scholarly journals Morphological Changes in Carotid Arteries in Stroke Cases

2013 ◽  
Vol 52 (189) ◽  
pp. 251-254 ◽  
Author(s):  
Guna Bahadur Thapa ◽  
Alin Sundas ◽  
Raj Kumar Rauniyar
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Morphological Changes ◽  
Cross Sectional ◽  
Ischemic Infarction ◽  
Atherosclerotic Plaque Formation ◽  
Ischemic Infarct ◽  
Medial Complex ◽  
Carotid Bulb ◽  
Soft Plaque

Introduction: Majority of stroke is due to ischemic infarction and occurs in carotid artery territory. The extra cranial parts of carotid arteries are the common sites for the atherosclerotic plaque formation. Ultrasonography is the first line of investigation for screening of the carotid artery diseases to localize and characterize the plaques. Objective was to study the morphological changes in extra cranial part of carotid arteries in cases of ischemic infarction using Ultrasonography. Methods: It was an institution based prospective study and convenience sampling method was used. Computed Tomography proven ischemic infarct, lacunar infarction and transient ischemic infarction cases were included in the study. Results: Fifty four cases were included in the study. Mean of Intimo-medial Complex Thickness was 0.89 mm and 0.88 mm in right and left side respectively. Sixty five percent cases had plaque in extra cranial part of carotid artery. Ninety three percent of plaque was found in and adjacent to the carotid bulb region. Ipsilateral plaque was found in 76% and 65% cases on right and left side respectively. Fifty three percent of cases had soft plaque. Majority of cases had less than 50% narrowing of the lumen diameter in term of cross-sectional area due to plaque. Thirteen (24%) cases had plaque in internal carotid artery. Conclusions: Carotid ultrasound can be used for screening of the asymptomatic but high-risk cases and following up of the symptomatic cases to plan for necessary management as required. Keywords: carotid artery, carotid ultrasonography, ischemic infarction, plaque.

scholarly journals Carotid smooth muscle contractility changes after severe burn

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kevin DeSpain ◽  
Charles R. Rosenfeld ◽  
Ryan Huebinger ◽  
Xiaofu Wang ◽  
Jayson W. Jay ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Ex Vivo ◽  
Total Body Surface Area ◽  
Male Rats ◽  
Severe Burn ◽  
Cross Sectional ◽  
Severe Burns ◽  
Force Relaxation

AbstractSevere burns result in cardiovascular dysfunction, but responses in the peripheral vasculature are unclear. We hypothesize that severe burns disturb arterial contractility through acute changes in adrenergic and cholinergic receptor function. To address this, we investigated the changes in carotid artery contractility and relaxation following a severe burn. Thirty-four adult Sprague–Dawley male rats received a 40% total body surface area (TBSA) scald burn and fluid resuscitation using the Parkland formula. Control animals received sham burn procedure. Animals were serially euthanized between 6 h and 14 days after burn and endothelium-intact common carotid arteries were used for ex vivo force/relaxation measurements. At 6 h after burn, carotid arteries from burned animals demonstrated a > 50% decrease in cumulative dose-responses to norepinephrine (p < 0.05) and to 10−7 M angiotensin II (p < 0.05). Notably, pre-constricted carotid arteries also demonstrated reduced relaxation responses to acetylcholine (p < 0.05) 6 h after burn, but not to sodium nitroprusside. Histologic examination of cross-sectional planes revealed significant increases in carotid artery wall thickness in burned rats at 6 h versus 3 days, with increased collagen expression in tunica media at 3 days (p < 0.05). Carotid artery dysfunction occurs within 6 h after severe burn, demonstrating decreased sensitivity to adrenergic- and angiotensin II-induced vasoconstriction and acetylcholine-induced relaxation.

scholarly journals Coiled Internal Carotid Arteries Associated with Bilateral Sequential Strokes

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Gary G. Tse ◽  
Elna M. Masuda ◽  
Aaron M. McMurtray ◽  
Beau K. Nakamoto
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Carotid Bulb ◽  
Internal Carotid Arteries ◽  
Cervical Internal Carotid Artery

The risk of stroke and management of coiling of the cervical internal carotid artery in the absence of an atherosclerotic carotid bulb lesion is unclear. We report a case of an otherwise healthy 39-year-old woman who developed bilateral sequential strokes associated with bilateral coiled internal carotid arteries. We discuss the risk of stroke and management of coiled carotid arteries as they relate to the patient presented.

