Application analysis of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply / 国际外科学杂志

Objective:To study the application effect of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply.Methods:The clinical data of 14 patients undergoing carotid-subclavian artery blood vessel prosthesis bypass grafting to reconstruct cerebral blood supply in the Department of Vascular Surgery, Beijing Tiantan Hospital, Capital Medical University from March 2019 to March 2022 was retrospective collected. And the surgical indications, clinical effect and complications were analyzed.Results:There were 12 males and 2 females, aged from 47 to 74 years, with an average age of 60.5 years. Of 14 patients, 2 patients suffered from common carotid artery stenosis with posterior dilatation, 12 patients suffered from subclavian artery occlusion with vertebral artery steal. All the procedures were successfully performed without intraoperative cerebral infarction, cardiovascular accident, lymphatic leakage or artificial vascular infection. Phrenic nerve injury occurred in 1 patient after operation. During the follow-up of 3-27 months, average 14 months, there were no artificial vascular stenosis, anastomotic stenosis, vertebral artery steal, new cerebral infarction, upper limb ischemia or cerebral ischemia.Conclusion:Carotid-subclavian artery blood vessel prosthesis bypass grafting can be used in reconstructing the blood supply of both the anterior circulation, and the posterior circulation safely and effectively.

Protective effects of adrenomedullin on rat cerebral tissue after transient bilateral common carotid artery occlusion and reperfusion

Abstract Objective: We aimed to investigate the protective effect of adrenomedullin (ADM) on cerebral tissue of rats with cerebral ischemia/reperfusion (I/R) injury. Methods: Thirty-two Wistar rats were randomized into four groups (n=8). In the I/R Group, bilateral common carotid arteries were clamped for 30 minutes and, subsequently, reperfused for 120 minutes. In the ADM Group, rats received 12 µg/kg of ADM. In the I/R+ADM Group, bilateral common carotid arteries were clamped for 30 minutes and, subsequently, the rats received 12 µg/ kg of ADM. Then, reperfusion was performed for 120 minutes. The Control Group underwent no procedure. Blood and brain tissue samples were collected for biochemical and histopathological analysis. Serum malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were analysed. Brain tissue was evaluated histopathologically and neuronal cells were counted in five different fields, at a magnification of ×400. Results: Brain MDA in I/R Group was significantly higher than in ADM Group. Brain GPx and SOD in I/R+ADM Group were significantly higher than in I/R Group. The number of neurons was decreased in I/R Group compared to the Control Group. The number of neurons in I/R+ADM Group was significantly higher than in I/R Group, and lower than in Control Group. Apoptotic changes decreased significantly in I/R+ADM Group and the cell structure was similar in morphology compared to the Control Group. Conclusion: We demonstrated the cerebral protective effect of ADM in the rat model of cerebral I/R injury after bilateral carotid artery occlusion.

MRI for characterizing progressive carotid plaques at different sites in elderly carotid atherosclerosis patients / 中华老年心脑血管病杂志

Objective To study the relationship between progression and clinical characteristics of carotid plaques at different sites in elderly carotid atherosclerosis patients.Methods Fifty-one elderly carotid atherosclerosis patients who underwent twice of high resolution MRI in our hospital were included in this study.The MRI data of 75 carotid arteries,annual progression of stenosis,maximum wall thickness,wall size,lumen size at plaques in common carotid artery (CCA),carotid bifurcation (BIF) and internal carotid artery (ICA) were analyzed.Results Of the 131 plaques in 75 carotid arteries,42 were detected in ICA,54 were detected in BIF.The annual progression rates of wall size and maximum wall thickness were higher at plaques in ICA than at those in CCA and BIF (P=0.036,P=0.028).The wall size of plaques in ICA was related with age,hypertension and diabetes (r=0.39,P=0.011;r=0.37,P=0.016;r=0.31,P=0.041).Conclusion The progression of plaques in ICA is faster than that of those in CCA and BIF,and is related with the high clinical risk factors.MRI follow-up can characterize the progressive plaques in elderly carotid atherosclerosis patients.

