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Ultrasonography revealed that a ease of acute internal carotid artery (ICA) occlusion caused by acute thrombosis due to severe stenosis and intraplaque hemorrhage. The patient is male and 81 years old with blurred vision in the right eye. Carotid artery ultrasound ( CDU) showed that severe stenosis of right proximal ICA, the discontinuous fibrous cap at the top of atherosclerotic plaques, and intraplaque hemorrhage. Besides, the blood flow of the right distal ICA disappeared suddenly during the examination. Therefore, ICA occlusion caused by acute thrombosis was detected by CDU. The patient was followed-up day by day using ultrasonography and treated with dual antiplatelet therapy. Three days later, CDU showed that the right ICA was re-open but still accompanied by severe stenosis. The patient was treated by carotid endarterectomy for revascularization after six days of admission. According to this process of diagnosis and treatment, carotid ultrasound provides an important clinical role for the diagnosis, treatment, and follow-up of acute thrombosis with carotid artery stenosis.
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@#AIM: To compare the macular subfoveal choroidal thickness(SFCT)and choroidal vascular index(CVI)between the patients with internal carotid artery stenosis(ICAS)but without ocular symptoms and controlled healthy people.<p>METHODS: This is a retrospective comparative study. Forty eyes(grouped as ICAS group)from 40 ICAS patients and 40 eyes(grouped as control group)from 20 matched healthy people were included in this study. All included eyes were received OCT scanning to measure the SFCT. And OCT images were binarized with Image J software to measure CVI values. These values were compared between the two groups.<p>RESULTS: SFCT of ICAS group and control group were 208±66μm and 234±77μm respectively, with no statistical difference between the two groups(<i>P</i>=0.27). The CVI of ICAS group(64.5%±1.7%)was significantly lower compared with that of control group's(66.1%±2.7%)(<i>P</i>=0.04). The area under the curve(AUC)of CVI in the ROC curve was 0.76 <i>(P</i>=0.005), while the AUC of SFCT was 0.58(<i>P</i>=0.41). <p>CONCLUSION: It is suggested that compared with the detection of SFCT, the detection of CVI is more helpful to the early discovering of the changes of choroidal circulation in this kind of patients.
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@#AIM: To investigate the correlation between intracranial internal carotid artery stenosis and ocular arterial blood flow and retinal vascular morphology.<p>METHODS: Totally, 251 patients admitted to our hospital due to suspected cerebral ischemia from January 2017 to June 2018 were selected. According to the degree of internal carotid artery stenosis, the patients were divided into non-stenosis group(39 cases), mild stenosis group(80 cases), moderate stenosis group(83 cases), and severe stenosis group(49 cases). The ocular hemodynamic indexes and retinal vascular diameters of the four groups were compared. The correlation and diagnostic value were analyzed between eye blood flow parameters and severe intracranial internal carotid artery stenosis.<p>RESULTS: In the severe stenosis group, the peak systolic velocity(PSV)and diastolic peak velocity(EDV)of ophthalmic artery(OA), central retinal artery(CRA)and posterior ciliary artery(PCA)were significantly lower than those of the other three groups. In the blood flow parameters of OA, CRA and PCA, PSV and EDV were significantly negatively correlated with severe intracranial internal carotid artery stenosis. The optimal diagnostic thresholds of PCA PSV and PCA EDV for severe intracranial internal carotid artery stenosis were 11.26cm/s and 5.21cm/s, respectively.<p>CONCLUSION: Intracranial internal carotid artery stenosis was significantly negatively correlated with PSV and EDV in the ocular arteries. PCA PSV and PCA EDV were most sensitive to intracranial internal carotid artery stenosis under the same index.
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No abstract available.
Subject(s)
Asymptomatic Diseases , Carotid Artery, Internal , Carotid Stenosis , FingersABSTRACT
Objective To investigate the correlation between white matter hyperintensities (WMH)and hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging(MRI)in old adults and to explore the risk factors and pathogeneses of WMH.Methods We retrospectively collected imaging and clinical data of patients who had received both head and neck CTA and brain MRI within one month at our hospital from 2013 to 2016.The Fazekas visual scale was used to evaluate periventricular white matter hyperintensity(PWMH)and deep white matter hyperintensity(DWMH)in each brain hemisphere.According to the presence or absence of HVS in a cerebra[hemisphere,patients were assigned into an HVS-positive group or an HVS-negative group.Clinical data,PWMH,and DWMH differences were compared between the two groups.Results A total of 271 patients(542 cerebral hemispheres)were included in this study.HVS-positive imaging occurred in 79(14.6％)cerebral hemispheres and negative imaging was observed in 463 (85.4％) cerebral hemispheres.There was a significant difference between the HVS-positive and negative groups in the ipsilateral CIA stenosis(x2 =126.840,P＜0.01).The incidence of ipsilateral severe carotid artery stenosis in the HVS-positive group was 62.0％ (49/79),which was significantly higher than 9.9％ (46/463)in the HVS-negative group.The incidence of moderate-severe DWMH was 65.8％(52/79) in the HVS-positive group,which was higher than 34.8％ (161/463)in the negative group(x2 =34.962,P ＜20.01).Nevertheless,the incidences of moderate-severe PWMH in the two groups were 65.8％ (52/79) and 55.5％ (257/463),respectively,without a significant difference between them (x2 =6.944,P =0.074).After adjusting for age,gender,ipsilateral ICA stenosis,hypertension,diabetes,etc.multivariate analysis suggested that HVS-positive imaging was still an independent risk factor for DWMH(OR =2.653,95％CI:1.489-4.726,P =0.001).Conclusions HVS-positive imaging is an independent risk factor for DWMH in the elderly,but no clear correlation with PWMH is found.It suggests that hypoperfusion is a possible mechanism for the development of DWMH in the elderly.