Homocysteine Associated With Low Cognitive Function Independent of Asymptomatic Intracranial and Carotid Arteries Stenoses in Chinese Elderly Patients: An Outpatient-Based Cross-Sectional Study

2021 ◽  
pp. 089198872098891
Author(s):  
Xiaona Wang ◽  
Tian Qiao ◽  
Min Liu ◽  
Xiang Wang
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Cerebral Blood Flow Velocity ◽  
Underlying Mechanism ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional ◽  
Thcy Level

Introduction: A high homocysteine (Hcy) concentration is correlated with cognitive impairment; however, the exact underlying mechanism is still not fully elucidated. The present study aimed to investigate whether asymptomatic intracranial and carotid arteries stenoses are involved in Hcy-related low cognitive function. Methods: This was a cross-sectional study in outpatient clinics. Residents aged ≥60 years, who came to the Stroke and Rehabilitation Clinic of Shandong Provincial Third Hospital in Jinan, Shandong Province from December 2019 to May 2020 to seek consultation due to abnormal transcranial Doppler reports (eg., increased cerebral blood flow velocity) were eligible. Information including demographics, medical history, lifestyle habits were collected. Fasting blood was used to detect total serum homocysteine level (tHcy). Cerebrovascular magnetic resonance angiography and neck vascular ultrasound examination were used to confirm the diagnosis of intracranial and carotid artery stenoses. The Mini-Mental State Examination was used to assess the cognitive function of each participant. Logistic regression was used to evaluate the relationship between tHcy levels and cognitive function. Results: This study included 236 participants (mean age: 64.0 (SD, 7.5) years, female: 58.1%). Multivariable analyses adjusted for several potential confounders, including creatinine and cardiovascular risk factors, showed that tHcy was associated with carotid artery stenosis (CAS). After adjusting for CAS, ICAS and several potential confounders, the association between tHcy level and low cognitive function remained significant (odds ratio: 1.09, 95% confidence interval: (1.03, 1.16), P = 0.032) . Conclusion: Increased serum tHcy level was associated with low cognitive function independent of asymptomatic intracranial and carotid arteries stenoses.

Optimized geometry of the carotid artery cross-section: Comparison between circular and elliptical approximations in B-mode ultrasound images

2020 ◽  
pp. 2150004
Author(s):  
Effat Soleimani ◽  
Hazhir Saberi ◽  
Niloofar Ayoobi-Yazdi
Keyword(s):  
Carotid Artery ◽  
Goodness Of Fit ◽  
Carotid Arteries ◽  
Computational Cost ◽  
Point Clouds ◽  
Pattern Search ◽  
Ultrasound Images ◽  
Relative Deviation ◽  
Cross Sectional ◽  
Atherosclerotic Stenosis

Cross-sectional area (CSA) measurement obtained from transverse ultrasound images is the general method used for carotid artery stenosis calculation which assumes a circular CS, however, atherosclerotic stenosis may change the CSA geometry and lead to miscalculation. This study aims to determine the accuracy of circular or elliptical approximation of the normal and stenosed carotid artery CSA. Sixty transverse B-mode ultrasound images (30 from healthy and 30 from stenosed carotid arteries) were recorded. Contours of the internal lumen of the arteries were segmented and the encompassed lumen area was calculated. Based on the fitting accuracy and computational cost effectiveness, pattern search (PS) optimization algorithm was selected by which the parameterized equations of the circular and elliptical geometries were fitted to the segmented point clouds. Goodness of fit analysis of two geometries was carried out using root mean square error (RMSE) and the relative deviation of the approximated CSA. Results of this study showed that elliptical approximation better fits to the artery CS of carotid arteries, with the average RMSE of [Formula: see text] and [Formula: see text] pixels in healthy and [Formula: see text] and [Formula: see text] pixels in stenosed carotid arteries, respectively, for circle and ellipse approximation. Mean values of the relative deviation of the approximated CSA by circle and ellipse geometries were 5.14%[Formula: see text]±[Formula: see text]4.53% and 3.89%[Formula: see text]±[Formula: see text]4.19% in normal arteries; and 12.18%[Formula: see text]±[Formula: see text]10.94% and 4.59%[Formula: see text]±[Formula: see text]3.75% in stenosed arteries, respectively. This study represented that elliptical approximation provides increased accuracy for carotid artery CSA for both normal and stenosed carotid arteries.