Hemodynamic analysis of radiation-induced damage in common carotid arteries by using color Doppler ultrasonography

PURPOSE: The aim of this study was to assess vascular changes and blood flow abnormalities in the common carotid arteries of patients with head and neck cancers after external radiotherapy, using color Doppler ultrasonography. METHODS: We studied 24 patients treated with external radiotherapy for various head and neck cancers. In order to study the acute effects of irradiation on common carotid blood flow and arterial diameter changes, color Doppler ultrasonography parameters such as peak systolic velocity, end diastolic velocity, mean velocity, systolic-to-diastolic velocity (S/D) ratio, pulsatility index (PI), resistive index (RI), and instantaneous diameter changes were evaluated before and after external radiotherapy. Additionally, the blood volume flow (VF) values in the peak systolic and end diastolic phases, as well as mean velocity, were evaluated throughout three cardiac cycles using B-mode ultrasonic image processing. RESULTS: The findings showed significant changes in the S/D ratio, PI, and RI of the common carotid arteries before and after external radiotherapy (P < 0.05). Moreover, a significant decrease in artery diameter and blood VF was observed after radiotherapy relative to the pretreatment values. A significant correlation was found between the blood VF values estimated using ultrasonic measurements and mathematical methods throughout three cardiac cycles. CONCLUSION: The hemodynamic parameters of the common carotid arteries changed during radiotherapy. These arterial changes may lead to late adverse effects of radiotherapy, such as ischemic strokes and ischemic attacks.

Predicting Coronary Atherosclerosis by Right Subclavian Artery Ultrasound and Lipid Levels / 中国医学影像学杂志

Purpose To analyze the correlation of right subclavian artery ultrasound and individual blood lipid level with coronary atherosclerosis (CA) using carotid ultrasound as control so as to explore the clinical value of them in predicting CA.Materials and Methods Coronary CT angiography (CCTA) and right subclavian artery/neck vessel ultrasound in 55 patients were retrospectively analyzed.Gensini score was used to calculate the degree of coronary artery lesions.According to the result of CCTA,patients were divided into normal group,mild coronary atherosclerosis group,severe coronary artery stenosis group.The intina-media thickness (IMT) at the origin of right subclavian artery and carotid artery bifurcation on ultrasound was measured to evaluate carotid lesions.The correlation between the IMT and Gensini score of coronary artery was analyzed.The blood lipid levels of the 3 groups were analyzed,and the efficacy of right subclavian artery,carotid artery ultrasound and blood lipid in predicting CA was evaluated.Results ① The IMT at right subclavian artery and carotid artery bifurcation were positively correlated with Gensini score,and the former had higher correlation than the latter (r=0.636,r=0.462,P＜0.01);the prediction efficacy of the IMT at right subclavian artery was slightly higher than that at carotid artery bifurcation (with sensitivity and specificity of 78.3％,64.5％,and 77.5％,60.0％ respectively).② Compared with normal control group,the levels of low-density lipoprotein cholesterol,triglycerides,total cholesterol were higher,but the level of highdensity lipoprotein cholesterol (HDL-C) was lower in mild coronary atherosclerosis and severe coronary artery stenosis group,and the difference between the severe coronary artery stenosis group and normal groups was bigger,among which the level of triglycerides had the largest difference among the three groups with no statistical significance (P＞0.05).The HDL-C had a more significant correlation with Gensini score than other index of blood lipid (r=-0.151).③ The combination of IMT and HDL-C had a sensitivity of 81.0％ and specificity of 66.7％ in predicting CA,which were higher than that of each individual index (with sensitivity of 78.3％,64.5％ and specificity of 64.3％,55.5％respectively).Conclusion The IMT at right subclavian artery has a better predictive value in determining the degree of coronary artery lesions than that at carotid artery bifurcation.The combined application of blood lipid levels and the IMT at right subclavian artery can improve the sensitivity and specificity of predicting CA.

