentation with Reciproc File but no obturation (group IV), and instrumentation with Reciproc File and obturated with warm vertical lateral compaction (group V). AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) was used along with gutta-percha points. One week later, a vertical load was applied to the specimen's canal until fracture occurred. Data were statistically analyzed using one-way analysis of variance (p = 0.05). Results The mean fracture load was 312.83 N for group I, 297.35 N for group II, 359.15 N for group III, 231.51 N for group IV, and 275.81 N for group V. Conclusion The fracture resistances exhibited a statistically significant difference between all the groups. Teeth instrumented by SAF exhibited a better fracture resistance. How to cite this article Tyagi S, Choudhary E, Kabra P, Chauhan R. An in vitro comparative Evaluation of Fracture Strength of Roots Instrumentated with Self-adjusting File and Reciproc Reciprocating File, with and without Obturation. Int J Clin Dent Res 2017;1(1):20-25.

Carotid Artery Stenosis Is Associated with Better Intracranial Collateral Circulation in Stroke Patients

2020 ◽  
Vol 49 (2) ◽  
pp. 200-205
Author(s):  
Juha-Pekka Pienimäki ◽  
Niko Sillanpää ◽  
Pasi Jolma ◽  
Sara Protto
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Clinical Outcome ◽  
Acute Stroke ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Collateral Circulation ◽  
Artery Stenosis ◽  
Stroke Patients ◽  
Significant Difference

Background: Adequate collateral circulation improves the clinical outcome of ischemic stroke patients. We evaluated the influence of ipsilateral carotid stenosis on intracranial collateral circulation in acute stroke patients. Methods: We collected the data of 385 consecutive acute stroke patients who underwent mechanical thrombectomy after multimodal computed tomography (CT) imaging in a single high-volume stroke center. Patients with occlusion of the first segment (M1) segment of the middle cerebral artery were included. We recorded baseline clinical, laboratory, procedural, and imaging variables and technical, imaging, and clinical outcomes. The effect of carotid stenosis on intracranial collateral circulation was studied with appropriate statistical tests and ordinal regression analysis. Results: Fifty out of the 247 patients eligible for analysis had severe ipsilateral carotid stenosis (≥75%). These patients were 4-times more likely to have very good intracranial collaterals (Collateral Score 3–4, p = 0.001) than the nonstenotic and slightly stenotic (<75%) patients. The severely stenotic patients had a longer mean operation time (41 vs. 29 min to reperfusion, respectively, p = 0.001). Nevertheless, 54% of severely stenotic patients had good 3-month clinical outcome (modified Rankin Scale ≤2) with no significant difference between the 2 groups. Conclusions: Carotid artery stenosis of over 75% of vessel diameter was associated with better intracranial collateral circulation of patients with acute ischemic stroke. This did not significantly change the 3-month clinical outcome.

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