Carotid Plaques Among Different Ethinic Patients with Ischemic Stroke

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 19-22
Author(s):  
Bhakta Dev Shrestha ◽  
Sunny Bajracharya ◽  
Samrat Shrestha ◽  
Manen Prasad Gorkahly
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Ethnic Groups ◽  
Carotid Plaque ◽  
Morphological Changes ◽  
Primary Objective ◽  
Cross Sectional ◽  
Carotid Plaques ◽  
Bilateral Carotid ◽  
The Mean

Introduction: Sonographic evaluation of the carotid artery is commonly used for risk assessment in stroke. In Nepal, there are few studies regarding morphological changes in the carotid artery including the percentage of stenosis, types of plaque, sites of plaque. These changes quite vary in relation to age, sex, and ethnicity, and other risk factors. The primary objective of the study was to find the prevalence of carotid plaques in different ethnic groups with ischemic stroke. Materials and Methods: The study was an observational, cross-sectional descriptive study conducted in the Neuromedicine department of the National Academy of Medical Sciences. The study included a consecutive sampling of the patients diagnosed with ischemic stroke admitted in the neuro/medicine ward or those visiting neuro/medicine OPD of Bir hospital. Results: Out of the 80 study patients,26.3% patients were Brahmans/Chhetri,11.3% were Madhesi,10 % were Dalits,25% were Newars and 27.5% were Janajati. In descending order, the presence of carotid plaque in Janajati (20%) was followed by Newars (18.8), Brahmans (17.5%), Madhesi group (8.8%), and Dalit (7.5%). The mean number of plaque was higher in Brahman/Chhetri group 3.33 with S.D 3.28 and lowest in Janajati group 2.20 with S.D 3.16. It was found that around 24% of the cases had unilateral carotid plaques and 49% had bilateral carotid plaques. Janajati group had a maximum proportion of bilateral plaques while Dalit had the least proportion (15% vs 2.5%). However, the difference among the ethnic groups was not significant. Conclusion: The prevalence of carotid plaques, the maximum number of plaques, and the number of bilateral plaques, all were highest in the Janajati group. However, the mean number of the carotid plaque was highest among the Dalit group. Further larger studies are required to study the association of the Nepalese ethnicity with carotid morphological changes.

scholarly journals Histological disorders of neurons of phylogenetically different parts of the cerebral cortex in partial, subtotal, stepwise subtotal, and total cerebral ischemia

2021 ◽  
Vol 90 (1) ◽  
pp. e493
Author(s):  
Lizaveta I. Bon ◽  
Nataliya Y. Maksimovich
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Parietal Cortex ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
Morphological Changes ◽  
Oxygen Deficiency ◽  
Progressive Increase ◽  
Histological Changes ◽  
Common Carotid Arteries

Aim. Measure of the histological changes in neurons in the parietal cortex and hippocampus of rats with partial, subtotal, stepwise subtotal, and total cerebral ischemia. Material and Methods. Studies were performed on 84 rats. Partial cerebral ischemia was modelled by ligation of one common carotid artery. Subtotal cerebral ischemia was modelled by ligation of both common carotid arteries. Stepwise subtotal cerebral ischemia was performed by sequential ligation of both common carotid artery with 7-day, 3-day or 1-day intervals. Total cerebral ischemia (CI) was modelled by decapitation. Results. When comparing the morphological changes of neurons in the parietal cortex and hippocampus, we observed that, with the aggravation of the severity of cerebral ischemia, there was a progressive increase in the number of hyperchromic shrivelled neurons and neurons with pericellular oedema. Modelling of more severe types of ischemic damage lead to pronounced morphological changes in neurons – a decrease in size, deformation of the perikaryon, and increase in the degree of neuronal chromatophilia with their wrinkling. Conclusions. The smallest morphological changes in neurons were noted in the partial cerebral ischemia groups and subgroup 1 of stepwise subtotal cerebral ischemia, with an interval between common carotid artery dressings of 7 days. The most obvious morphological changes were observed in the conditions of total cerebral ischemia after 1 day. Changes in the parietal cortex and hippocampus were unidirectional, but in the parietal cortex, which is most sensitive to oxygen deficiency, they were more pronounced.