Inlfuence of High Density Lipoprotein Cholesterol Upon Carotid Artery Structure and Elasticity：Assessed with Ultrasound Radio Frequency-data Technique / 中国医学影像学杂志

PurposeTo explore the value of ultrasound radio frequency technique in the quantitative evaluation of common carotid artery intima-media thickness (IMT) and elasticity change in patients with dyslipidemia, and to discuss the influence of high density lipoprotein cholesterol (HDL-C) upon carotid artery structure and elasticity function. Materials and Methods A hundred and fifty patients with abnormal serum lipid were selected as case group and further divided into three groups: group A--50 patients with hyperlipidemia and high HDL-C, group B--50 patients with hyperlipidemia and normal HDL-C, group C--50 patients with hyperlipidemia and low HDL-C. Meanwhile, 50 healthy people were enrolled in the study as control group (group D). The ultrasound radio frequency-data technique was employed to analyze the influence of hyperlipidemia and HDL-C upon IMT, CC,β, PWV and AIx.Results The IMT,β, PWV and AIx in group B were higher than those in group D, but group B had lower CC (the differences with statistic significance,t=5.141, 4.219, 4.898, 4.142 and-3.758,P0.05). In patients with hyperlipidemia, the increase of HDL-C led to the reduction of the common carotid artery IMT and wall stiffness and the increase of elasticity and vice versa.Conclusion The ultrasound radio frequency technique could measure the real-time common carotid artery IMT and elasticity automatically and accurately, thus provides reliable quantitative index for the evaluation of early artery structure and change of function in lipid lowering therapy.

Feasibility of Low Tube Voltage Combined with Low Contrast Dose in 64-slice Spiral CT Cerebral and Carotid Arteriography / 中国医学影像学杂志

PurposeTo evaluate the feasibility of a low-dose contrast medium protocol for 64-slice spiral CT angiography (CTA) of cerebral and carotid using a low-tube-voltage setting, and to compare the display effect of cerebral and carotid arteries by low-tube-voltage low-dose contrast medium and routine-tube-voltage routine-dose contrast medium scanning, and to assess the effect on radiation dose.Materials and MethodsEighty consecutive patients were prospectively selected to perform cerebral and carotid CTA inspection. The patients were randomly divided into control group and low dose group with 40 people in each group. The voltage in control group was 120 kV and the contrast agent was 80 ml; those in low dose group were 80 kV and 50 ml, respectively. The artery image quality was evaluated and venous interference was scored. The CT value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and radiation dose in both groups were statistically analyzed.Results The consistency of uniform in artery image quality score and venous interference score was rather high according to the assessment of two physicians (Kappa=0.782 and 0.867). There was no statistical difference in artery image quality score, venous interference score, SNR and CNR between the two groups (Z=-0.864--0.032,P>0.05). The CT value in low dose group was higher than that in control group (differences with statistical significance,t=-8.789-1.715,P<0.05). The CT dose index of volume, dose-length product and effective dose in low dose group were all signiifcantly lower than those in control group (Z=-8.888,t=78.092 and 78.350, respectively,P<0.05).Conclusion The use of low tube voltage and low contrast dose in cerebral and carotid CTA examination can result in high quality images which meets the diagnostic needs and obviously reduce radiation dosage.

Atorvastatin attenuates atherosclerosis of common carotid artery in apolipoprotein E gene-deficient mice by down-regulating NF-κB / 国际脑血管病杂志

