Common Carotid Artery In Patients Research Articles

Carotid Endarterectomy with Twisted Internal Jugular Vein Located Anterior to the Common Carotid Artery

AbstractThe knowledge of both normal and abnormal anatomy of the veins of the neck may be important for surgeons performing carotid endarterectomy (CEA), to avoid inadvertent injury to vascular structures. We present three cases of abnormal course of the internal jugular vein (IJV) which run anterior to the common carotid artery, named twisted IJV, that usually run posterolateral to the common carotid artery in patients undergoing CEA. These twisted IJV cases were detected by preoperative multidetector computed tomography angiography evaluation. During the CEA procedure, before identifying the common carotid artery, we dissected the retromandibular space to find the common facial vein. Then, dissection proceeded along the common facial vein caudally to find the IJV. After ligation and cutting of the common facial vein, a carotid sheath with the IJV turned laterally revealed the common carotid artery safely, and CEA was accomplished. Our clinical experience shows that knowledge of the anatomical anomaly of the IJV allows safe dissection of the carotid triangle avoiding inadvertent injury to the vasculature and vagus nerve.

Comprehensive ultrasound assessment of the state complex intima-media brachiocephalic arteries in patients with metabolic syndrome

Objective. Comprehensive ultrasound assessment of the state complex intima-media (CIM) of brachiocephalic arteries in patients with metabolic syndrome (MS). Materials and methods. 82 patients were examined, including 62 patients with MS and 20 practically healthy individuals. All patients underwent biochemical blood analysis, ultrasound of the extracranial sections of the brachiocephalic arteries with an assessment of the qualitative and quantitative characteristics of CIM bifurcation of the brachiocephalic trunk (BCT), common carotid arteries (CCA) and vertebral arteries (VA).Results. 100% of patients with MS, changes in the echostructure of CIM were recorded in the form of pathological layering, 9 (14.5%) patients – in the form of hyperechogenic inclusions. Thickness of CIM in the bifurcation of BCT and CCA in patients with MS statistically significantly exceeds the same indicator in practically healthy persons and demonstrates direct correlation between the components of MS. The modified Carnegan index patients with MS is statistically significantly higher than the same indicator in practically healthy individuals and demonstrates direct correlation with the thickness of CIM estimated in different segments of the brachiocephalic arteries (BCT k 0.356, RCCA k 0.718, LCCA k 0.846, in the bifurcation of CCA on the right k 0.431, on the left k 0.519).Conclusion. Comprehensive ultrasound assessment of the state brachiocephalic arteries in patients with MS allows us to obtain complex of qualitative and quantitative signs characteristic of metabolic angiopathy.

Vasa vasorum interna in the carotid wall of active forms of Takayasu arteritis evidenced by ultrasound localization microscopy.

Introduction: Takayasu arteritis (TA) is associated with microvascularization of the wall of large arteries and is related to inflammation. Ultrasound localization microscopy (ULM), combining ultrafast ultrasound imaging with microbubble (MB) injection, can track the path of MBs within the arterial wall and thus provide imaging of the vasa vasorum. From the analysis of MB tracks in the common carotid arteries of patients with active TA, we report the presence of microvessels in connection with the carotid lumen (i.e., vasa vasorum interna [VVI]). Methods: ULM maps were obtained on five patients with active disease in the observational single-center series of the TAK-UF study. MB tracks connected to the carotid lumen were automatically identified, allowing the reconstruction of VVI. Results: MB tracking allows us to observe a microvascular network on the inner part of the wall, with some vessels in communication with the carotid lumen. This type of vessel was identified in all patients with active TA (n = 5) with a median of 2.2 [1.1-3.0] vessels per acquisition (2D longitudinal view of 3 cm of the common carotid artery). The blood flow within these vessels is mainly centrifugal; that is, toward the adventitia (88% [54-100] of MB tracks with flow directed to the outer part of the wall). Conclusion: VVI are present in humans in the case of active TA and emphasize the involvement of the intima in the pathological process. ClinicalTrials.gov Identifier: NCT03956394.