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Limb shaking transient ischemic attack (LS-TIA) can be recognized by paroxysmal cerebral hemisphere hemodynamic damage performance that lasts for several seconds or minutes, often occurring after exercise or standing and may be accompanied by numbness of the local limb. Clinically LS-TIA is ignored by doctors and misdiagnosed as epilepsy and the disease has a high risk of stroke and poor prognosis. The prompt recognition of the limb-shaking transcient ischemic attack is crucial to implement options aiming at preventing future stroke. Patients with LS-TIA can benefit from therapies aiming at improving cerebral perfusion.However, the benefit of revascularization and drug conservative treatment remains to be determined and specific diagnosis and treatment should be formulated according to the specific clinical characteristics of patients.
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Abstract?AlM: To investigate the relationship between carotid artery stenosis and ischemic ocular diseases.?METHODS: The clinical data of 30 cases ( 37 eyes ) of patients with ischemic eye diseases were collected from November 2010 to May 2014, and they were accepted the fundus fluorescein angiography ( FFA ) , transcranial Doppler ( TCD) ultrasonic blood vessels of the eye, neck vascular color Doppler flow imaging ( CDFl) , the neck CT angiography ( CTA ) and carotid artery digital subtraction angiography ( DSA) examination, and then the ischemic eye disease patients with ocular symptoms were analyzed. The peak systolic velocity ( PSV) and resistance index ( Rl) of ophthalmic artery and central retinal artery were compared. Correlation between the internal carotid artery intima- media thickness ( lMT ) and ophthalmic artery, central retinal artery PSV and Rl correlation risk;ipsilateral internal carotid artery plaque and ophthalmic artery PSV and Rl; PSV and Rl associated ipsilateral internal carotid artery plaque and central retinal artery were analyzed.?RESULTS:Eye symptoms:a black dim, reduced vision, the eyes flash, and around the eye pain were 75. 7%, 83. 8%, 51. 4% and 32. 4%;The eye signs:the dilatation of retinal vein, retinal hemorrhage, arterial stenosis and cotton spot and the contralateral side were regarded as main signs. Ophthalmic artery PSV and Rl value of the differences were statistically significant ( P0. 05 ); The ipsilateral internal carotid artery plaque and ophthalmic artery PSV had no correlation with Rl values (P>0. 05); PSV and Rl and the ipsilateral internal carotid artery plaque and central retinal artery had no correlation (P>0. 05).?CONCLUSlON: The incidence of ischemic eye diseases and internal carotid artery stenosis is associated with very close, the clinical can regard the degree of internal carotid artery stenosis as an important basis for diagnosis and treatment of eye diseases.
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Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.
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No abstract available.
Subject(s)
Carotid Artery, Internal , Carotid Stenosis , Cranial Nerve Diseases , OphthalmoplegiaABSTRACT
No abstract available.
Subject(s)
Carotid Artery, Internal , Carotid Stenosis , Cranial Nerve Diseases , OphthalmoplegiaABSTRACT
BACKGROUND AND OBJECTIVES: Abdominal Aortic Aneurysm (AAA) and carotid disease have medical and social significance, considering their morbidity, disability, and economic consequences. The study objectives were to determine the prevalence of asymptomatic internal carotid artery (ICA) lesions > or =70% in patients with AAA, the correlation of AAA diameter with the degree of ICA stenosis and symptoms, and the importance of preventive ultrasound checkups. SUBJECTS AND METHODS: A prospective non-randomized controlled study including 740 patients, aged from 18-85 years, who were suitable for the inclusion and exclusion criteria and reported at the vascular laboratory of the Institute for Vascular and Endovascular Surgery, Clinical Center of Serbia from 1st of December 2011 to the 1st of November 2012. RESULTS: The prevalence of asymptomatic ICA stenosis > or =70% in patients with AAA is 10.8%. Male representatives have more symptomatic ICA stenosis > or =70%. Patients with small aneurysms more often have asymptomatic ICA stenosis > or =70%. The occurrence of symptoms of carotid disease was more prevalent among patients with ICA stenosis > or =70% compared to the group with stenosis or =70% in patients with AAA is found to be 10.8%. Male patients with ICA stenosis > or =70% more often had symptoms of carotid disease. In the smaller aneurysms, ICA stenosis > or =70% occurs frequently, but without the symptoms of carotid disease, and there was no correlation between the size of AAA and the grade of ICA stenosis. Clinical implications of ICA imaging in patients with previously diagnosed AAA is necessary.