Objective To investigate the effect of atorvastatin on atherosclerosis formation of common carotid artery and its possible mechanism. Methods A total of 36 male apolipoprotein E gene knockout (ApoE-/-) mice were randomly divided into 3 groups: a control group, a model group, and an atorvastatin group. The mice of the control group were fed with normal diet and received a sham operation, while the mice in the model group and the atorvastatin group were given high fat diet and received a right common carotid artery cannulation. At 5 weeks after procedure, the mice in the model group and the atorvastatin group were intragastric administration of normal saline and atorvastatin (10 mg/kg daily), respectively. At 8 weeks after procedure, the blood from femoral arteries was obtained for biochemical detection, then right common carotid arteries were taken out for histopathological study. Real-time quantitative polymerase chain reaction (PCR) was used to detect the expression levels of NF-κB mRNA in the plaques. Western blotting was used to detect phosphorylated NF-κB p65. Results The lipid levels in the model group and the atorvastatin group were significant higher than those in the control group (al P 0. 05 ). The histopathological study showed that the obvious plaque formation and the necrotic core and neovessels in plaques were observed in the model group; obviously thickened intima and more intact endothelial cel s in the vessel wal were observed in the atorvastatin group. The plaque burden in the model group and the atorvastatin group was significantly higher than that in the control group (al P<0. 001), while the plaque burden in the atorvastatin group was significantly less than that in the model group (P<0. 001). Real-time fluorescence quantitative PCR detection showed that the expression levels of NF-κB mRNA in the model group and the atorvastatin group were significantly higher than that in the control group (al P<0. 001), and the expression level of NF-κB mRNA in the atorvastatin group was significant lower than that in the model group (P= 0. 022). Western blotting showed that the expression level of the phosphorylated NF-κB p65 was significantly higher than that of the control group (P<0. 001), and the expression level of the phosphorylated NF-κB p65 was significantly lower than that in the model group (P<0. 001). Conclusions Atorvastatin may reduce atherosclerosis in the common carotid artery in ApoE-/-) mice by down-regulating NF-κB.

Associação de PTH e espessura carotídea em pacientes com falência renal crônica e hiperparatireoidismo secundário / Association of PTH and carotid thickness in patients with chronic kidney failure and secondary hyperparathyroidism

Introdução: Doenças cardiovasculares (DCVs) são as principais causas de mortalidade em pacientes portadores de falência renal crônica (FRC). Diversos fatores de risco estão envolvidos na patogênese e são classificados em tradicionais - que afetam a população em geral; e não tradicionais - que são peculiares aos pacientes renais crônicos. Hiperparatireoidismo secundário, um fator não tradicional e comum na FRC, causa aumento da taxa de reabsorção óssea e mobilização do cálcio e do fósforo. À medida que o produto cálcio x fósforo aumenta, a solubilidade desse par iônico pode ser excedida e ocorrer deposição de fosfato de cálcio nos tecidos cardiovasculares (denominada calcificação metastática). Objetivo: Verificar possível relação entre a espessura da artéria carótida primitiva e os níveis de PTH em pacientes com FRC. Métodos: Foram realizados exames ultrassonográficos com Doppler para medir a espessura da artéria carótida e avaliar possíveis correlações entre diferentes elevações nos níveis séricos do PTH, distúrbios minerais e fatores de risco tradicionais e as alterações encontradas na carótida de portadores de FRC dialítica e hiperparatireoidismo secundário. Resultados: Foi observada diferença no nível de colesterol e na idade dos pacientes que apresentavam sinais de calcificação arterial. Também foi detectada relação significativa entre os níveis de PTH e a espessura da parede da carótida (r = 0,31; p = 0,03). Conclusão: Dados desse estudo mostram a possível concomitância de fatores tradicionais e os relacionados com a FRC na gênese das DCVs na uremia. .

Introduction: Cardiovascular diseases (CVDs) are the leading cause of death in terminal patients with chronic kidney failure (CKF). Diverse risk factors are involved in the pathogenesis, and are classified as traditional, which affect the general population; and non-traditional, which are peculiar to patients with CKF. Secondary hyperparathyroidism, a non-traditional and common factor in CKF, can cause an increased rate of bone absorption with mobilization of calcium and phosphorus. If the product of calcium x phosphorus is increased, the solubility of this ionic pair may be exceeded and deposition of calcium phosphate in cardiac and vascular tissues occur (called metastatic calcification). Objective: To verify eventual relationship between the thickness of the common carotid artery and the levels of PTH in patients with CKF. Methods: Evaluations by Doppler ultrasonography were performed to measure the width of the carotid artery wall and to search for possible correlations between different values of PTH serum levels, mineral disturbances and traditional risk factors in the carotid changes found in individuals with dialytic CKF and secondary hyperparathyroidism. Results: Differences in the cholesterol level and age were observed in patients with signals of arterial calcification. A significant relationship was also observed between the PTH serum levels and the carotid artery wall thickness (r = 0.31, p = 0.03). Conclusion: Data from this study show the possible concomitance of traditional factors and factors related to CKF in the genesis of CVDs in uremia. .

