scholarly journals CAROTID DOPPLER AS A BIOMARKER TO DETERMINE STENOSIS IN ISCHEMIC STROKE AND MANAGEMENT OF ICU PATIENT

2020 ◽  
Vol 8 (10) ◽  
pp. 375-380
Author(s):  
Samia Perwaiz Khan ◽  
◽  
Sabeeh Jaffrey ◽  
Safia Izhar ◽  
Khwaja Zafar Ahmed ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
General Hospital ◽  
Color Doppler ◽  
Invasive Procedure ◽  
Intima Media Thickness ◽  
Cerebrovascular Diseases ◽  
Consent Form ◽  
Plaque Morphology ◽  
Media Thickness ◽  
Carotid Doppler

Atherosclerosis is common cause of cerebrovascular diseases. Carotid Doppler is tool to determine atherosclerotic risk in patients leading to stroke. Carotid sonography isa invasive procedure and is most commonly being used. Proper management of atherosclerotic plaque and thickness could be reducing morbidity and mortality.All those patients with stroke admitted to Medicare cardiac and general hospital will be included in the study. All those patients with stroke due to intracerebral hemorrhage will be excluded from the study .Consent form was filled by the relatives of patients. Carotid Doppler was carried out external, middle and internal carotid arteries. Performa and consent form was filled by patient/ attendant. Pre and post antiplatelet and antithrombotic therapy color Doppler was done.Out of a total of 25 patients with stroke admitted or attending the walk-in clinic of medicare cardiac 7 general hospital . Intima media thickness was increased in 25 (100%) above 0.1mm ,calcified plaques were found in 20 ( 90%) patients and stenosis was less than 40% in 19 patients and above 50% in 6 patients. Control shown to have normal intima media thickness 0.1-0.6 mm , no plaques or stenosis. Carotid Doppler is found to be most useful biomarker to determine stenosis in ischemic stroke and plaque morphology also to management of intensive care unit patient.

Ischemic Stroke and its Association with Risk Factors at Nepalgunj Medical College Teaching Hospital Kohalpur

2021 ◽  
Vol 18 (2) ◽  
pp. 48-50
Author(s):  
Shyam Kumar BK ◽  
Sushil Baral ◽  
Nabin Paudel ◽  
Hitesh Neupane
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
College Teaching ◽  
Intima Media Thickness ◽  
Cerebrovascular Diseases ◽  
Media Thickness ◽  
Number Of Patients ◽  
Carotid Doppler

Introduction: Incidence of stroke increases with age and growing elderly population worldwide, the number of patients with stroke are likely to increase. It is the third most common cause of death in world in that 85% are ischemic in nature. Atherosclerosis is a major risk factor in cerebrovascular diseases. Carotid Intima Media thickness (CIMT) is a surrogate marker of atherosclerosis and provides a non-invasive method for the risk assessment of cerebrovascular diseases. Aims: To study the atherosclerotic risk profile of patients admitted with ischemic stroke in medical ward with study of the carotid artery intima-media thickness in patients with acute ischemic stroke. Methods:  92 patients with ischemic strokes were studied in this observational study. Carotid Doppler was performed in all patients with emphasis on carotid artery stenosis and intima thickening. Analysis of Association of various risk factors was done in detail. Study period was from June 2019 to May 2020. Results: Higher degree of stenosis was associated with hypoechoic plaques and cortical strokes. Hypertension was the most common and most significant risk factor. Multiple risk factors also appear to have synergistic actions. Conclusion: Various modifiable risk factors provide valuable target for primary and secondary prevention of stroke. Carotid Doppler is a very cheap and highly effective tool for further management of stroke patients. Most of the asymptomatic patients, risk factors may warrant precautionary carotid Doppler, and may result in significant reduction in disease burden on the families and the community and should be encouraged.

scholarly journals A study of carotid intima media thickness (CIMT) in cases of ischemic stroke

2017 ◽  
Vol 4 (5) ◽  
pp. 1227
Author(s):  
Prakash R. Relwani ◽  
Vrinda K. Kulkarni
Keyword(s):  
Ischemic Stroke ◽  
Ischaemic Stroke ◽  
Tertiary Care ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Stroke Incidence ◽  
Non Invasive ◽  
Media Thickness ◽  
Doppler Study ◽  
Carotid Doppler