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Aged , Humans , Male , Aneurysm , Aortic Aneurysm, Abdominal , Carotid Artery, Internal , Carotid Stenosis , Constriction, Pathologic , Prevalence , Prospective Studies , SerbiaABSTRACT
Background Carotid stenosis is one of the important causes of ocular ischemic diseases,To study their relationship is helpful for us to classify and manage the ocular ischemic diseases.Objective This study was to investigate the correlation between ocular ischemic diseases and carotid stenosis.Methods Twenty patients with internal carotid artery stenosis rate more than 60％ defined by digital subtraction angiography(DSA) or magnetic resonance angiography (MRA) were selected,including 9 patients with lateral carotid artery stenosis and 11 patients with bilateral carotid artery stenosis.The best corrected visual acuity,intraocular pressure and fundus examinations were carried out,and the peak systolic velocity (PSV) and end diastolic velocity (EDV) of the central retinal artery(CRA) were detected with color doppler flowimaging (CDFI).The resistance index(RI) was calculated by the formula RI =PSV- EDV/PSV.The correlation between internal carotid artery stenosis rate and PSV or RI was evaluated by Spearman rank correlated analysis.Results The subjective inanifestations included transient amaurosis in 77.4％ frequency and visual blur in 22.6％ frequency in the 31 carotid artery stenosis.Twelve eyes(38.7％ ) appeared the ocular vascular abnormality.Other 2 patients were diagnosed as hypoperfusion retinopathy complicated by neovascular glaucoma.A negative relationship was found between internal carotid artery stenosis rate and PSV of CRA ( r =-0.41,R2 =0.168,P =0.021 ＜0.05 ),but no significant relationships was found between internal carotid artery stenosis rate and RI ( r =- 0.26,R2 =0.068,P =0.159 ).Conclusions Carotid artery stenosis can cause the of ocular ischemic symptoms.The characteristics of retinal hemodynamics is the type of low speed and normal resistance.
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BACKGROUND: Microembolic signals (MES) are associated with the pathogenic mechanism of ischemic stroke with large-artery atherosclerotic disease. We examined the relationship between MES on a transcranial Doppler ultrasonography (TCD) and lesion patterns on diffusion-weighted MR imaging (DWI) in acute ischemic strokes associated with atherosclerotic diseases of the middle cerebral artery (MCA) and internal carotid artery (ICA). METHODS: A total of 405 consecutive patients were monitored for MES within 48 hours of symptom onset. Patients with MES and DWI lesions in the territory of the MCA or ICA and corresponding MCA/ICA stenosis or occlusion on MR angiography (MRA) were included. MCA velocities and lesion patterns on DWI were compared. RESULTS: MES were detected in 25 patients (MCA: 13, ICA: 12). The mean number of MES during 30 minutes of monitoring was 14.2+/-17.3 (range: 1-64, MCA: 13.9+/-13.6, ICA: 14.5+/-21.6, p-value=0.098). The mean flow velocity in the ipsilateral MCA in patients with MCA disease was higher than in patients with ICA disease (129.9+/-74.4 cm/s vs 61.1+/-28.2 cm/s, p=0.006). The frequency of multiple lesions on DWI was higher inpatients with ICA disease than in those with MCA disease (46.1% vs 100%, p=0.003). CONCLUSIONS: Multiple lesions on DWI were more frequent in ICA disease with MES than in MCA disease. Artery-to-artery embolism may be a more important stroke mechanism in acute ischemic stroke with ICA disease.
Subject(s)
Humans , Angiography , Arteries , Carotid Artery, Internal , Carotid Stenosis , Constriction, Pathologic , Embolism , Inpatients , Middle Cerebral Artery , Stroke , Ultrasonography, Doppler, TranscranialABSTRACT
Objective To study the relationship between velocity of middle cerebral artery(MCA),severity of disease and watershed infarction(WSI) in patients with extracranial internal carotid artery(EICA) stenosis or occlusion.Methods Transcranial Doppler(TCD) was used to detect the mean velocity(MV) of MCA in 120 patients with EICA stenosis or occlusion.The National Institutes of Health Stroke Scale(NIHSS) was used to evaluated the patients′ condition.And CT or MRI was used to diagnosised the WSI.Results MV of MCA was severe reduced in 10 cases,middle reduced in 38 cases,and mild reduced in 42 cases,while there were 30 cases with normal MV.The scores of NIHSS in the four groups(12.5?4.7,3.9?4.8,3.2?4.7,2.4?4.9 respectively) had significant different(P