scholarly journals Carotid ultrasonographic parameters as markers of atherogenesis and mortality rate in patients on hemodialysis

2010 ◽  
Vol 67 (11) ◽  
pp. 916-922 ◽  
Author(s):  
Radojica Stolic ◽  
Goran Trajkovic ◽  
Aleksandar Jovanovic ◽  
Dragica Stolic ◽  
Vladan Peric ◽  
...  
Keyword(s):  
Survival Rate ◽  
Carotid Artery ◽  
Cross Section ◽  
Carotid Arteries ◽  
Duplex Ultrasound ◽  
Intima Media Thickness ◽  
Lumen Diameter ◽  
Study Patient ◽  
Serum Triglycerides ◽  
Negatively Associated

Background/Aim. Vascular endothelium plays an important role in atherogenesis. The aim of this study was to estimate the correlation of endothelium malfunction and arteriosclerosis in patients on hemodialysis. Methods. The investigation was designed as a clinical, non-randomized, fiveyear study in the 'Kragujevac' Clinical Center and included 146 patients. We evaluated demographic characteristics, smoking, duration of dialysis, existence of tissue calcification and duplex ultrasound parameters of the carotid artery. All lethal outcomes, including the cause and time of death were recorded. Results. The cumulative survival rate was 57.5%. Survival was short in patients with wider lumen diameter of the carotid arteries. Carotid artery lumen diameter in men was wider than in women. The area cross section was closely correlated with intima media thickness (r = 0.913; p < 0.0001), as well as with the lumen diameter of the carotid arteries (r = 0.527; p < 0.0001). Carotid artery lumen diameter was negatively associated with serum cholesterol (r = - 0.278; p = 0.019), while serum triglycerides correlated negatively with the cross section of intima media (r = -0.261; p = 0.028). Positive correlations were found between the serum total protein level and carotid artery lumen diameter (r = 0.235; p = 0.047), cross section intima media (r = 0.269; p = 0.022) and cholesterol (r = 0.248; p = 0.037). Time on dialysis showed a negative correlation with carotid artery cross section (r = -0.241; p = 0.04), while age was positively correlated with intima media (r = 0.295; p = 0.013), lumen diameter (r = 0.296; p = 0.012) and intima media cross section (r = 0.347; p = 0.003). Regression analysis pointed to predictive importance of carotid artery lumen diameter for survival (Beta = 0.437; p = 0.011) of the examined patients. The cumulative rate of survival was 57%. Conclusion. In our study patient age correlated positively with all parameters of arteriosclerosis. The average duration of dialysis was negatively associated with carotid artery diameter, which was significantly higher in males. Regression correlation analyses indicated that the survival rate of the patients on hemodialysis was lower if the carotid artery diameter was larger.

Adaptation of Cardinal Points Symmetry Landmarks Distribution Model to in-vivo B-Mode Ultrasound Images of Transverse Cross-section of Carotid Arteries

2021 ◽  
Vol 6 (7) ◽  
pp. 107-113
Author(s):  
Charles Nnamdi Udekwe ◽  
Akinlolu Adediran Ponnle
Keyword(s):  
Carotid Artery ◽  
Cross Section ◽  
Carotid Arteries ◽  
Region Of Interest ◽  
Transverse Cross Section ◽  
Transverse Plane ◽  
Distribution Model ◽  
Ultrasound Images ◽  
Symmetry Line

The geometry of the imaged transverse cross-section of carotid arteries in in-vivo B-mode ultrasound images are most times irregular, unsymmetrical, full of speckles and usually non-uniform. We had earlier developed a technique of cardinal point symmetry landmark distribution model (CPS-LDM) to completely characterize the Region of Interest (ROI) of the geometric shape of thick-walled simulated B-mode ultrasound images of carotid artery imaged in the transverse plane, but this was based on the symmetric property of the image. In this paper, this developed technique was applied to completely characterize the region of interest of the geometric shape of in-vivo B-mode ultrasound images of non-uniform carotid artery imaged in the transverse plane. In order to adapt the CPS-LD Model to the in-vivo carotid artery images, the single VS-VS vertical symmetry line common to the four ROIs of the symmetric image is replaced with each ROI having its own VS-VS vertical symmetry line. This adjustment enables the in-vivo carotid artery images possess symmetric properties, hence, ensuring that all mathematical operations of the CPS-LD Model are conveniently applied to them. This adaptability was observed to work well in segmenting the in-vivo carotid artery images. This paper shows the adaptive ability of the developed CPS-LD Model to successfully annotate and segment in-vivo B-mode ultrasound images of carotid arteries in the transverse cross-sectional plane either they are symmetrical or unsymmetrical.

scholarly journals Acute ischaemic stroke secondary to a mobile thrombus in the common carotid artery - case report