Comparison of the intima-media thickness of the common carotid artery in patients with rheumatoid arthritis: A single-center cross-sectional case-control study, and a brief review of the literature.

Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease affecting 0.5%-1%of adults worldwide. The carotid intima-media thickness (CIMT) is a simple, reliable, noninvasive marker for subclinical atherosclerosis. The aim of this study was to compare the intima-media thickness of the common carotid artery in patients with RAwith that of healthy patients. In this case-control study, subjects were recruited from the patients who presented to a private rheumatology clinic. RAwas documented by a rheumatologist. All subjects underwent an ultrasound examination of the carotid artery to assess CIMT. Subjects with RA filled out the disease activity score (DAS28) questionnaire. Sixty-two subjects (31 subjects with RA and 31 healthy subjects) took part in the study. The mean age of the subjects in the RA and the control groups was 42.39 ± 12.98 and 44.48 ± 13.56 years, respectively. Values of CIMT were significantly greater in RA subjects compared with their healthy counterparts (p < 0.001). The CIMTincreased significantly with increased disease severity (r = 0.73). Subjects were divided into two age groups (≤40and >40 years). A comparison of CIMT in the mentioned subgroups revealed a remarkable difference in CIMT values between those of the RA patients and those of their control counterparts in both age groups(p = 0.002 and p < 0.001 for those below and above 40 years, respectively). CIMT could be used as an efficient clinical index for identifying the early stages of atherosclerosis and predicting cardiovascular events following atherosclerosis in RA patients.

Association between telomere length and intima-media thickness of both common carotid arteries in patients with coronary heart disease: From the CORDIOPREV randomized controlled trial

Background and aimsA critical telomere length (TL) is associated with cardiovascular mortality. Dietary habits have been demonstrated to affect cardiovascular risk. However, it remains unclear how exactly TL determines the response to specific dietary approaches in the reduction of arterial injury. We aimed to evaluate whether TL was associated with the progression of arterial injury (assessed by intima-media thickness of both common carotid arteries: IMT-CC), after long-term consumption of two healthy dietary models in patients with coronary heart disease (CHD). MethodsFrom the 1002 CHD patients of the CORDIOPREV study, 903 completed IMT-CC and TL evaluation at baseline and were randomized to follow a Mediterranean diet or a low-fat diet for 5 years. ResultsPatients at risk of short TL (TL < 20th percentile) presented an elevated IMT-CC, (0.79 ± 0.17 vs patients at non-risk 0.74 ± 0.17 p < 0.001). TL and IMT-CC showed an inverse association (β = −0.035, p = 0.002). Patients who consumed a Mediterranean diet, regardless of the risk of short TL, showed a significant decrease in IMT-CC, with a higher reduction in those patients with risk of short TL (−0.03 ± 0.11, p = 0.036). TL (β = 0.019, p = 0.024), age (β = −0.001, p = 0.031), energy intake (β = −0.000, p = 0.036), use of statins (β = −0.027, p = 0.028) and allocation into the Mediterranean diet (vs low-fat diet) (β = −0.024, p = 0.003) were significant contributors to changes in IMT-CC. ConclusionsPatients who had a reduced TL exhibited a greater decrease in IMT-CC after consuming a Mediterranean diet.