Incidentally diagnosed Takayasu arteritis on thyroid ultrasonography showing prominent collateral vessels of thyroidal arteries and common carotid artery occlusion

We report a case of middle-aged woman incidentally diagnosed with Takayasu arteritis during the ultrasonography of a thyroid gland nodule. Prominent collaterals of the thyroidal arteries and a thin common carotid artery with mural thickening and deficient intraluminal flow signals were initially depicted on the ultrasonography with color Doppler. Subsequent magnetic resonance angiography and computed tomography aortography confirmed the diagnosis with the imaging features of a bilateral long segment common carotid artery occlusion and segmental stenosis of the left subclavian artery in addition to the suggestive physical findings.

Spatial distribution of wall shear stress in the common carotid artery of type 2 diabetes mellitus patients / 中华超声影像学杂志

Objective To investigate the wall shear stress(WSS) in the common carotid artery of type 2 diabetes mellitus(DM) patients,and analyzed the spatial distribution of WSS by using quantitative visualization of blood flow shear stress analysis software.Methods Eighteen male type 2 DM subjects were enrolled as DM group and 18 age-matched healthy subjects were selected as control group.None of the participants was hypertensive,hyperlipidemic or a cigarette smoker.Intimal-medial thickness (IMT),number and size of plaques in the common carotid artery were evaluated by high-resolution echo-Doppler.Color Doppler flow images of common carotid arteries in the two groups were extracted from DICOM files.WSS in the common carotid arteries was calculated by shear stress visualization quantitative analysis software,and the corresponding spatial distribution maps of WSS were designed.Results WSS of the common carotid arteries in the control group were ranged from 4 to 14 dyne/cm2.WSS of the common carotid arteries in the DM group were ranged from 2 to 8 dyne/cm2.Compared to mean WSS value [(6.96 ± 1.17)dyne/cm2] of common carotid arteries in the control group,mean WSS value [(3.14 ± 0.79)dyne/cm2] of common carotid arteries in the DM group was significantly lower (t =9.380,P =0.000).Six diabetic participants had a plaque in one carotid artery and no lesions in the contralateral carotid.Among these subjects,mean WSS was significantly lower in the side with lesion (t =7.324,P =0.000).Therefore,IMT of common carotid arteries in participants was significantly inversely related to WSS (r =-0.76,P ＜0.01).Conclusions The common carotid arteries of DM patients are more prone to atherosclerosis which is associated with reduction of WSS.The hemodynamic profile might represent an additional factor contributing to the increased prevalence and severity of carotid atherosclerosis in diabetic patients compared with general population.

The Application of Chimney Technique in Thoracic Endovascular Aortic Repair of Thoracic Aortic Lesions / 天津医药

Objective To evaluate the feasibility of strent-graft with Chimney technique in thoracic endovascular aortic repair (TEVAR) of thoracic aortic dissection left subclavian artery (LSA) disease and left common carotid artery (LCCA) disease without good landing zone. Methods A total of 21 patients with thoracic aortic diseases complicated by in-sufficient proximal anchoring area,who were presented in our hospital in recent years,were selected in this study. The clini-cal data were retrospectively analyzed. The thoracic aortic diseases included aortic dissection ( n=11), aortic pseudoaneurysm (n=2), aortic aneurysm(n=1) and penetrating ulcer(n=7). Among all 21 patients,lesion was located in distal to LSA in 18 pa-tients with distance to LSA anchoring less than15 mm,and the lesion was located between the LSA and LCCA in the rest 3 patients.Thoracic aortic stent-graft placement was carried out.The ostium of LSA was intentionally and completely cov-ered by thoracic aortic stent-graft and left subclavian artery or left internal carotid artery stent-graft placement was subse-quently performed. The patients were observed for symptoms of cerebral and upper limb ischemia. The postoperative com-plications such as endoleak and the patency of LSA were assessed with angiography. Results Thoracic aortic stent-graft placement was suceessfully carried out in all 21 patients. In addition,one“Chimney”stent was properly implanted in LSA or LICA in each patient. After the procedure,no complications of nervous system or severe ischemia of upper extremity was observed. Follow-up examinations between to 38 months after the treatment revealed that the aortic stent-graft remained in stable condition without type I endoleak. Meanwhile the blood flow in“chinney”stent was unobstructed. Conclusion Chimney technique can expand the applicability of TSGP with high tolerance. Chimney technique expand the applicability of TEVAR for patients with challenging anatomy. It is a safe,effective and microinvasive method to treat thoracic aortic lesions.