2015 ◽  
Vol 1 (2) ◽  
pp. 68-70 ◽  
Author(s):  
Zoltán Bajkó ◽  
Smaranda Maier ◽  
Silvia Rusu ◽  
Anca Moțățăianu
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
Treatment Strategies ◽  
Duplex Ultrasound ◽  
Neurological Status ◽  
Heavy Smoker ◽  
Left Middle Cerebral Artery ◽  
Ischemic Attack ◽  
The Right

Abstract A mobile thrombus in the carotid arteries is a very rare ultrasonographic finding and is usually diagnosed after a neurological emergency, such as a transient ischemic attack or cerebral infarction. We present the case of a 54-year-old man with vascular risk factors (a heavy smoker, untreated hypertension) who was admitted to the emergency unit with right sided hemiparesis and aphasia. A cerebral CT scan showed a left middle cerebral artery territory infarction. The duplex ultrasound examination revealed mild atherosclerotic changes in the right common and internal carotid arteries, right-sided complete subclavian steal phenomenon and a complicated hypoechoic atherosclerotic plaque in the left common carotid artery with a large mobile thrombus. Due to the high embolization risk, the patient was hospitalised and prescribed Aspirin together with low molecular weight Heparin. We recorded an improvement in the patient’s neurological status and the control duplex scan revealed disappearance of the thrombus. The presence of floating thrombus in a patient with clinical and imagistic evidence of stroke is a major therapheutic challenge for the neurologist. The treatment strategies are not standardized and must be individualized, however in our case parenteral anticoagulation proved to be successful.

Asymmetrical distribution of atherosclerosis in the carotid artery: identical patterns across age, race, and gender

2011 ◽  
Vol 19 (4) ◽  
pp. 687-697 ◽  
Author(s):  
Parvin Tajik ◽  
Rudy Meijer ◽  
Raphaël Duivenvoorden ◽  
Sanne AE Peters ◽  
John J Kastelein ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Carotid Atherosclerosis ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Carotid Bifurcation ◽  
Carotid Intima Media Thickness ◽  
Future Design ◽  
The Common ◽  
The Individual

Background: Small autopsy studies and clinical practice indicated that carotid atherosclerosis develops in an asymmetrical helical pattern coinciding with regions of low shear stress. We investigated the distribution of carotid atherosclerosis as determined by maximum carotid intima-⊟media thickness (CIMT), to assess if we could confirm this atherosclerotic configuration across various populations with different cardiovascular risk. Methods and results: We used the individual baseline CIMT data from 3364 subjects from four recent international multicentre randomized controlled trials in which the carotid artery was systematically examined using the same ultrasound protocol and method to quantify CIMT. For each subject, circumferential information on the maximum CIMT of the left and right carotid arteries was obtained for the common carotid, bifurcation, and internal carotid artery segments. In each segment (common, bifurcation, internal), mixed modelling was used to study the differences in CIMT between angles, sides, gender, age, race, and studies. Each segment showed a different circumferential CIMT pattern. In all segments there were statistically significant differences between maximum CIMT across circumferential angles ( p < 0.001); on average CIMT was highest in the posteromedial wall of the bifurcation and internal carotid segments and in the anterolateral wall of the common carotid segment. This asymmetric circumferential pattern was found to be identical in men and women, in young and old age, in different race groups, and across the studies. Conclusions: We confirmed the asymmetrical helix-like distribution of atherosclerosis in the carotid arteries and expand the evidence by showing that the atherosclerotic configuration is similar across populations with different vascular risks and across gender, age, and race. This has implications for future design of carotid ultrasound studies, as the angle of insonation is an important predictor of maximum CIMT.

scholarly journals Digital Subtraction Angiogram (DSA) is Superior to Duplex Ultrasound (USD) in Diagnosis of Extracranial Carotid Stenosis - A Comparative Study

1970 ◽  
Vol 12 (1) ◽  
pp. 12-16
Author(s):  
Rajib Nayan Chowdhury ◽  
Kazi Mohibur Rahman ◽  
Shariff Uddin Khan ◽  
Rabindranath Sarker ◽  
Shahriar Nabi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Arteries ◽  
Duplex Ultrasound ◽  
Diagnostic Efficiency ◽  
Digital Subtraction ◽  
Key Word ◽  
Digital Subtraction Angiogram ◽  
Sensitivity Specificity ◽  
Carotid Vessels

