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Spectral CT Imaging Using MARS Scanners
Published in Katsuyuki Taguchi, Ira Blevis, Krzysztof Iniewski, Spectral, Photon Counting Computed Tomography, 2020
Aamir Y. Raja, Steven P. Gieseg, Sikiru A. Adebileje, Steven D. Alexander, Maya R. Amma, Fatemeh Asghariomabad, Ali Atharifard, Benjamin Bamford, Stephen T. Bell, Srinidhi Bheesette, Anthony P. H. Butler, Philip H. Butler, Pierre Carbonez, Alexander I. Chernoglazov, Shishir Dahal, Jérôme Damet, Niels J. A. de Ruiter, Robert M. N. Doesburg, Brian P. Goulter, Joseph L. Healy, Praveen K. Kanithi, Stuart P. Lansley, Chiara Lowe, V. B. H. Mandalika, Emmanuel Marfo, Aysouda Matanaghi, Mahdieh Moghiseh, Raj K. Panta, Hannah M. Prebble, Nanette Schleich, Emily Searle, Jereena S. Sheeja, Rayhan Uddin, Lieza Vanden Broeke, V. S. Vivek, E. Peter Walker, Michael F. Walsh, Manoj Wijesooriya
Patients with advanced unstable plaques identified following a stroke are often treated by carotid endarterectomy, a surgical procedure where the carotid artery is cut open and the plaque tissue is peeled off the artery muscle layer. This surgery has a significant risk associated with it, so surgeons prefer to operate only when there is a clear risk to the patient from further rupture events. The current imaging techniques, though, provide only limited indications of the plaque stability with much of the decision based on level of stenosis, calcification, and the patient's general health for surgery. MARS imaging of excised atheroma, under typical clinical x-ray dose and energy levels, has shown that the key features of these vulnerable plaques can be clearly seen [6, 18, 92, 93].
Finite element analysis of braided dense-mesh stents for carotid artery stenosis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Atherosclerotic stenosis of the carotid artery is a major cause of ischemic stroke, accounting for about 15–20% of all cases (Woo et al. 2017). Carotid endarterectomy (CEA) and carotid stenting (CAS) are effective technical options for the treatment of carotid stenosis, and CAS has been increasingly recognized by physicians and patients for its advantages of less trauma, less patient pain, and shorter hospital stays (Coelho et al. 2019; ACST-2 Collaborative Group, 2021). Many types of vascular stents are in clinical use, among which braided stents have the advantages of high flexibility and good wall adhesion and have received wide attention. Moeri et al. (Moeri et al. 2021) followed 150 patients with post-thrombotic syndrome who were implanted with braided stents and laser-carved stents for 12 months and found a higher rate of patency after implantation of braided stents. Reports on the Casper double-layer braided dense-mesh stent (Microvention, USA) show that the stent exhibits good plaque blockage and a low incidence of adverse events in the treatment of carotid stenosis (Mutzenbach et al. 2020; Imamura et al. 2021).
Central arterial pressure estimation based on two peripheral pressure measurements using one-dimensional blood flow simulation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Dániel Gyürki, Péter Sótonyi, György Paál
One of the most frequent localisation of plaque formation is on the carotid artery wall at the bifurcation, thus narrowing the lumen area. One possible solution is an open surgery when the plaque is removed from the artery, called carotid endarterectomy. The main disadvantage of this surgical intervention is the need for the clamping of the carotid arteries, which are the main suppliers of the brain. One of the reasons for the Circle of Willis (CoW), which is the most important collateral system of the brain, is to create redundancy and support the brain in the case of narrowing or blocking of the supplying arteries. However, sometimes anatomical variations in the CoW can hinder this functionality (Montisci et al. 2013; Banga et al. 2018).
Endovascular treatment of extracranial carotid artery stenosis using a dual-layer micromesh stents: a systematic review
Published in Expert Review of Medical Devices, 2021
Daniela Mazzaccaro, Matteo Giannetta, Fabiana Fancoli, Paolo Righini, Giovanni Nano
The current literature about the treatment of extracranial carotid stenosis brings evidence of comparable mid-term outcomes between carotid artery stenting (CAS) and carotid endarterectomy (CEA) [1,2]. Nevertheless, CAS is burdened by a higher risk of perioperative distal microembolizations, which can occur as a result of plaque remodeling immediately after stent implantation [3]. Microembolization may occur asymptomatically but it can also be responsible of neurological events, as well as of cognitive deterioration [4].