Carotid Artery Stenosis Correlation with Hyperhomocysteinemia in Stroke Patient Group: a Prospective Study

Purpose: To investigate the short-term outcomes and complications of straight vs tapered carotid stent placement for patients with symptomatic carotid stenosis. Methods: A prospective study was conducted to examine if tapered carotid stents (TCS) performed better than straight carotid stents (SCS) in terms of complications and outcomes in patients with a unilateral, symptomatic, internal carotid artery stenosis ⩾70%. Between January 2014 and January 2016, 236 patients were screened; 88 were excluded, leaving 148 patients for 1:1 randomization to carotid artery stenting with either SCS or TCS. The data were analyzed for differences between the groups in terms of complications (hemodynamic depression, cerebral hyperperfusion syndrome, puncture site sequelae) and endpoint events (stroke, myocardial infarction, and death) at 30 days and 6 months. Results: Two patients in the TCS group underwent endarterectomy after allocation, leaving 72 patients (mean age 65.1±8.8 years; 59 men) in the TCS group for analysis vs 74 (mean age 65.0±7.9 years; 58 men) in the SCS group. The technical success was 100% in both groups. The incidence of hemodynamic depression (hypotension and bradycardia) after the procedures were higher in the SCS group (p=0.04), and the patients who underwent SCS procedures had longer hospital stays (p=0.01). There was no difference in the incidences of complications, myocardial infarction, mortality, or stroke at 30 days or 6 months between the SCS and TCS groups. The rates of restenosis (4% SCS vs 1% TCS) were similar (p=0.63); all restenoses were moderate (50%–70%). Conclusion: When compared to straight stents, tapered carotid stents significantly decreased hemodynamic complications and hospital stay.

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Asymptomatic carotid artery stenosis associated with peripheral vascular disease: a prospective study

Cardiovascular Surgery ◽

10.1016/s0967-2109(98)00076-3 ◽

1999 ◽

Vol 7 (1) ◽

pp. 44-49 ◽

Cited By ~ 23

Author(s):

A House

Keyword(s):

Carotid Artery ◽

Prospective Study ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Carotid Artery Stenosis ◽

Artery Stenosis ◽

Peripheral Vascular ◽

Asymptomatic Carotid ◽

Asymptomatic Carotid Artery Stenosis ◽

A Prospective Study

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Abstract 2352: 18F-fluorodeoxyglucose PET Can Identify The Inflamed and Vulnerable Carotid Plaque - A Prospective Study in Japan

Stroke ◽

10.1161/str.43.suppl_1.a2352 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Satoshi Kuroda ◽

Hisayasu Saito ◽

Katsuhiko Maruichi ◽

Naoki Nakayama ◽

Kenji Hirata ◽

...

Keyword(s):

Carotid Artery ◽

Prospective Study ◽

Carotid Artery Stenosis ◽

Fdg Pet ◽

Vulnerable Plaque ◽

Japanese Patients ◽

Artery Stenosis ◽

Fdg Uptake ◽

Standardized Uptake Values ◽

18F Fdg

Objective - There are few studies that denote the validity of 8F-fluorodeoxyglucose (FDG) PET to detect the inflammation of severe (>70%) carotid artery stenosis in Asian populations. This study was aimed to clarify whether 18F-FDG PET can identify inflamed and vulnerable plaque at higher risk for subsequent ischemic stroke in Japanese patients with severe carotid artery stenosis. Methods - This prospective study included 33 patients with severe carotid artery stenosis between 2006 and 2011. Of these, 12 patients were symptomatic and other 21 were asymptomatic. There were 28 males and 5 females. Their mean age was 71.1 ± 8.2 years, ranging from 48 to 85. Their clinical data were precisely collected. All 33 patients underwent 18F-FDG PET and ultrasound sonography (US) to evaluate the plaque composition prior to carotid endarterectomy (CEA). FDG uptake was quantified by maximum standardized uptake values (SUV). Following surgery, the specimens were stained with the antibodies against CD68 and MMP-9. Results - High FDG uptake (SUV>2.0) was observed in 15 (45%) of 33 operated plaques. High FDG uptake significantly correlated with the other vascular disorders (P=0.048), echolucent plaque (P=0.041), lipid-rich plaque (P<0.001), CD68 expression (P<0.001), and MMP-9 expression (P=0.002). 18F-FDG PET showed significantly higher sensitivity and specificity to identify lipid-rich and CD68-positive plaque than US. However, high FDG uptake was not related to patients’ gender, age, and the degree of stenosis. There was no significant correlation between FDG uptake and symptomatic or asymptomatic patients. Conclusion - These findings strongly suggest that 18F-FDG PET would provide more valuable information to identify the inflamed, vulnerable plaque than conventional ultrasound in Japanese patients with severe carotid artery stenosis.