Background: Measurement of Carotid Intima Media Thickness (CIMT) by carotid doppler is a non-invasive, safe and inexpensive investigation. CIMT may predict ischaemic stroke. However, the data about the usefulness of CIMT as a predictor in Indian scenario is relatively less. The primary objective of the present study was to determine utility of CIMT as a predictor of ischemic stroke.Methods: This study was a case control study carried out at a tertiary care institute. The study included fifty cases of ischaemic stroke. Fifty age and sex matched controls were selected who were not relatives of cases.Results: A detailed history of cases and controls was taken. They were subjected to routine investigations; blood sugars and lipid profile were sent.  CIMT was measured by doing carotid doppler study on both sided carotid arteries. The results were analysed.Conclusions: From this study, we concluded that there is increase in CIMT in patients of ischemic stroke. Age, gender and side of the vessel had no significant effect on CIMT. It was concluded that CIMT value has a direct correlation with ischemic stroke. Thus, Carotid intima media thickness can be used as a non-invasive predictor of future ischemic stroke incidence.

scholarly journals Pengaruh Simvastatin Terhadap Ketebalan Intima-Media Karotis Pada Pasien Stroke Iskemik Dengan Diabetes Mellitus Tipe 2

2019 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Aditya Kurnianto ◽  
Dodik Tugaswowo Pramukarso
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
T Test ◽  
Stroke Patients ◽  
Media Thickness

BACKGROUND :Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process. OBJECTIVE : To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus. METHOD : This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1st week and 24th week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test. RESULT : There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus (p=0,008). CONCLUSION : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. Keyword : simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus   LATAR BELAKANG :Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis. TUJUAN :Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2. METODE :Penelitian ini adalah dengan Randomized Pretest-Posttest Design dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan  diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan Saphiro wilk, lalu di analisis menggunakan uji beda paired t testdan independent t test. HASIL :  Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 + 0,46; p=0,514), KESIMPULAN : Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2. Kata Kunci     :simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2      

Remodeling of ipsilateral ulnar artery after radial artery harvesting for coronary artery bypass graft

2021 ◽  
Vol 99 (2) ◽  
pp. 231-236
Author(s):  
Melchior L. Lima ◽  
Héber S.M. Silva ◽  
Lourival N. Lougon ◽  
Fanilda S. Barros ◽  
Walter J. Gomes
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Radial Artery ◽  
Ultrasound Examination ◽  
Color Doppler ◽  
Artery Bypass ◽  
Ulnar Artery ◽  
Intima Media Thickness ◽  
Diabetic Patients ◽  
Media Thickness

There are controversies in the literature on the blood supply to the forearm after surgical removal of the radial artery in coronary artery bypass grafting (CABG). The objective was to investigate the arterial remodeling of the ulnar artery after the removal of the radial artery in myocardial revascularization by means of ultrasound examination with color Doppler in the pre- and post-operative periods. This paper describes an observational prospective study of the remodeling of the left brachial and ulnar arteries (donor arm) in 103 right-handed non-consecutive adult patients undergoing CABG with removal of the ipsilateral radial artery using the color Doppler ultrasound examination. In the ulnar artery, a significant increase (P < 0.05) was seen in the following measurements: lumen diameter by 13%, lumen area by 26%, peak systolic flow by 40%, and average flow by 46%. Intima-media thickness measured in the ulnar artery did not show a statistically significant difference (P = 0.22), except in diabetic patients (P = 0.007). We conclude that the ulnar artery undergoes positive physiological remodeling, adapting to the new requirements of chronic increase in flow after the ipsilateral removal of the radial artery to serve as a graft in CABG. There was no evidence of increased intima-media thickness, except in diabetic patients.

scholarly journals Carotid Atherosclerosis Evolution When Targeting a Low-Density Lipoprotein Cholesterol Concentration <70 mg/dL After an Ischemic Stroke of Atherosclerotic Origin