Intima-media Thickness Measured at the Common-carotid Artery in Patients Treated with Lipoprotein Apheresis

<h3>Lead Author's Financial Disclosures</h3> Nothing to disclose. <h3>Study Funding</h3> None. <h3>Background/Synopsis</h3> Common carotid intima-thickness (CIMT) is as a marker of arterial wall injury and arteriosclerosis. Healthy asymptomatic young and middle-aged individuals of the European-ancestry show mean CIMT of 610 + /-110μmmicrometers with a strong linear relation between age and CIMT. In the general population, an annual rate of change in mean common CIMT is estimated at 15μm (95% CI, 12 to 17), with a median standard deviation of 53. <h3>Objective/Purpose</h3> We sought to compare annual CIMT progression rates in 10 patients with severe hypercholesterolemia treated with lipoprotein apheresis with published annual CIMT progression estimates in age-comparable 1) healthy individuals based on the nomograms, 2) patients with elevated lipoprotein(a), and 3) familial hypercholesterolemia (FH). <h3>Methods</h3> Patients (mean age 60+/-9 years, 70% female, 80% statin intolerant) were treated with the dextran sulfate adsorption apheresis system for primary and secondary atherosclerotic cardiovascular disease (ASCVD) prevention every two weeks between 2005 and 2020 (mean duration, 10+/-4 years). To minimize intra-individual and inter-individual variability in CIMT assessment we used computerized algorithms with measurements performed by the same sonographer. <h3>Results</h3> The baseline mean CIMT was 850+/-170μm and maximum CIMT was 1040+/-220um across the age range of 46 to 70 years. The baseline median levels of total cholesterol were 317 (interquartile range (IQR), 262 to 361); LDL-C, 214 (133 to 253); HDL-C, 56 (44 to 68); triglycerides, 170 (121 to 215), lipoprotein(a), 26 (9 to 120), all in mg/dL. Acute effects of lipoprotein apheresis determined as a difference before and immediately after the procedure were estimated as a median of 72+/-8% and 75+/-7% reduction in the LDL-C and lipoprotein(a) levels, respectively. Regular treatment with lipoprotein apheresis resulted in average reduction in the mean CIMT of −40μm (IQR, −50 to 20). An annual CIMT progression rate was associated with the combined percentage reduction in the lipoprotein(a) (P=0.032) and LDL-C levels (P=0.029). Using the Bayesian Estimation Supersedes the t -Test (BEST) method, the annual rate of CIMT progression was compared to those reported in the literature (Table 1). <h3>Conclusions</h3> Composite CIMT progression rates were slowed with lipoprotein apheresis. In this cohort of high-risk patients with poor statin tolerance, the use of CIMT surveillance was noted to increase compliance with long-term lipid-modifying therapies in the clinical setting.

Ultrasound shear wave elastography imaging of common carotid arteries in patients with Spontaneous Coronary Artery Dissection (SCAD)

BackgroundShear wave elastography (SWE) is emerging as a valuable clinical tool for a variety of conditions. The aim of this pilot study was to assess the potential of SWE imaging of the common carotid arteries (CCA) in patients with spontaneous coronary artery dissection (SCAD), a rare but potentially life-threatening condition, hypothesized to be linked to changes in vessel wall elasticity.MethodsUltrasound shear wave elastography (SWE) estimates of artery wall elasticity were obtained from the left and right CCAs of 89 confirmed SCAD patients and 38 non-dissection controls. SWE images obtained over multiple cardiac cycles were analysed by a blinded observer to estimate elasticity in the form of a Young’s Modulus (YM) value, across regions of interest (ROI) located within the anterior and posterior CCA walls.ResultsYM estimates ranged from 17 to 133 kPa in SCAD patients compared to 34 to 87 kPa in non-dissection controls. The mean YM of 55 [standard deviation (SD): 21] kPa in SCAD patients was not significantly different to the mean of 57 [SD: 12] kPa in controls, p = 0.32. The difference between groups was 2 kPa [95% Confidence Interval − 11, 4].ConclusionsSWE imaging of CCAs in SCAD patients is feasible although the clinical benefit is limited by relatively high variability of YM values which may have contributed to our finding of no significant difference between SCAD patients and non-dissection controls.

