Carotid Artery Stenosis In Patients Research Articles

Arterial transit artifacts and carotid Plaque-RADS may predict symptoms in patients with carotid stenosis

AimTo analyze the correlation of carotid stenosis severity, the Plaque Reporting and Data System (RADS) score, arterial transit artifacts (ATAs), and cerebral blood flow (CBF) with clinical cerebral ischemic symptoms in patients with carotid artery stenosis (CAS). Materials and methodsSixty-one patients with unilateral internal carotid artery stenosis or occlusion (≥50% stenosis) diagnosed by ultrasound, Computed Tomography(CT) angiography, or Magnetic Resonance(MR) angiography in Yichang City Central People's Hospital from January 2022 to February 2024 were retrospectively enrolled and divided into two groups according to the presence or absence of symptoms. Both groups underwent MR plaque imaging and arterial spin labeling (ASL)-based 3.0 T MRI to compare the differences in stenosis degree, Plaque-RADS score, ATA grade, and CBF between the two groups. Binary regression analysis was used to identify the parameters with statistically significant differences between the two groups and to evaluate their diagnostic efficacy using the area under the workup curve of the subjects. ResultsThe Plaque-RADS score, ATA grade, and CBF differences in the anterior cerebral artery(ACA)blood supply region were correlated with symptoms, and the areas under the ROC curves for the CBF differences in the ACA blood supply region, Plaque-RADS score, ATA grade and a joint model that combines all three to predict symptoms in CAS patients were 0.672, 0.796, 0.788 and 0.919, respectively. ConclusionsCBF, Plaque-RADS and ATAs were identified as independent risk factors for symptoms in patients with CAS and have a certain predictive value for symptoms, and the combined predictive value is greater, potentially providing a more effective imaging modality for clinical treatment and evaluation.

Association of carotid endarterectomy at low-volume centers with higher likelihood of major complications and nonroutine discharge.

Carotid artery stenosis (CAS) is associated with an annual stroke risk of 2%-5%, and revascularization with carotid endarterectomy (CEA) can reduce this risk. While studies have demonstrated that hospital CEA volume is associated with mortality and myocardial infarction, CEA volume cutoffs in studies are relatively arbitrary, and no specific analyses on broad complications and discharge disposition have been performed. In this study, the authors systematically set out to identify a cutoff at which CEA procedural volume was significantly associated with major complications and nonroutine discharge. Asymptomatic and symptomatic CAS patients undergoing CEA were retrospectively identified in the Nationwide Readmissions Database (2010-2018). The association of CEA volume with outcomes was explored as a continuous variable using locally estimated scatterplot smoothing. The identified volume cutoff was used to generate dichotomous volume cohorts, and multivariate analyses of patient and hospital characteristics were conducted to evaluate the association of CEA volume with major complications and discharge disposition. Between 2010 and 2018, 308,933 asymptomatic and 32,877 symptomatic patients underwent CEA. Analysis of CEA volume with outcomes as a continuous variable demonstrated that an increase in volume was associated with a lower risk until a volume of approximately 7 cases per year (20th percentile). A total of 6702 (2.2%) asymptomatic and 1040 (3.2%) symptomatic patients were treated at the bottom 20% of hospital procedure volume. Increased rates of complications were seen at low-volume centers among asymptomatic (3.66% vs 2.77%) and symptomatic (7.4% vs 6.87%) patients. Asymptomatic patients treated at low-volume centers had an increased likelihood of major complications (OR 1.26, 95% CI 1.07-1.49; p = 0.007) and nonroutine discharge (OR 1.36, 95% CI 1.24-1.50; p < 0.0001). Symptomatic patients treated at low-volume centers were also more likely to experience major complications (OR 1.47, 95% CI 1.07-2.02; p = 0.02) and nonroutine discharge (OR 1.26, 95% CI 1.07-1.47; p = 0.005). Mortality rates were similar between low- and high-volume hospitals among asymptomatic (0.36% and 0.32%, respectively) and symptomatic (1.06% and 1.49%, respectively) patients, while volume was not significantly associated with mortality among asymptomatic (OR 1.06, 95% CI 0.67-1.65; p = 0.81) and symptomatic (OR 0.81, 95% CI 0.43-1.54; p = 0.52) patients in multivariate analysis. CEA patients, asymptomatic or symptomatic, are at a higher risk of major complications and nonroutine discharge at low-volume centers. Analysis of CEA as a continuous variable demonstrated a cutoff at 7 cases per year, and further study may identify factors associated with improved outcome at the lowest-volume centers.