Circulation ◽  
2020 ◽  
Vol 142 (8) ◽  
pp. 748-757 ◽  
Author(s):  
Pierre Amarenco ◽  
Cristina Hobeanu ◽  
Julien Labreuche ◽  
Hugo Charles ◽  
Maurice Giroud ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Arteries ◽  
Carotid Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Target Group ◽  
Low Density Lipoprotein Cholesterol ◽  
Media Thickness ◽  
Common Carotid Arteries

Background: The TST trial (Treat Stroke to Target) showed the benefit of targeting a low-density lipoprotein cholesterol (LDL-C) concentration of <70 mg/dL in terms of reducing the risk of major cardiovascular events in 2860 patients with ischemic stroke with atherosclerotic stenosis of cerebral vasculature. The impact on carotid atherosclerosis evolution is not known. Methods: TST-PLUS (Treat Stroke to Target–Plaque Ultrasound Study) included 201 patients assigned to an LDL-C concentration of <70 mg/dL and 212 patients assigned to a target of 100±10 mg/dL. To achieve these goals, investigators used the statin and dosage of their choice and added ezetimibe as needed. Ultrasonographers were certified and carotid ultrasound examinations were performed using M′Ath software at baseline and at 2, 3, and 5 years. All images were uploaded to the Intelligence in Medical Technologies database directly from the carotid ultrasound device. The central core laboratory performed all offline measurements of the intima–media thickness of both common carotid arteries blinded from the randomization arm. The main outcomes were newly diagnosed atherosclerotic plaque on carotid bifurcation or internal carotid artery using the Mannheim consensus definition and between-group comparison of common carotid arteries intima–media thickness change. Results: After a median follow-up of 3.1 years, the achieved LDL-C concentrations were 64 mg/dL (1.64 mmol/L) in the lower-target group and 106 mg/dL (2.72 mmol/L) in the higher-target group. Compared with the higher-target group, patients in the lower-target group had a similar incidence of newly diagnosed carotid plaque: 46/201 (5-year rate, 26.1%) versus 45/212 (5-year rate, 29.7%). The change in common carotid arteries intima–media thickness was −2.69 µm (95% CI, −6.55 to 1.18) in the higher-target group and −10.53 µm (95% CI, −14.21 to −6.85) in the lower-target group, resulting in an absolute between-group difference of −7.84 µm (95% CI, −13.18 to −2.51; P =0.004). Conclusions: In patients with ischemic stroke and atherosclerosis, an LDL-C target of <70 mg/dL (1.8 mmol/L) did not reduce the incidence of new carotid plaques but produced significantly greater regression of carotid atherosclerosis than an LDL-C target of 90 to 110 mg/dL. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875.

scholarly journals Thicker Carotid Intima Media Thickness in Children with Monocyte Chemoattractant Protein-1: A-2138T and A-2464G Mutation

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Yuyun Yueniwati ◽  
Valentina Yurina ◽  
Mohammad Rasjad Indra
Keyword(s):  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Promoter Polymorphism ◽  
Stroke Patients ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Monocyte Chemoattractant Protein ◽  
Media Thickness ◽  
Pcr Method

Carotid intima media thickness (CIMT) is clearly associated with atherosclerosis. Studies in ischemic stroke patients reveal that there is a significant association between CIMT with monocyte chemoattractant protein-1 (MCP-1) and osteopontin (OPN) promoter polymorphism. This research aims to explain the effect of MCP-1 and OPN promoter polymorphism toward CIMT changes identified in Javanese Indonesian children. Subjects were 54 children: 27 were from parents with ischemic stroke (cases), and 27 were from healthy parents (controlled). The CIMT was examined by utilizing high resolution B-mode ultrasound. Physical examination and genotyping analysis of MCP-1 promoter were conducted by employing PCR method. Research results indicate that two polymorphisms were obtained, that is, A-2138T and G-2464A, respectively. A-2138T polymorphism was found in 5% of case children and in 14.3% of controlled children. G-2464A polymorphism was found in 5% of case children. CIMT of case children was significantly different from that of controlled children (0.61±0.012 mm versus,0.52±0.015 mm,P=0.021). Subjects with MCP-1 promoter polymorphism have 1.471 times higher tendency to have thicker CIMT than subjects with no polymorphism in MCP1 promoter. OPN promoter T-66G was also studied but it did not indicate occurrence of polymorphism in samples.

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