Correlação da espessura médio-intimal das carótidas primitivas proximal e distal / Correlation between the intima-media thickness of the proximal and distal common carotids

FUNDAMENTO: O aumento da espessura do IMT (do inglês intima-media thickness) das carótidas é utlizado como marcador precoce de aterosclerose e para avaliação do risco de eventos cardiovasculares. O ultrassom é utilizado na sua avaliação pela acessibilidade e baixo custo. São descritas medidas realizadas em diferentes regiões das carótidas. OBJETIVOS: Correlacionar o IMT nas regiões proximal e distal da carótida primitiva bilateral no intuito de orientar a sua utilização na prática clínica. MÉTODOS: O IMT foi medido nas porções proximais e distais da artéria carótida primitiva de 798 indivíduos (35-74 anos) de ambos os sexos usando ultrassom de alta resolução. O coeficiente de correlação de Pearson foi usado para se estabelecer as associações. As análises foram feitas inicialmente para toda a amostra e nos subgrupos com IMT < 0,90 mm (49% da amostra) e > 0,90 mm em pelo menos um sítio de medida. A significância estatística foi considerada para p <0 ,05. RESULTADOS: Ocorreu correlação significativa entre todas as correlações testadas. No grupo com IMT < 0,90 mm, o resultado situou-se entre 0,44 e 0,62. No subgrupo com IMT > 0,90 mm, houve expressiva queda de correlações, que se situaram entre 0,20 e 0,40. CONCLUSÃO: Os dados sugerem que o espessamento médio-intimal é mais uniforme ao longo das carótidas em fases mais precoces do desenvolvimento e tende a adquirir desenvolvimento focal à medida que progride. Portanto, na avaliação clínica de pacientes, toda a extensão das carótidas comuns deve ser investigada bilateralmente para melhor utilizar os softwares disponíveis e concluir sobre a presença ou não de espessamento do complexo médio-intimal.

BACKGROUND: Increased IMT (intima-media thickness) in carotids is used as an early atherosclerosis marker and to evaluate the risk of cardiovascular problems. Ultrasound is used in the evaluation because it is accessible and low cost. Measurements for different carotid regions are described. OBJECTIVE:To compare the proximal and distal region IMTs for the bilateral common carotid and guide its use in clinical practice. METHODS: The IMT was measured in the proximal and distal common carotid arteries of 798 individuals (35-74 years old) of both genders using high-resolution ultrasound. Pearson's correlation coefficient was used to establish associations. The analyses were initially performed for the entire sample as well as subgroups with IMT < 0.90 mm (49% of the sample) and > 0.90 mm for at least one measurement site. The statistical significance was p < 0.05. RESULTS: The correlations investigated were significant. In the group with an IMT < 0.90 mm, the correlations were between 0.44 and 0.62. In the subgroup with an IMT > 0.90 mm, the correlations were significantly reduced to between 0.20 and 0.40. CONCLUSION: The data suggest that the IMT is more uniform along the carotid during early development and tends develop focally as it progresses. Therefore, in clinical evaluations of patients, the common carotid length should be investigated bilaterally to better use the available software and discern the IMT.