Risk factors of internal carotid artery stenosis in patients with proliferative diabetic retinopathy: an analysis using optical coherence tomography and optical coherence tomography angiography

BackgroundThis research investigates the correlation between the severity of internal carotid artery (ICA) stenosis and retinal parameters in patients with proliferative diabetic retinopathy (PDR), aiming to uncover potential risk factors.MethodsA retrospective analysis of 68 patients (136 eyes) diagnosed with bilateral PDR from January 1, 2017, to December 31, 2021, was conducted. Carotid artery stenosis (CAS) was assessed using neck computed tomography angiography (CTA) and carotid duplex ultrasound (CDUS), with stenosis classified into two groups: normal (group 1) and mild or above (group 2), based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Optical coherence tomography (OCT) and OCT angiography (OCTA) measured several retinal parameters, including sub foveal choroidal thickness (SFCT), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, vessel density (VD), and foveal avascular zone (FAZ) area. Statistical analyses determined correlations between ICA degrees and retinal parameters.ResultsThis study showed significant differences between groups in total VD, FAZ area, total RNFL thickness, and temporal RNFL thickness, indicating that patients with more severe ICA stenosis had noticeable retinal changes. Other parameters such as hyperlipidemia, total cholesterol levels, and intraocular pressure (IOP) also differed significantly, while no notable differences were observed in SFCT, central VD, average GCIPL, and superior, nasal, and inferior RNFL thickness.ConclusionThe study findings highlight retinal changes, such as an increased FAZ area, decreased total VD, and a total and thinner temporal RNFL, which suggest the need for carotid artery evaluation in patients. These findings have important clinical implications for the need for carotid work up in patients with PDR.

Quantitative assessment of retinochoroidal microvasculature in patients with carotid artery stenosis using OCT angiography

PurposeTo investigate the alterations in retinochoroidal parameters measured by optical coherence tomography (OCT) and OCT angiography (OCTA) in patients with carotid artery stenosis (CAS) and assess their associations with digital subtraction angiography (DSA) data. MethodThis study enrolled patients diagnosed with CAS and age-matched healthy controls. Both groups underwent OCT and OCTA examinations. DSA and assessment of carotid artery stenosis were performed only in the CAS group. The study evaluated various retinochoroidal parameters from OCT and OCTA, including linear vessel density (LVD), foveal avascular zone (FAZ), choroidal thickness (ChT), and retinal nerve fiber layer (RNFL) thickness. DSA-derived measures included cervical segment (C1) diameter, cavernous segment (C4) diameter, stenosis percentage, ophthalmic artery (OA) filling time, C1-OA filling time, and residual stenosis. ResultsA total of 42 eyes from 30 CAS patients and 60 eyes from 30 healthy controls were included. Patients with CAS displayed significantly decreased LVD compared to controls (p < 0.001). Additionally, the CAS group had thinner choroid and RNFL (p = 0.047 and p < 0.001, respectively). Macular LVD negatively correlated with both stenosis percentage and C1-OA filling time (p = 0.010 and p = 0.014, respectively). In patients who underwent carotid artery stenting, preoperative ChT significantly correlated with residual stenosis (Pearson r = -0.480, p = 0.020). ConclusionOCT and OCTA provide a quantitative assessment of retinochoroidal microstructural changes associated with CAS, suggesting potential for noninvasive evaluation of the disease. This might contribute to the prevention of irreversible ocular complications and early detection of CAS. Furthermore, ChT may not only aid in diagnosing CAS more reliably but also offer prognostic information.