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Comparison of Mid-, and Late- Term Morbidity and Mortality Results of Surgical Endarterectomy Versus Endovascular Stent Implantation in Carotid Artery Stenosis

Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society ◽

10.5222/gkdad.2021.63496 ◽

2021 ◽

Author(s):

İsmail Selçuk ◽

Nehir Selçuk ◽

Murat Fatih Can ◽

Ahmet Turan Yılmaz

Keyword(s):

Carotid Artery ◽

Stent Implantation ◽

Carotid Artery Stenosis ◽

Laboratory Data ◽

Neurological Complications ◽

Artery Stenosis ◽

Morbidity And Mortality ◽

Endovascular Stent ◽

Group A ◽

Group B

Objective: Carotid artery stenosis is an important etiological cause of cerebrovascular events and stent implantation is widely used as an alternative treatment to endarterectomy. In this study, we compared the mid and late-term results of carotid artery stenosis patients who underwent endarterectomy and stent implantation. Methods: Patients who underwent endarterectomy (Group A, n: 27) and endovascular stent implantation (Group B, n: 22) due to carotid artery stenosis between 2008 and 2014 were included in the study. All examination, laboratory data and radiological images were collected from the hospital database. Morbidity and mortality developed in the mid (1-12 months) and late term (>12 months) periods were evaluated retrospectively. Results: While there were no neurological complications and restenosis in the midterm in Group A, 2 patients (9.09%) had stroke and 2 patients (9.09%) had restenosis in Group B. In the late-term, while there were no neurological complications in Group A, stroke in 3 patients (13.63%) (p=0.048) in Group B, restenosis was observed in 1 patient in Group A and 5 patients in Group B (3.7% vs 22.72%, p=0.043). Conclusion: We recommend endarterectomy as the primary approach for carotid artery revascularization and percutaneous approach especially in high-risk patients with recurrent ICA stenosis and distal carotid artery lesions.

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Comparative Study of Risk Factors Between Lacunar and Non-lacunar Ischemic Strokes

Bangladesh Journal of Neuroscience ◽

10.3329/bjn.v28i2.17176 ◽

2013 ◽

Vol 28 (2) ◽

pp. 88-95

Author(s):

Dewan Md Elyas ◽

Aminur Rahman ◽

Quazi Deen Mohammad ◽

Badrul Alam Mondol ◽

Sakhawat Hossain ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Myocardial Infarction ◽

Ischemic Stroke ◽

Carotid Artery ◽

Carotid Artery Stenosis ◽

Artery Stenosis ◽

Lacunar Stroke ◽

Group A ◽

Group B

Background: Stroke is a leading cause of mortality and morbidity in both developed as well as developing countries The risk factors in lacunar stroke differ in comparison to nonlacunar strokes. In this study risk factors of lacunar stroke in comparison to non-lacunar were evaluated. Objectives: The aim of the study was to compare the risk factors among lacunar stroke and non-lacunar stroke. Methodology: This comparative study conducted in the department of Medicine and Neurology, Dhaka Medical College Hospital, Dhaka from September 2010 to August 2011. MRI of brain was done in 151 patients above 18 years of age with ischemic stroke and Lacunar stroke was found in 31 patients and non-lacunar stroke was detected in 120 patients. Based on the inclusion and exclusion criteria from them 30 patients with lacunar stroke were selected as Group-A patients and equal number of non-lacunar stroke same ages as group B were compared of. The risk factors of stroke were defined as hypertension, diabetes mellitus, hypercholesterolemia, smoking, history of transient ischemic attack, myocardial infarction, atrial fibrillation and carotid artery stenosis. Results: Out of 151 patients with ischemic stroke non-lacunar stroke was predominant, which was 79.47% and lacunar stroke was 20.52%. The mean age was found 60.9±10.2 years in Group A and 56.2±11.8 years in Group B, which was almost similar between two groups (p>0.05). Male were predominant, which was 63.33% and 76.67% in lacunar and non-lacunar stroke respectively. Male and female ratio was 2.3:1. Regarding the risk factors hypertension was observed most common risk factor among the patients having lacunar and non-lacunar strokes. Hypertension and diabetes mellitus were common in lacunar stroke and myocardial infarction, carotid artery stenosis and hypercholesterolemia were common in non-lacunar stroke which were statistically significant (p<0.05) between the both groups. However, the percentage of smoking, previous TIA and atrial fibrillation were not significantly (p>0.05) different between lacunar and non-lacunar stroke. Conclusion: Hypertension and diabetes mellitus were common in lacunar stroke, and myocardial infarction, whereas carotid artery stenosis and hypercholesterolemia were common in non-lacunar stroke and the both groups were statistically significant (p<0.05) . So modification of risk factors may reduce the incidence of ischemic stroke. DOI: http://dx.doi.org/10.3329/bjn.v28i2.17176 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 88-95