Study on distributions of low wall shear stress in common carotid arteries of patients with intima-media thickening / 中华超声影像学杂志

Objective To measure wall shear stress (WSS) in common carotid arteries of normal subjects and patients with intima-media thickening and analyze the spatial distribution of low wall shear stress by quantitative analysis of blood flow shear stress visualization software.Methods Color Doppler flow images of common carotid arteries in normal subjects (control group) and patients with intima-media thickening (study group) were extracted from DICOM files.Two-dimensional distribution images of WSS,three-dimensional distribution images of WSS and the value of WSS in the common carotid arteries were obtained by this new algorithm.Then,the data and images of WSS were analyzed.Results WSS in the common carotid arteries of the control group were ranged from 4 to14 dyn/cm2.WSS in the common carotid arteries of the study group were ranged from 2 to 6 dyn/cm2.Compared to mean WSS values [(6.91 ±1.20) dyn/cm2] in common carotid arteries of the control group,mean WSS values [(2.87 ± 0.59)dyn/cm2] in common carotid arteries of the study group was significantly lower (t =17.828,P =0.000).Conclusions Low WSS areas have been emerged in local common carotid arteries in the patients with intima-media thickening.The reduction of WSS caused by local hemodynamic change might be related to common carotid artery intima media thickening.

Value of blood vessel diameter tracking and X-strain technique in evaluating the carotid arterial elasticity in patients with diabetes / 中华超声影像学杂志

Objective To investigate the clinical value of blood vessel diameter tracking and X-strain technology in evaluating the carotid elasticity in patients with diabetes.Methods Thirty-eight patients who were confirmed as diabetes without complications were enrolled in this study as the patient group and thirtyseven healthy volunteers matched with the patient group with sex,ages were typed as controls.The parameters reflecting common carotid elasticity:pulse wave velocity ( PWV),compliance coefficient (CC),stiffness index ( β),endovascular circumferential strain,strain rate,strain time ( EN _ CS,EN _ CS_ T,EN_CSR,EN_CSR_T),adventitial circumferential strain,strain rate,strain time (EP_CS,EP_CS_T,EP_CSR,EP_ CSR_ T),radial strain ( RS),radial strain rate (RSR) and radial strain time (RST) were measured using blood vessel diameter tracking technique and X-strain technique.Significant difference between the two groups and correlations among these variables were evaluated.Results In patient group,PWV and β were significantly higher than those of the control group,while variables like CC,EN_CS,EN_CSR,EP_CS,EP_CSR,RS and RSR were lower with P ＜0.05.All strain time prolonged in patient group ( P ＜0.05).No significant differences were observed in longitudinal strain index.Furthermore,CC was inversely related with PWV( r =- 0.872,P ＜0.001 ),and age,systolic pressure,β were positively related with PWV ( r =0.322,P =0.005; r =0.384,P =0.001; r =0.927,P ＜0.001) in patients group.Conclusions The stiffness and compliance indexes measured by blood vessel diameter tracking technique and the circumferential and radial strain index obtained by X-strain technique can reflect vessel elasticity change of patient with diabetes objectively.

Procedure-Induced Acute Common Carotid Artery Perforation Presenting With Airway Obstruction and Successful Treatment by Endovascular Stent Graft

A 63-year-old female was admitted to our hospital for catheter ablation during atrial fibrillation. After catheter ablation, the patient was transferred to the cardiac care unit and mechanically ventilated due to dyspnea and hypotension. Imaging showed active bleeding from the right common carotid artery (CCA) with extensive hematoma into the mediastinum. She was successfully treated with a stent graft at the CCA. Further bleeding or neurologic sequel did not occur after treatment.

Quantitative evaluation of common carotid arterial intima-media thickness and elasticity in healthy adults by ultrasound radio-frequency data technology / 中华超声影像学杂志

Objective To evaluate common carotid arterial intima-media thickness (IMT) and elasticity using ultrasound radio-frequency data (RF-data) technology, the normal values of the related parameters were determined in healthy adults for their potential clinical applications.Methods One hundred and sixty healthy adults were included and divided into 4 age groups with 20 males and 20 females in each group.The quantitative parameters of common carotid arterial IMT, common carotid arterial distensibility (CD),local pulse wave velocity(PWVβ) and stiffness(β) were calculated automatically.The correlations that the IMT, PWVβ and β were correlated positively with aging and CD was correlated negatively with between IMT and PWVβ or β, while no correlation between IMT and CD.The positive correlation was found correlation between IMT and age ( P＜0.05) ;In 30～39 and 40～49 years old groups,PWVβ increased and CD decreased with aging;In 50～59 years old group,PWVβ and β increased with aging;But in 60～69 years these parameters changed with aging in subjects＜60 years old.Conclusions RF-data technology could quantitativly evaluate common carotid arterial IMT and elasticity, the normal values of the related parameters were determined with aging,it may be a promising modality to assess the arterial condition.