Incidence, Risk Factor and Prognosis of Carotid Artery Stenosis in Patients with Atherosclerotic Occlusive Disease

Incidence, Risk Factor and Prognosis of Carotid Artery Stenosis in Patients with Atherosclerotic Occlusive Disease

Uncommon Carotid Artery Stenting Complications: A Series by Images.

To describe through emblematic images rare but clinically relevant carotid artery stenting complications that occurred at two high-volume centres for carotid artery stenting (CAS). CAS is an alternative to carotid endarterectomy (CEA) for the treatment of carotid artery stenosis in patients judged to be at high risk for CEA. CAS complications range between 1 and 9% and are higher in older patients complaining of neurological symptoms at the time of presentation. Besides periprocedural or early-after-procedure stroke, which remains the true Achilles' heel of CAS, other dramatic complications might compromise the clinical outcomes of this procedure. Five infrequent complications, out of more than 1000 CAS performed in the years 2016-2021, have been described. Among CAS complications, acute carotid stent thrombosis, rescue retrieval of a disconnected distal cerebral embolic protection device, plaque prolapse after carotid stenting, cerebral hyperperfusion syndrome (CHS), and radial artery long sheath entrapment requiring surgical intervention were found to account for 0.3% of the total number of procedures performed by operators with high CAS volume. Unusual CAS complications may infrequently occur, even in hands of expert operators. To know how to deal with such complications might help interventionalists to improve CAS performance.

Relationship between Atherosclerosis Risk Factors and Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Graft

Background: Evaluation of the risk factors of atherosclerosis and carotid artery stenosis have been subjected to several investigations. The present study was conducted to determine the degree of carotid artery stenosis and investigate the relationship between atherosclerosis risk factors and coronary artery involvement in coronary artery bypass graft (CABG) patients. Methods: This cross-sectional study was conducted on 450 CABG candidate patients who visited Shahid Beheshti Hospital in Qom. The patients were divided into 4 groups according to the degree of carotid artery stenosis and were examined in terms of risk factors for atherosclerosis and coronary artery involvement. Finally, the data were analyzed using SPSS statistical software. Results: In total, about 18% of the patients had carotid artery stenosis, of them 13.6% had stenosis of less than 50%, 3.2% had stenosis of 50%–70%, and 1.2% had stenosis of more than 70%. Age, history of hypertension (HTN), hyperlipidemia, and previous history of cerebrovascular accident (CVA) showed a significant relationship with carotid artery stenosis. However, gender, BMI, diabetes, history of smoking, history of angiography and lipid profile of the patients did not show a significant relationship. Also, the incidence of CVA after CABG was 1.2%. Conclusion: The present study showed that old age, HTN, hyperlipidemia, and history of CVA are directly related to the severity of carotid artery stenosis.

Preoperative Evaluation for Carotid Endarterectomy Using CT and MRI Fusion Images Without Contrast Media.

The usefulness of carotid endarterectomy (CEA) for carotid artery stenosis has been established even in the era of endovascular treatment. Digital subtraction angiography (DSA) and three-dimensional computed tomography angiography (3D-CTA) are used for preoperative evaluation of CEA; however, contrast agents cannot be used in patients with renal dysfunction or contrast agent allergy. Since the introduction of a three-dimensional image analysis software, SYNAPSE VINCENT (Fujifilm, Tokyo, Japan) in February 2016, we initially fused cervical CT, carotid three-dimensional time-of-flight magnetic resonance angiography, and carotid plaque imaging using 1.5 T magnetic resonance imaging to evaluate carotid artery stenosis in patients with renal dysfunction. Since then, we have gradually accumulated several cases, and at present, this fusion imaging is our first choice for preoperative evaluation of CEA instead of DSA or 3D-CTA. This evaluation method has many advantages over DSA and 3D-CTA, including the fact that it does not require contrast media. We report its usefulness, limitations, and cautions.