This retrospective crossectional observational study was conducted in the department of Neurology, DMCH, Dhaka from December 2008 to December 2009. This study included a total of 40 patients, out of all, 35 suffered from nondisabling ischaemic stroke, other 5 had TIAs. Patients with ≥50% extracranial carotid stenosis on Duplex Ultrasound were then selected for DSA. DSA was done on these vessels and stenosis was measured using NASCET criteria. Results of USD and DSA were compared to determine the sensitivity, specificity and accuracy of Duplex Ultrasound (USD). ROC graph of RICA and LICA showed that most left and upper point of the curve lies at the level of 70% stenosis. At ≥70% stenosis of RICA and LICA the Sensitivity, Specificity and Accuracy were 91.2%, 50%, 85% and 86.83%, 50%, 85% respectively. This level of diagnostic efficiency of USD is less than that of DSA of carotid arteries. Study revealed that USD underestimates or overestimates degree of carotid stenosis, and DSA is safe and effective in determining stenosis. So before taking any decision to intervene in the form of Carotid endarterectomy or carotid artery stenting, it would be wise to do Digital Subtraction Angiogram of carotid vessels. Key word: Digital Subtraction Angiogram; Duplex Ultrasound; carotid vessels. DOI: 10.3329/jom.v12i1.6926J Medicine 2011; 12 : 12-16

scholarly journals Carotid Intima–Media Thickness and Markers of Brain Health in a Biracial Middle-Aged Cohort: CARDIA Brain MRI Sub-study

2019 ◽  
Vol 75 (2) ◽  
pp. 380-386 ◽  
Author(s):  
Pavla Cermakova ◽  
Jie Ding ◽  
Osorio Meirelles ◽  
Jared Reis ◽  
Dorota Religa ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Carotid Artery ◽  
Gray Matter ◽  
Carotid Arteries ◽  
White Matter Hyperintensities ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Total Brain

Abstract Background We investigated whether carotid intima–media thickness is associated with measures of cerebral blood flow (CBF), white matter hyperintensities, and brain volume in a biracial cohort of middle-aged individuals. Methods We performed a cross-sectional cohort study based on data from a multicenter, population-based study Coronary Artery Risk Development in Young Adults. Using linear and logistic regression, we estimated the association of the composite intima–media thickness measured in three segments of carotid arteries (common carotid artery, carotid artery bulb, and internal carotid artery) with volume (cm3) and CBF (mL/100 g/min) in the total brain and gray matter as well as volume of white matter hyperintensities (cm3). Results In the analysis, 461 participants (54% women, 34% African Americans) were included. Greater intima–media thickness was associated with lower CBF in gray matter (β=−1.36; p = .04) and total brain (β=−1.26; p = .04), adjusting for age, sex, race, education, and total brain volume. The associations became statistically nonsignificant after further controlling for cardiovascular risk factors. Intima–media thickness was not associated with volumes of total brain, gray matter, and white matter hyperintensities. Conclusions This study suggests that lower CBF in middle age is associated with markers of atherosclerosis in the carotid arteries. This association may reflect early long-term exposure to traditional cardiovascular risk factors. Early intervention on atherosclerotic risk factors may modulate the trajectory of CBF as people age and develop brain pathology.

Abstract 184: The 8.7-year Follow-up For Prediction Of Stroke By Enlargement Of Carotid Arteries In a General Urban Cohort: The Suita Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Yoshihiro Kokubo ◽  
Masatoshi Koga ◽  
Makoto Watanabe ◽  
Kazunori Toyoda ◽  
Kazuyuki Nagatsuka ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Proportional Hazards ◽  
Intima Media Thickness ◽  
Cox Proportional Hazards ◽  
Baseline Survey ◽  
External Carotid ◽  
Diastolic Phase ◽  
General Populations