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P702Diagnostic and prognostic micro-RNAs in ischemic stroke due to carotid artery stenosis and in acute coronary syndrome: the 4-year prospective study

European Heart Journal ◽

10.1093/eurheartj/ehx501.p702 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

J. Gacon ◽

A. Kablak-Ziembicka ◽

R. Badacz ◽

E. Stepien ◽

M.C. Costa ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Ischemic Stroke ◽

Carotid Artery ◽

Prospective Study ◽

Carotid Artery Stenosis ◽

Artery Stenosis ◽

Coronary Syndrome ◽

Micro Rnas

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Takotsubo syndrome in a stroke patient with carotid artery stenosis

eNeurologicalSci ◽

10.1016/j.ensci.2018.11.011 ◽

2018 ◽

Vol 13 ◽

pp. 46-48

Author(s):

Claudia Stöllberger ◽

Lenka Gerencerova ◽

Josef Finsterer

Keyword(s):

Carotid Artery ◽

Stroke Patient ◽

Carotid Artery Stenosis ◽

Artery Stenosis ◽

Takotsubo Syndrome

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Predictive Value of Neutrophil-to-Lymphocyte, Aspartate-to-Alanine Aminotransferase, Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratios in Severity and Side of Carotid Artery Stenosis: Are Those Significant?

The Heart Surgery Forum ◽

10.1532/hsf.3431 ◽

2021 ◽

Vol 24 (1) ◽

pp. E072-E078

Author(s):

ÖZGÜR ALTINBAŞ ◽

Şeniz Demiryürek ◽

Mehmet Işık ◽

Ömer Tanyeli ◽

Yüksel Dereli ◽

...

Keyword(s):

Carotid Artery ◽

Patient Group ◽

Carotid Artery Stenosis ◽

Alanine Aminotransferase ◽

Healthy Subjects ◽

Artery Occlusion ◽

Artery Stenosis ◽

Mortality And Morbidity ◽

Significant Difference ◽

The Relationship

Background: Atherosclerosis is a chronic disease that leads to mortality and morbidity by affecting arterial vascular structures. Carotid artery is one of these arterial structures and occlusive disease of carotid artery may cause stroke or cranial ischemic infarction. Inflammation plays a role in the atherosclerotic process. In this study, we aimed to discuss the relationship between the severity and side of carotid artery occlusion and novel inflammatory parameters include platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios. Methods: One-hundred-fifteen patients who had carotid artery stenosis between 50%-99% and 115 healthy subjects with no carotid artery stenosis or additional disease were included in the study. The relationship between the side and degree of the lesion and platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios were studied in the patient group. The patients with carotid artery stenosis and the healthy subjects were compared, in the terms of same parameters. Data were evaluated statistically. Results: There were no statistically significant differences between the groups, in the terms of platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios and the degree of stenosis. There was no statistically significant difference between the sides of the lesions and the parameters above except lymphocyte-to-monocyte ratio. It was statistically significantly higher in left-sided lesions. Aspartate-to-alanine aminotransferase and neutrophil-to-lymphocyte ratios were markedly higher in the patient group, when compared to controls. Conclusion: Platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios are inexpensive, easy, fast, and reproducible parameters that can be used in determining the prediction of carotid artery stenosis.

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