Risk Factors for Ankle Brachial Index and Carotid Artery Stenosis in Patients with Type 2 Diabetes.

Type 2 diabetes mellitus (T2DM) significantly increases the risk of atherosclerotic cardiovascular disease. Ankle brachial index (ABI) and carotid artery stenosis are non-invasive indicators of generalized atherosclerosis. This study aimed to explore the risk factors for ABI and carotid artery stenosis and discover which factors simultaneously influence both conditions in T2DM. The study included a total of 101 patients with T2DM. ABI was performed via Doppler ultrasound, and both common carotid arteries were examined via ultrasound to obtain the percentage of carotid artery stenosis. A negative correlation was noted between the ABI and the percentage of carotid artery stenosis (p = 0.043). ABI correlated significantly negatively with waist circumference (p = 0.031), total cholesterol (p = 0.003), low-density lipoprotein (LDL) cholesterol (p = 0.003), and C-reactive protein (CRP) (p = 0.017), whereas the percentage of carotid artery stenosis correlated with the smoking habit (p = 0.017) and CRP (p = 0.042). The best model for predicting the ABI value (R2 = 0.195) obtained from stepwise regression analysis included waist circumference, LDL cholesterol, triglycerides, and CRP, while the best model for the percentage of the carotid artery stenosis (R2 = 0.112) included smoking and CRP. CRP influenced the ABI value with a negative parameter estimate of -0.008962 (p = 0.053) and the percentage of the carotid artery stenosis with a positive parameter estimate of 0.443655 (p = 0.006) relative to a one-unit change of it, presenting the negatively significant impact of CRP on the association between carotid artery stenosis and low ABI. Our results suggest that CRP is the most important risk factor that connects ABI and carotid artery stenosis, which are important non-invasive indicators of generalized atherosclerosis in T2DM.

FEATURES OF THE LIPID PROFILE AND ADIPOSE TISSUE IN PATIENTS WITH CAROTID ARTERY STENOSIS ON THE BACKGROUND OF CORONARY ARTERY DISEASE

HighlightsIntra-abdominal adipose tissue thickness (IAAT) was statistically significantly greater in patients with hypertriglyceridemia compared to patients with normal triglyceride levels. Linear regression analysis confirmed the following findings: the greater the thickness of IAAT and preperitoneal fat thickness (PFT), the higher the levels of triglycerides and very-low-density lipoproteins.AbstractAim. To assess the lipid profile and distribution of adipose tissue (based on ultrasound parameters) and their role in the development of carotid artery stenosis in patients with coronary heart disease (CHD).Methods. Ultrasound parameters of adipose tissue in 125 patients, diagnosed with coronary heart disease (CHD), were studied. The average age of the patients was 68 (61.0; 74.0) years old. The sample was represented predominantly by males (58.4%).Results. It was determined that in patients who did not reach the target levels of triglycerides (TG), the thickness of the IAAT is 15 mm more than in patients with the adequate level of this indicator (p = 0.031). Subcutaneous adipose tissue (SAT) values also exceeded the values ​​in individuals with low HDL levels (p = 0.050), in contrast to patients with normal HDL. Linear regression analysis (after adjusting for gender and age) showed that the increase in IAAT thickness was associated with the increase in TG (b = 0.002, p = 0.028) and VLDL (b = 0.001, p = 0.023). It was also found that only 43.4% of the examined individuals received lipid-lowering therapy, and 17.3% received an adequate dose of statins (reached the target LDL values).Conclusion. No statistically significant patterns were found between the achievement of lipid targets and the presence of carotid stenosis. An extremely low percentage of patients taking adequate lipid-lowering therapy (17.3%) was determined, and the proportion of the people with carotid stenosis who reached the target levels of total cholesterol was 58.4%, TG – 79.3%, HDL – 31.7%, LDL – 12.2%. The thickness of the IAAT is statistically significantly higher in individuals with hypertriglyceridemia, in contrast to patients with normal TG levels. The tendencies towards statistical significance of PFT indicators in individuals with hypertriglyceridemia, minimum and maximum SAT values, depending on the level of HDL, were determined. Linear regression analysis confirmed the data obtained: the higher the thickness of IAAT and PFT, the higher the levels of TG and VLDL.