Circumferential strain and local arterial stiffness in carotid arteries in healthy individuals and in patients with cardiovascular risk factors

Aim. To assess the parameters affecting circumferential strain and local arterial stiffness in carotid arteries in healthy individuals and in patients with cardiovascular risk factors.Methods. We analysed data from 111 adults, aged 20–45 years (38.3 ± 7 years). Of these, 63.06% of men had no known medical history of clinically manifest atherosclerosis. Study participants were categorised into two groups—group I (n = 50) comprising of healthy volunteers without known cardiovascular risk factors and group II (n = 61) consisting of individuals with one of the modifiable risk factors (e.g., smoking, obesity, hypertension or hypercholesterolemia). Patients with diabetes mellitus, cardiac arrhythmias or asymptomatic atherosclerotic plaques in the carotid arteries, even if hemodynamically insignificant, were excluded. The following were measured for the common carotid artery (CCA): circumferential strain (CS, %), strain rate (CSR, s−1), time to peak (TTP) strain (ms), and fraction area change CCA (FAC, %) and local arterial stiffness (β2).Results. CCA mechanics correlated with age, blood pressure, body mass index and left-ventricular myocardial mass index. The lowest CS values were seen in group II patients with hypertension (HTN) (with HTN, 2.4% ± 0.9%, 95% CI = 2.07–2.86; without HTN, 3.6% ± 1.1%, 95% CI = 3.2–4). β2 increased to the greatest extent in patients with HTN (19.3% ± 6.1%, 95% CI = 16–21) as compared to those without HTN (13.5% ± 4.5%, 95% CI =13–16). FAC was inversely correlated with age, both in healthy subjects (Rs = −0.63, p = 0.0001) and in patients with cardiovascular risk factors (Rs = −0.61, p = 0.0001).Conclusion. While CS, strain rate and FAC decreased with age, TTP strain and local arterial stiffness increased. Both mechanics and function of the CCA in patients at risk of developing cardiovascular complications demonstrate a close association with hypertension, obesity, smoking and hypercholesterolemia.Received 19 November 2020. Revised 14 January 2021. Accepted 18 January 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributionsConception and study design: Yu.S. Sinelnikov, E.N. Orekhova, T.V. Matanovskaya, E.O. Kopytova, D.O. BaranovaData collection and analysis: E.O. Kopytova, D.O. BaranovaStatistical analysis: E.N. Orekhova, T.V. MatanovskayaDrafting the article: E.N. OrekhovaCritical revision of the article: Yu.S. SinelnikovFinal approval of the version to be published: Yu.S. Sinelnikov, E.N. Orekhova, T.V. Matanovskaya, E.O. Kopytova, D.O. Baranova

Influence of alpha-lipoic acid on the metabolic and adipocytokine status in patients with type 2 diabetes mellitus and chronic pancreatitis

Objective — to analyze the effects of the proposed therapy regimen with the use of alpha‑lipoic acid on the dynamics of the adipokines’ levels: vaspin, TNF‑a, parameters of carbohydrate and lipid metabolism and the thickness of the intima‑media complex of the common carotid artery in patients with type 2 diabetes mellitus and chronic pancreatitis.Materials and methods. The investigation involved 60 patients (38 women and 22 men, aged 53 to 61 years, the mean age 56.7 years) with type 2 diabetes mellitus combined with chronic pancreatitis. The parameters of lipid and carbohydrate metabolism, the functional state of the pancreas, levels of c‑reactive protein and adipocytokines — vaspin and tumor necrosis factor‑a, have been evaluated. The condition of the wall of the common carotid artery was assessed by the ultrasound method. All parameters were assessed twice, before and after completion of the therapy (after 3 months), which included hypoglycemic and hypolipidemic therapy and an alpha‑lipoic acid. All drugs were used at an individually adjusted dosage, except for alpha‑lipoic acid, which was administered at a dose of 600 mg per day for 3 months.Results. Against the therapy background, the positive dynamics of the main parameters of carbohydrate and lipid metabolism and the main laboratory indices of pancreas execratory dysfunction has been established. In patients administered alpha‑lipoic acid, the significant increase in the vaspin levels and decrease in TNF‑a levels have been revealed, as well the improvement of parameters of functional pancreas state. In patients with and without atherosclerotic plague who were taken alpha‑lipoic acid, a tendency was established towards a decrease in the thickness of the IMC CA (1.17 ± 0.09 mm vs 1.11 ± 0.08 mm) and (1.26 ± 0, 08 vs 1.22 ± 0.05 mm), respectively.Conclusions. The effects of the proposed treatment scheme with the use of alpha‑lipoic acid have been established in terms of activation of the compensatory mechanisms of the reduction in the levels of insulin resistance, TNF‑a, activity of inflammatory process and improvement of sensibilization to the endogenous insulin resulting from the increased vaspin levels.