Evaluation of common carotid arterial wave intensity in healthy volunteers / 中华超声影像学杂志

Objective To summarize the characteristics of common carotid arterial wave intensity (WI) in healthy volunteers and offer the normal reference values of WI. Methods Common carotid arteries (CCA) in 525 healthy volunteers were examined using Aloka Prosound α10 equipped with wave intensity software. The volunteers were divided into six group according to age,group A,＜20 years old;group B,20 - 29 years old;group C,30 - 39 years old;group D,40 - 49 years old;group E,50 - 59 years old and group F,≥60 years old. Carotid arterial wave intensity in normal subjects had two positive peaks, the first peak,W1 ,and the second peak, W2. Between the two positive peaks, a negative area (NA), the time interval between the R-wave of ECG and the first peak(R-W1 ) and that between the first and second peaks (W1-W2) were observed. Results ① 1050 common carotid arteries in 525 volunteers were studied. The mean values of W1,W2,NA,R-W1,and W1-W2 were (8332±4796) mmHg · m-1 · s-3,(1853±1143)mmHg · m-1 · s-3,(38 ± 26) mmHg · m-1 · s-2, (102 ± 19)ms and (266 ± 42)ms,respectively. ②These values were no significant between the left and right CCA in same group. W1 and NA were correlated with age ( r = - 0. 204 and r = -0.301, P ＜0. 001). W1 and NA in group A and B were significant increased than those in other groups( P ＜0. 05 or P ＜0. 001 ). ③There were statistical significances in W1 and W1-W2 of CCA between male and female. ④There were no statistical significances in all values in common carotid arteries of both sides (P ＞0. 05). ConclusionsWI technique is useful for evaluating the dynamic behavior of the heart and the vascular system and their interaction. W1 is very sensitive to the changes in the working condition of the cardiovascular system.

Application of MWI-a new parameter of wave intensity / 中国医学影像技术

Objective To investigate the feasibility of mean wave intensity (MWI), W1 and W2 in assessing the function of common carotid artery (CCA) before and after cold presser test with wave intensity analysis. Methods Twenty-four healthy subjects were enrolled. The W1, W2, and other parameters of blood flow in resting, before and after cold presser test of CCA, the inner diameter different rate and MWI of blood flow were calculated respectively. The receiver operation characteristic (ROC) curves were drawn, and of the effectiveness of MWI, W1 and W2 was compared. Results The different rate of diameters and W1 decreased significantly when subjects underwent cold presser test (P＜0.05), but MWI and W2 increased significantly (P＜0.05). The area under ROC curves was 0.858, 0.731 and 0.698, corresponding to MWI, W1 and W2 (P＞0.05). Conclusion The function of CCA can be evaluated with MWI calculated from conventional parameters.

Hemodynamics and morphology of common carotid artery in pig model of obstructive sleep apnea-hypopnea syndrome / 第二军医大学学报

Objective: To prepare a pig model of obstructive sleep apnea-hypopnea syndrome (OSAHS) and to observe the hemodynamics and pathological characteristics of common carotid artery, so as to lay a foundation for further studying the effect of OSAHS on cardiovascular system. Methods: Twelve male small-type pigs were randomly divided into model group and control group (n = 6). Animals in the model group were housed in a negative pressure chamber for 6 months to establish OSAHS model and those in the normal control group were fed routinely. After pigs in the model group presented the symptoms of OSAHS, the changes in hemodynamics of carotid artery were detected with color Doppler ultrasound. The morphological changes of common carotid artery were analyzed under light microscope and electron microscope. Results: Animal model of OSAHS was successfully created. The internal diameter of carotid artery of pigs in the model group was decreased, the intima was increased, and the peak-systolic mean velocity (S) and the resistance index (RD were both increased compared with those of the control group (P