Introduction: Carotid intima-media thickness (IMT) has been increasingly used as a subclinical marker for stroke and ischemic heart disease (IHD). However, no study has examined the association between enlargement of carotid arteries and the incidence of stroke in general populations. We assessed the hypothesis that carotid artery enlargement was a predictor for stroke events in a general urban Japanese population. Methods: We studied 5,330 Japanese individuals (mean age 55.3 years, without stroke or IHD) who completed a baseline survey and carotid ultrasonography in the Suita Study, and were then followed for 8.7 years on average. Carotid atherosclerosis was evaluated by high-resolution ultrasonography (7.5MHz transducer) with atherosclerotic indexes of IMT in the common carotid artery (CCA), carotid artery bulbs (Bulbs), and internal and external carotid arteries (ICA and ECA, respectively). The CCA-int and the CCA-adv diameters were defined as the means of the minimal lumen-intima diameters and the maximal media-adventitia diameters for both sides of the CCA, respectively, at the beginning points of dilation of the Bulbs in the diastolic phase. The ICA and the ECA diameters were defined as the means of the minimal intima-lumen diameters for both sides of the ICA and the ECA at the points where the ICA and the ECA were divided from the Bulbs in the diastolic phase, respectively. The risks of stroke across quartiles according to carotid arteries diameters were compared by the use of multivariable-adjusted Cox proportional-hazards models. Results: In 46,553 person-years of follow-up, we documented 124 cerebral infarctions, 49 hemorrhagic strokes, 12 unclassified strokes, and 125 IHD events. The multivariable-adjusted hazard ratios (HRs; 95% confidence intervals [CIs]) in the highest quartile of the CCA-int diameter (>6.65 mm) for all strokes, ischemic and hemorrhagic strokes were 2.62 (1.54 to 4.47), 2.27 (1.17 to 4.41), and 4.38 (1.51 to 12.68), respectively, compared with the lowest quartile of the CCA-int diameter (<5.7 mm). The multivariable-adjusted HRs (95% CIs) for all strokes, ischemic and hemorrhagic strokes, lacunar, and atherothrombotic infarctions were 1.61 (1.32 to 1.96), 1.51 (1.19 to 1.92), 2.12 (1.41 to 3.19), 1.31 (0.86 to 2.00), and 2.53 (1.45 to 4.41) in 1-mm increments of the CCA-int diameter, respectively. Those HRs (95% CIs) were 1.24 (1.05 to 1.47), 1.18 (0.97-1.45), 1.49 (1.07 to 2.07), 0.87 (0.62 to 1.23), and 1.97 (1.19 to 3.24) in 1-mm increments of the ICA diameter, respectively. The risks of strokes for the CCA-adv diameter were similar to those for CCA-int. No association of the ECA diameter with stroke was observed. Conclusions: Enlargement of both the CCA and the ICA is an independent risk factor for stroke and its subtypes in the general population. Carotid artery enlargement may be a good predictor for stroke in general populations.

Does Oral Hygiene Trigger Carotid Artery Intima-Media Thickness?

2013 ◽  
Vol 16 (4) ◽  
pp. 232 ◽  
Author(s):  
Ihsan Sami Uyar ◽  
Veysel Sahin ◽  
Mehmet Besir Akpinar ◽  
Feyzi Abacilar ◽  
Faik Fevzi Okur ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Oral Hygiene ◽  
Carotid Arteries ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Poor Oral Hygiene ◽  
Media Thickness ◽  
Group I ◽  
History Of ◽  
Dmft Index

<p><b>Background and Purpose:</b> The aim of this study was to evaluate whether poor oral hygiene is associated with the intima-media thickness of the carotid arteries, which is one of the predictors of future progression of subclinical atherosclerosis.</p><p><b>Methods:</b> We selected 108 patients during periodontal examinations according to their oral hygiene. The patients had no history of atherosclerotic disease. The results of carotid artery B-mode ultrasonography examinations were analyzed at baseline and after a mean of 7.8 months. Patients were scored on the DMFT index for the number of decayed (D), missing (M), and filled (F) teeth (T). We also used the Silness-Loe plaque index (SLI) to evaluate oral hygiene and dental plaque. The patients were divided into 2 groups according to DMFT and SLI criteria. Group I had a DMFT index of 0 to 3 and an SLI score of 0 or 1; group II had a DMFT index of 4 to 28 and an SLI score of 2 or 3.</p><p><b>Results:</b> Dental status and oral hygiene were significantly associated with carotid artery intima-media thickness. Patients with increasing DMFT and SLI indices were correlated with intima-media thickness of the carotid artery.</p><p><b>Conclusions:</b> Chronic poor oral hygiene and tooth loss are related to subclinical atherosclerotic changes in the carotid arteries and might be indicative of future progression of atherosclerosis.</p>

scholarly journals Common Carotid Artery Diameter and Cardiovascular Risk Factors in Overweight or Obese Postmenopausal Women

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kelly D. Lloyd ◽  
Emma Barinas-Mitchell ◽  
Lewis H. Kuller ◽  
Rachel H. Mackey ◽  
Eric A. Wong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Cardiovascular Risk Factors ◽  
Postmenopausal Women ◽  
Common Carotid Artery ◽  
Intima Media Thickness ◽  
Lumen Diameter ◽  
Vascular Health ◽  
Cross Sectional

Arterial diameter is an underutilized indicator of vascular health. We hypothesized that interadventitial and lumen diameter of the common carotid artery would be better indicators of vascular health than carotid plaque or intima media thickness (IMT). Participants were 491 overweight or obese, postmenopausal women who were former or current hormone therapy (HT) users, 52–62 years, with waist circumference>80 cm. We evaluated cross-sectional associations of cardiovascular risk factors with carotid measures, by HT status. Former HT users had a worse cardiovascular profile than current HT users: larger adventitial (6.94 mm versus 6.79 mm) and lumen diameter (5.44 mm versus 5.31 mm, bothP<0.01) independent of cardiovascular risk factors; IMT and plaque were similar. Larger diameters were best explained by former HT use, higher pulse pressure, and greater weight. Independent of potential confounders, overweight and obese postmenopausal former HT users had larger carotid diameters than current HT users. Carotid diameter should be considered in studies of HT.

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