Does the Carotid Bulb Offer a Better 10-Year CVD/Stroke Risk Assessment Compared to the Common Carotid Artery? A 1516 Ultrasound Scan Study.

The objectives of this study are to (1) examine the "10-year cardiovascular risk" in the common carotid artery (CCA) versus carotid bulb using an integrated calculator called "AtheroEdge Composite Risk Score 2.0" (AECRS2.0) and (2) evaluate the performance of AECRS2.0 against "conventional cardiovascular risk calculators." These objectives are met by measuring (1) image-based phenotypes and AECRS2.0 score computation and (2) performance evaluation of AECRS2.0 against 12 conventional cardiovascular risk calculators. The Asian-Indian cohort (n = 379) with type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), or hypertension were retrospectively analyzed by acquiring the 1516 carotid ultrasound scans (mean age: 55 ± 10.1 years, 67% males, ∼92% with T2DM, ∼83% with CKD [stage 1-5], and 87.5% with hypertension [stage 1-2]). The carotid bulb showed a higher 10-year cardiovascular risk compared to the CCA by 18% (P < .0001). Patients with T2DM and/or CKD also followed a similar trend. The carotid bulb demonstrated a superior risk assessment compared to CCA in patients with T2DM and/or CKD by showing: (1) ∼13% better than CCA (0.93 vs 0.82, P = .0001) and (2) ∼29% better compared with 12 types of risk conventional calculators (0.93 vs 0.72, P = .06).

Relationship between the severity of Obstructive Sleep Apnea syndrome and the intima media thickening of common carotid artery in patients with stroke (5527)

Relationship between the severity of Obstructive Sleep Apnea syndrome and the intima media thickening of common carotid artery in patients with stroke (5527)

Study on blood flow velocity waveform in common carotid artery in patients with atherosclerosis

Study on blood flow velocity waveform in common carotid artery in patients with atherosclerosis

Subclinical features of atherosclerotic remodeling of arteries in patients with rheumatoid arthritis

The aim of the research – to study the structural-functional state of artery walls in patients with rheumatoid arthritis depending of disease duration, seropositivity for rheumatoid factor/ cyclic citrullinated peptide antibodies, disease activity. Materials and methods. 82 patients with rheumatoid arthritis were investigated: 19 men (23.1 %) and 63 women (76.9 %), the average age of whom was (37.6 ± 5.1) years old. The control group consisted of 30 apparently healthy persons. In all the patients measurements of diameter and thickness of intima-media complex of common carotid arteries were carried out, the stiffness index was calculated. Results. 47.5 % (n = 39) of patients had rheumatoid arthritis with the present illness duration less than 3 years, in 47.5 % of patients (n = 39) the duration of rheumatoid arthritis was more than 3 years. In 48 (58.5 %) of patients rheumatoid factor/cyclic citrullinated peptide antibodies were present – seropositive variant of rheumatoid arthritis, in 34 (41.5 %) patients – rheumatoid factor/cyclic citrullinated peptide antibodies seronegative variant of the disease. Within all investigated patients with rheumatoid arthritis the highest rates of intima-media thickness complex of common carotid arteries were detected in patients with longer-term (more than 3 years) present illness rheumatoid factor/cyclic citrullinated peptide antibodies of seropositive rheumatoid arthritis; in patients of this group higher stiffness index of common carotid arteries was also detected that characterizes the local (carotid) rigidity of artery wall. Correlation analysis showed the existence of direct relationship between DAS28 and intima-media complex of common carotid arteries, the duration of rheumatoid arthritis and stiffness index of intima-media complex of common carotid arteries, and also between their size and the level of rheumatoid factor, cyclic citrullinated peptide antibodies, which shows the substantial contribution of activity and duration of autoimmune inflammation course in rheumatoid arthritis to changes of common carotid arteries architectonics. Conclusions. The data obtained demonstrate the existence of subclinical lesion of common carotid arteries in patients with rheumatoid arthritis and absence of cardiovascular diseases, more significant in long-term course (more than 3 years) of seropositive for rheumatoid factor/ cyclic citrullinated peptide antibodies disease variant.

