ABSTRACT
Stroke is the third most common cause of death in North America and ever year approximately 700,000 new strokes are reported in the United States. Seventy-five percent of these occur in the distribution of the carotid arteries. Among strokes of a thromboembolic etiology, carotid occlusive disease is the most common cause. As many as 150,300 stroke-related fatalities are documented annually, with a total cost for the health-care system of approximately $ 18 billion per year. This review will focus on the different pathomorphologic aspects of carotid plaque, outlining the similarities and differences with the coronary plaque, with particular attention on how intravascular imaging may contribute to a better stratification of the patient treatment.
Subject(s)
Angioplasty, Balloon , Carotid Stenosis/diagnostic imaging , Carotid Stenosis/therapy , Plaque, Atherosclerotic/diagnostic imaging , Stents , Stroke/prevention & control , Ultrasonography, Interventional , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/therapy , Carotid Stenosis/complications , Carotid Stenosis/economics , Carotid Stenosis/epidemiology , Evidence-Based Medicine , Humans , Incidence , Italy/epidemiology , Risk Assessment , Stroke/etiology , Treatment OutcomeABSTRACT
One quarter of patients with STEMI submitted to primary percutaneous coronary intervention (PCI) need repeated target vessel revascularization (TVR) because of stent restenosis or thrombosis. Introduction of DES has effectively reduced the incidence of these complications but the safety of this type of stent in the setting of AMI is limited due to the unpredictable risk of stent malapposition and vessel remodelling in the long term follow-up. Recently, treatment with drug eluting balloon (DEB) in association with bare metal stenting (BMS) has been reported to have an excellent efficacy and safety profile. However, little is known regarding the extent of stent coverage in BMS after DEB utilization.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Restenosis/diagnosis , Coronary Restenosis/prevention & control , Drug-Eluting Stents , Tomography, Optical Coherence , Aged , Follow-Up Studies , Humans , Male , Time FactorsABSTRACT
Coronary heart disease (CHD) is a leading cause of mortality in women worldwide. However CHD is still considered to be a male disease and it is likely to be under-diagnosed in women since symptoms are different in women and diagnostic tests may be less specific or sensitive. This review examines the symptoms and risk factors for CHD in women. The role of invasive and non-invasive tests together with their prognostic implications as well as indications for coronary revascularization will be discussed. New research should focus on the role of gender differences in CHD and trials specifically designed to study women.