Length of carotid plaque is associated with changes in retinal microvascular densities of carotid artery stenosis patients

Length of carotid plaque is associated with changes in retinal microvascular densities of carotid artery stenosis patients

Effect of collateral circulation in patients with multiple craniocervical artery stenoses.

Based on previous findings, collateral circulation in the brain is vital in mitigating cerebral ischemia's effects and influencing stroke risk. This retrospective study examined collateral circulation, admission ischemic stroke status, and long-term recurrence in patients with multiple craniocervical artery stenoses. Consecutive symptomatic internal carotid artery (ICA) stenosis patients from the First Affiliated Hospital of Soochow University were recruited. Baseline data including medical histories and neurological function at admission were collected. Imaging techniques assessed collateral compensative capacity. Multivariate logistic regression analysis was used to investigate the association between collateral circulation and case status. A total of 559 patients with symptomatic ICA stenosis were included, among whom 153 (27.4%) had concurrent moderate to severe vertebro-basilar artery (VBA) stenosis. Dizziness, weakness/numbness, and slurring of speech were the primary symptoms in all patients. Over 36 months, 71 (12.7%) patients experienced a recurrence of acute ischemic stroke (AIS). In multivariate analysis, collateral circulation was found to be negatively associated with AIS (regional leptomeningeal collateral [rLMC] scores: OR: 0.798, 95% CI: 0.743-0.857, p < 0.001; Tan scores: OR: 0.478, 95% CI: 0.336-0.679, p < 0.001). Meanwhile, the collateral circulation scores were significantly associated with the recurrence of AIS within 3 years (rLMC scores: OR: 0.926, 95% CI: 0.860-0.997, p = 0.042; Tan scores: OR: 0.467, 95% CI: 0.306-0.712, p < 0.001). Most associations remained significant in the subgroup of patients with VBA stenosis. Favorable collateral circulation in multiple craniocervical artery stenosis patients reduced long-term ischemic event recurrence. Stratifying treatment risks is essential for optimizing outcomes.

Technical aspects of hybrid interventions for multilevel lesion of brachiocephal arteries. Literature review

Carotid artery stenosis is one of the leading causes of ischemic strokes and accounts for about 20 % of all strokes. The widespread use of radiological diagnostic methods and recommendations for the carotid artery stenosis patients management led to the identification of atypical forms of damage to the brachiocephalic arteries — a combination of multi-level stenoses of extra and intracranial localization. Multilevel lesion of brachiocephalic arteries is characterized by a combination of hemodynamically significant stenosis of the internal carotid artery in combination with stenosis of the common carotid artery or brachiocephalic trunk. The prevalence of tandem lesions varies from 0.5 to 6.4 %. Despite the rarity of this pathology, the risk of ischemic complications against the background of tandem stenosis of the brachiocephalic arteries is higher than with a single-level lesion. The surgical intervention strategy should provide for the correction of both stenosis, which can be achieved in three ways: endovascular method, open prosthetics and hybrid method. The essence of the hybrid technique is the simultaneous correction of the distal and proximal zones of stenosis by one surgical team in a hybrid operating room. The aim of the study is to review the available literature data and to demonstrate the developed hybrid intervention technique with a detailed description of the technical aspects of all stages of the surgery.