Subclinical involvement of common carotid arteries in patients with fibromuscular dysplasia - a case-control study.

Background: Fibromuscular dysplasia (FMD) primarily involves medium-sized arteries, though the entire spectrum of vascular involvement is not fully understood. We hypothesized that larger arteries may also be affected, albeit sub-clinically. Patients and methods: We measured the cross-sectional diameter of the thoracic aorta, abdominal aorta, common iliac arteries (CIA) and common carotid arteries (CCA) in FMD subjects and compared them to matched controls. We retrospectively analyzed records of FMD subjects (n=74) and of age- and sex- matched controls (n=74) that underwent computed tomography of the neck, chest or abdomen. Cross-sectional diameters of the thoracic and abdominal aorta, CIA and CCA were measured in a standardized manner by two trained physicians. Results: The FMD group had a significantly greater diameter of the CIA and CCA bilaterally. The measurements (mm) in FMD and control groups were as follows: Right CIA: 10.85+1.75 vs. 10.23+1.36, p=0.04, left CIA: 11.01+1.93 vs. 10.15+1.38, p=0.007, right CCA: 7.70+0.81 vs. 6.80+1.10, p<0.001 and left CCA: 7.70+1.10 vs. 6.80+1.0, p<0.001). There was no difference in the diameter between the two groups in the ascending aorta, descending and the abdominal aorta. After adjusting for baseline differences, common carotid arteries (but not common iliac) were significantly larger in FMD group compared with controls. Conclusions: There is sub-clinical involvement of the common carotid arteries in patients with FMD and this manifests as a greater diameter of these arteries compared to age and sex matched controls.

Relationships Between the Cardio-Ankle Vascular Index and Pulsatility Index of the Common Carotid Artery in Patients With Cardiovascular Risk Factors.

BackgroundPulsatility index (PI) is a hemodynamic parameter determined using Doppler sonography; it reflects the degree of peripheral vascular resistance. Moreover, researchers have reported significant relationships between an increase in the PI of the common carotid artery (CCA) and ischemic stroke. This cross-sectional study aimed to clarify the relationships between cardio-ankle vascular index (CAVI) as a marker of arterial stiffness and the PI of the CCA in patients with cardiovascular risk factors for the primary prevention of ischemic stroke.MethodsA total of 405 outpatients undergoing treatment for cardiovascular risk factors (152 men and 253 women; mean age ± standard deviation, 64 ± 9 years) with no history of cardiovascular events, including ischemic stroke, were enrolled. The CAVI and the PI of the CCA were measured using commercial devices, and their relationships to various clinical parameters were examined.ResultsA significant positive correlation was observed between the CAVI and the PI of the CCA (r = 0.44, P < 0.001). Further, multiple regression analysis revealed that the CAVI (β = 0.19, P < 0.001) was selected as independent factor for PI of the CCA as a subordinate factor. Meanwhile, high-sensitivity C-reactive protein, as an inflammation marker, and skin autofluorescence, as a marker of advanced glycation end products in the tissues, were selected as independent variables for either the CAVI or the PI of the CCA as a subordinate factor. The receiver-operating characteristic curve analysis indicated that the cut-off point of the CAVI for high PI of the CCA (> 1.60) as a risk value of stroke incidence by previous report was 9.1 (area under the curve = 0.750, P < 0.001).ConclusionThe present results indicate that the CAVI reflects cerebrovascular resistance in patients with cardiovascular risk factors. Moreover, the risk value of the CAVI for ischemic stroke incidence was considered to be 9.1 in these patients.

