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Complications of carotid endarterectomy
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Laura T. Boitano, Mark F. Conrad
Coronary artery disease often accompanies carotid artery disease. Cardiac complications, including myocardial infarction (MI), are associated with significantly higher perioperative mortality, and a recent study found that such complications account for the majority of deaths following CEA.10 The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) found that patients who had an MI with EKG changes or postoperative biomarker elevation were significantly more likely to die in the follow-up period, even after adjusting for other risk-factors for mortality.11 Fortunately, over time the rate of cardiac complications have decreased due to improved preoperative risk stratification and management as well as improved medication regimens. Indeed, a recent systematic review and meta-analysis found that the rate of MI after CEA was under 1% in contemporary series.12
Paroxysmal Dyskinesias
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Patients with cerebrovascular disease may also have paroxysmal “shaking” or “jerking” movements (22). Most of these patients have severe carotid artery disease and are treated with carotid endarterectomy. However, some patients respond to aspirin (22) or dipyridamole (23). Phenytoin is not beneficial.
Current imaging strategies in cardio-oncology
Published in Susan F. Dent, Practical Cardio-Oncology, 2019
Mirela Tuzovic, Melkon Hacobian, Eric H. Yang
Carotid duplex is a noninvasive, relatively inexpensive, and readily available modality to assess extracranial circulation that is not reliant on ionizing radiation. Despite advances in magnetic resonance angiogram and CT angiography, due to other limiting factors (i.e., availability, cost, radiation, iodinated contrast exposure, claustrophobia), these studies may be difficult to perform serially (30). For asymptomatic patients with elevated risk for carotid artery disease based on the type of cancer treatment (such as those receiving mediastinal and/or neck radiation), it may be reasonable to obtain serial carotid ultrasounds for monitoring. However, in patients with signs and symptoms of cardiovascular disease, especially treated with high-risk agents such as nilotinib or ponatinib, carotid ultrasound and MR/CT angiography may be considered for further identification of baseline, and accelerated development of atherosclerotic disease with treatments (2).
Evaluation of Cerebral Vasomotor Reactivity by Transcranial Doppler Ultrasound in Patients with Diabetic Retinopathy
Published in Neuro-Ophthalmology, 2023
Aslı Yaman Kula, Çiğdem Deniz, Tuğçe Özdemir Gültekin, Muhammed Altinisik, Talip Asil
Patient history was obtained, and physical examination was performed in all patients. Age, gender, duration of DM, cerebrovascular risk factors, current medications, premorbid conditions, family history, and habits were recorded. The following tests were performed in all patients: fasting blood glucose; post-prandial 2-hour glucose; HbA1c; low-density lipoprotein (LDL); triglycerides; creatinine; aspartate aminotransferase (AST); alanine aminotransferase (ALT); urinary micro-albumin; vitamin B12; and haemoglobin. Also, electrocardiography (ECG) recordings were obtained. The presence of carotid artery disease was screened at the study entry with left and right carotid Doppler ultrasound examination (General Electric Logic 9R4) in all patients. Patients were excluded if they had significant narrowing (>50%) in one or both of their carotid arteries. This was followed by the BHI test using a SONORA TCD system (CareFusion, San Diego, CA, USA).
Bioinformatics analysis reveals the landscape of immune cell infiltration and immune-related pathways participating in the progression of carotid atherosclerotic plaques
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2021
Liao Tan, Qian Xu, Ruizheng Shi, Guogang Zhang
Carotid artery disease, caused by a buildup of atherosclerotic plaque inside the arterial wall, is one of the most important causes of cerebrovascular disease [1]. During carotid plaque formation, early-stage lesions may be asymptomatic, but the intermediate and advanced stages are more severe and comparatively more likely to rupture, leading to thrombus formation in the carotid artery, a frequent cause of ischaemic cerebrovascular events [2]. Many factors, such as oxidative stress and inflammation, have been found to participate in the progression from early to advanced stage plaque [3]. The infiltration of inflammatory cells and activation of immune-related pathways are critical features in plaque progression [4]. Several types of immune cells, such as lymphocytes [5], natural killer T cells [5], and T cells [6,7] are involved in plaque progression. In addition, inflammatory cytokines such as TNF-α, IFN-γ, IL-1β, IL-6, and IL-8 have been reported to play a critical role in the development of plaques [6]. However, the changes in immune cell types from the early to advanced plaque stages are still unclear. In addition, the underlying mechanisms regulating the development of carotid atherosclerotic plaques are still unclear.
Lipid profile, random blood glucose and carotid arteries thickness in human male subjects with different ages and body mass indexes
Published in The Aging Male, 2020
Mohammed Elimam Ahamed Mohammed, Safar Alshahrani, Gaffar Zaman, Magbool Alelyani, Ibrahim Hadadi, Mustafa Musa
Carotid arteries are the major vessels that carry the blood to the brain. There are two carotid arteries located on the left and right side of the neck. The two carotid arteries are divided to internal and external carotid arteries. The internal carotid arteries are responsible for supplying the brain by oxygenated blood while the external arteries supply the neck, face and scalp. The normal thickness of the common carotid arteries intima media is ranging from 0.4 mm to 1 mm. Carotid artery disease is characterized by accumulation of plaques on the inner side of the arteries leading to low blood supply to the brain and stroke. Risk factors of carotid artery disease include diabetes, high blood pressure, metabolic syndrome, overweight or obesity, smoking, unhealthy diet, lack of physical activity, family history of atherosclerosis, blood concentration of testosterone, mean platelet volume, and older age [28–33].