Association of carotid artery stenosis and ischemic stroke in patients undergoing coronary artery bypass grafting

Background. The incidence of stroke after Coronary artery bypass grafting (CABG) and the effect of carotid artery stenosis for risk assessment of stroke was strongly needed. This study compared the relation of ischemic stroke in the patients posted for CABG with varying degree of carotid artery stenosis (CAS) as measured by carotid artery Doppler. Patients and methods. This prospective cross-sectional study enrolled 422 patients with coronary artery disease (CAD) who underwent CABG. Out of them 170 patient with concomitant CAD were selected and divided into three groups such as mild, moderate and severe CAS. The occurrence of stroke was measured. Results. Unilateral CAS was common than bilateral CAS (71.2% vs 28.8%). Mild CAS was more than moderate and severe CAS (72.4% vs 21.2% vs 6.5%). Stroke observed in 1.2%, in which one patient had moderate CAS and other had severe CAS on the side of clinical stroke post CABG. Right carotid disease was frequent among 3 groups (51.8% vs 47.6%; 11.8% vs 10.6%; 4.1% vs 3.5%). Patient with old stroke showed significant correlation with the severity of CAD (p=0.02). Post-surgery stroke had significant correlation with previous history of stroke (p=0.001), severity of CAD (p=0.01) and bilateral CAS (p=0.02). Post-operative low volume state requiring prolonged ionotropic support showed significant correlation to stroke (p=0.02). Conclusion. Screening of patients for CAS in patients age &gt;65 years with previous stroke, and comorbidities aids the surgeon to take required measures to prevent stroke as a complication intraoperative or postoperative and decrease morbidity to the patient.

Length of Carotid Plaque Impacts Retinal Microvascular Densities of Carotid Artery Stenosis Patients.

We explored the retinal microvascular changes in carotid artery stenosis (CAS) and their relationship with carotid plaque morphology. All participants were diagnosed with carotid artery stenosis by a neurologist. Participants underwent digital subtraction angiography (DSA) and optical coherence tomography angiography (OCTA) imaging. The degree and length of carotid plaque were obtained from the DSA tool. OCTA tool measured the densities in the superficial vascular complex (SVC) and deep vascular complex (DVC). One hundred seventeen patients with CAS patients were included in our data analysis. Eyes with ipsilateral stenosis had reduced retinal microvascular densities when compared to contralateral eyes in patients with CAS (P = 0.016 for SVC, and P = 0.004 for DVC). Microvascular densities correlated with the length of carotid plaque (P = 0.015 for SVC, and P = 0.022 for DVC) in our CAS cohort, although they did not correlate with the degree of carotid plaque (P = 0.264 for SVC, and P = 0.298 for DVC). However, when stratified into moderate and severe subgroups, the degree of carotid plaque correlated with microvascular densities in patients with severe stenosis (P = 0.045 for SVC, and P = 0.038 for DVC). Our study suggests that OCTA can noninvasively detect retinal microvascular changes in patients with CAS and that these changes correlated with the length of the stenosis, but future studies are required to confirm these findings. Noninvasive and rapid acquisition of the OCTA image might have the potential to be used as a screening tool to detect microvascular changes in carotid artery stenosis.

Assessment of cerebral autoregulatory function and inter-hemispheric blood flow in older adults with internal carotid artery stenosis using transcranial Doppler sonography-based measurement of transient hyperemic response after carotid artery compression