Free-Floating Thrombus in the Distal Internal Carotid Artery Causing a Stroke

2020 ◽  
Author(s):  
Spyros Papadoulas ◽  
Konstantinos Moulakakis ◽  
Natasa Kouri ◽  
Petros Zampakis ◽  
Stavros K. Kakkos
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Medical Management ◽  
Internal Carotid ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Residual Stenosis ◽  
Floating Thrombus ◽  
Distal Internal Carotid Artery ◽  
Carotid Bulb

AbstractWe present a patient suffering from a stroke with a free-floating thrombus extending up to the distal internal carotid artery. The thrombus was totally resolved after a 2-week anticoagulation regimen without leaving behind any severe residual stenosis in the carotid bulb. The optimal treatment of this rare condition remains uncertain. We report some important treatment strategies that have been used in the literature, emphasizing the anticoagulation as the mainstay of therapy. Immediate surgical and interventional manipulations carry the risk of thrombus dislodgement and embolization and should be considered if there are recurrent symptoms despite medical management.

scholarly journals Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alessandro Robaldo ◽  
Guido Carignano ◽  
Alberto Balderi ◽  
Claudio Novali
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
High Risk Patient ◽  
Carotid Bifurcation ◽  
Left Common Carotid Artery ◽  
The Right ◽  
Bovine Aortic Arch ◽  
Common Carotid Arteries

Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

scholarly journals Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Péter J. Hegyi ◽  
Alexandra Soós ◽  
Emese Tóth ◽  
Attila Ébert ◽  
Viktória Venglovecz ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Morphological Changes ◽  
International Study ◽  
Study Data ◽  
Cross Sectional ◽  
Clinical Biomarkers ◽  
Stage Disease ◽  
Significant Difference ◽  
End Stage

AbstractChronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.

scholarly journals Carotid webs produce greater hemodynamic disturbances than atherosclerotic disease: a DSA time–density curve study

2021 ◽  
pp. neurintsurg-2021-017588
Author(s):  
Charlie C Park ◽  
Retta El Sayed ◽  
Benjamin B Risk ◽  
Diogo C Haussen ◽  
Raul G Nogueira ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Region Of Interest ◽  
Hemodynamic Parameters ◽  
Density Curve ◽  
Atherosclerotic Lesions ◽  
Clinically Significant ◽  
Flow Stasis ◽  
Time Density

BackgroundCarotid webs (CaWs) are associated with ischemic strokes in younger patients without degrees of stenosis that are traditionally considered clinically significant.ObjectiveTo compare the hemodynamic parameters in the internal carotid artery (ICA) bulbar segment in patients with CaW with those in patients with atherosclerotic lesions using time–density curve (TDC) analysis of digital subtraction angiography (DSA) images.MethodsWe retrospectively assessed DSA images of 47 carotid arteries in 41 adult patients who underwent ICA catheter angiography for evaluation after ischemic stroke. Hemodynamic parameters, including full width at half maximum (FWHM) and area under the time–density curve (AUC) as proxies for increased flow stasis, were calculated using TDC analyses of a region of interest (ROI) in the ICA bulb immediately rostral to the web/atherosclerotic plaque, relative to a standardized ROI in the ipsilateral distal common carotid artery (eg, relative FWHM (rFWHM)). Hemodynamic parameters were compared using non-parametric Kruskal-Wallis tests. Logistic regression was used to predict CaW versus mild/moderate atherosclerosis for each hemodynamic parameter, adjusting for degree of stenosis.ResultsMean age of patients was 56.0±13 years, with 22 (53.7%) women. 17 CaWs, 22 atherosclerotic plaques (15 mild/moderate and 7 severe), and eight normal carotid arteries were assessed. Significant between-group differences were present in the relative total AUC (p<0.001), relative AUC at wash out (p=0.031), and relative FWHM (p=0.001). Logistic regression to predict CaW versus mild/moderate atherosclerosis showed that rAUC total had the highest predictive value (pAUC=0.96, 95% CI 0.90 to 1.00), followed by rFWHM (0.87, 95% CI 0.74 to 1.00), and rAUC WO (0.74, 95% CI (0.57 to 0.91).ConclusionCaW results in larger local hemodynamic disruption, characterized by flow stasis, than mild/moderate carotid atherosclerotic lesions, suggesting that CaWs may produce larger regions of thrombogenic flow stasis.

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