Unhealthy vascular aging promotes atherogenesis, which may lead to significant internal carotid artery stenosis (CAS) in 5 to 7.5% of older adults. The pathogenic factors that promote accelerated vascular aging and CAS also affect the downstream portion of the cerebral microcirculation in these patients. Primary treatments of significant CAS are eversion endarterectomy or endarterectomy with patch plasty. Factors that determine adequate hemodynamic compensation and thereby the clinical consequences of CAS as well as medical and surgical complications of carotid reconstruction surgery likely involve the anatomy of the circle of Willis (CoW), the magnitude of compensatory inter-hemispheric blood flow, and the effectiveness of cerebral microcirculatory blood flow autoregulation. This study aimed to test two hypotheses based on this theory. First, we hypothesized that patients with symptomatic and asymptomatic CAS would exhibit differences in autoregulatory function and inter-hemispheric blood flow. Second, we predicted that anatomically compromised CoW would associate with impaired inter-hemispheric blood flow compensation. We enrolled older adults with symptomatic or asymptomatic internal CAS (>70% NASCET criteria; n = 46) and assessed CoW integrity by CT angiography. We evaluated transient hyperemic responses in the middle cerebral arteries (MCA) after common carotid artery compression (CCC; 10 s) by transcranial Doppler sonography (TCD). We compared parameters reflecting autoregulatory function (e.g., transient hyperemic response ratio [THRR], return to baseline time [RTB], changes of vascular resistance) and inter-hemispheric blood flow (residual blood flow velocity). Our findings revealed that CAS was associated with impaired cerebral vascular reactivity. However, we did not observe significant differences in autoregulatory function or inter-hemispheric blood flow between patients with symptomatic and asymptomatic CAS. Moreover, anatomically compromised CoW did not significantly affect these parameters. Notably, we observed an inverse correlation between RTB and THRR, and 49% of CAS patients exhibited a delayed THRR, which associated with decreased inter-hemispheric blood flow. Future studies should investigate how TCD-based evaluation of autoregulatory function and inter-hemispheric blood flow can be used to optimize surgical techniques and patient selection for internal carotid artery revascularization.

Abstract P1048: Lattice-Boltzmann Method Achieves Feasible Hemodynamic Analysis In Carotid Atherosclerosis With Low Computational Cost

Introduction: Atherosclerosis is a common cardiovascular pathophysiology that can lead to plaque-related complications, including stroke and myocardial infarction. Non-invasive hemodynamic analysis can provide valuable insights into the plaque's rupture vulnerability and growth progression. Computational fluid dynamics is widely studied to understand hemodynamic pathophysiology further; however, traditional computational fluid dynamics methods often require daily-based analysis time to visualize hemodynamic parameters. This study investigated the feasibility of using the lattice Boltzmann method (LBM) for hemodynamic analysis of atherosclerosis lesions. Methods: From ten carotid artery stenosis patients, 20 carotid artery models were generated and analyzed using LBM. Hemodynamic parameters, including time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT), were compared between the stenotic lesion and contralateral control sides. The patient-specific boundary conditions were applied. Their cardiac cycle was subdivided into three periods: systolic acceleration, systolic deceleration, and diastolic, and analyzed to investigate their relationship with the hemodynamic parameters. Results: LBM effectively captured the hemodynamic parameters associated with carotid atherosclerosis with an hourly-based computational cost (2.765 [2.435-3.233] hours). The analysis visualized high TAWSS and low RRT distribution at stenotic areas during the systolic deceleration period and low TAWSS and high RRT distribution at the post-stenotic distal lesion during the diastolic period. These findings were reproducible among the ten patients. Conclusion: LBM-based hemodynamic analysis has the potential to serve as a non-invasive diagnostic tool that can help understand atherosclerosis pathophysiology with low computational cost.

Left main coronary artery calcification and carotid artery stenosis in patients with aortic valve sclerosis

Left main coronary artery calcification and carotid artery stenosis in patients with aortic valve sclerosis

Swept-source optical coherence tomography angiography metrics of retinal ischaemic perivascular lesions in patients being evaluated for carotid artery stenosis and controls

Background/aimsRetinal microvascular ischaemia may produce localised middle retinal disruption with corresponding scotoma, a phenomenon termed paracentral acute middle maculopathy (PAMM). Small chronic middle retinal atrophic lesions termed retinal ischaemic perivascular...

Clinical results of 30 consecutive patients of carotid artery stenosis treated with CASPER stent placement: 1-year follow-up and in-stent findings on intravascular ultrasound examination immediately and 6 months after treatment

BackgroundThe CASPER stent is expected to reduce periprocedural ischemic complications, but there is concern about restenosis in the early period. One-year follow-up results of CASPER stenting and findings on intravascular...