Carotid Intima-Media Thickness: A Surrogate Marker for Cardiovascular Disease in Chronic Kidney Disease Patients.

Background:Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD). Carotid intima-media thickness (CIMT) is a measure of atherosclerotic vascular disease and considered a comprehensive picture of all alterations caused by multiple cardiovascular risk factors over time on the arterial walls. We therefore sought to determine the CIMT of the common carotid artery in patients with CKD and to evaluate the clinical pattern and prevalence of CVD in CKD patients.Methods:A case-control study involving 100 subjects made of 50 patients with CKD stages 2 to 4 and 50 age and sex matched apparently normal individuals. Carotid intima-media thickness of the common carotid artery was considered thickened if it measured greater than 0.8 mm. All subjects had laboratory investigations, 12-lead electrocardiogram, transthoracic echocardiography, and ankle-brachial index.Results:The mean CIMT was higher in CKD population compared with controls (P < .001). Eighty-four percent of the study population was found to have thickened CIMT compared with 18% of controls (P < .001). Patients with CKD had significantly higher blood pressure and heart rate than controls. Cardiovascular disease was also more prevalent among patients with CKD as compared with controls. Carotid intima-media thickness positively correlated with age, blood pressure, and random blood sugar.Conclusions:As CIMT was well correlated with many cardiovascular risk factors among CKD patients, it may serve as a surrogate marker for CVD and its early assessment may target patients who may need more aggressive therapy to retard the progression of kidney disease and improve outcome.

Remodeling of the common carotid artery in oncohematological pathology by ultrasound

The aimis the assessment of structural and functional state of common carotid artery by ultrasound in patients with non-Hodgkin malignant lymphomas (NHML) before and after chemotherapy.Materials and methods.The common carotid artery of 111 patients at different stages of NHML were examined via a “LOGIC 400” ultrasound.Results.The common carotid artery of patients with NHML is undergoing morphological modification with changes in thickness and diameter, which corresponds to a hypertrophic type of remodeling. There is an increase in the thickness of the complex “intima-media” and Kernogan`s index with decreasing the common carotid artery diameter by comparison with the control group. Chemotherapy improves the parameters of the common carotid artery while reducing the thickness of the complex “intima-media” and Kernogan`s index at different stages of NHML.Conclusion.Remodeling of the common carotid artery is associated with the developmental stage of NHML. Chemotherapy leads to an improvement of the morphological parameters of the common carotid artery, which evaluates the effect of the treatment.

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

PurposeThe 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.MethodsWe 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.ResultsThe 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.ConclusionThe 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.

Impact of Hemorheology Assessed by the Microchannel Method on Pulsatility Index of the Common Carotid Artery in Patients With Type 2 Diabetes Mellitus.

BackgroundType 2 diabetes mellitus is known to be closely associated with the risk of ischemic stroke. Recent clinical studies have reported that a high pulsatility index (PI) of the cerebral or carotid artery, which is estimated by ultrasonography, also reflects a risk of ischemic stroke. This cross-sectional study aimed to clarify the impact of hemorheology assessed by the microchannel method on the PI of the common carotid artery (CCA) in patients with type 2 diabetes mellitus in terms of the primary prevention of ischemic stroke.MethodsIn total, 349 outpatients on treatment for type 2 diabetes mellitus (131 men and 218 women; mean age ± standard deviation: 65 ± 11 years) with no history of cardiovascular events, including ischemic stroke, were enrolled. The whole blood passage time (WBPT) as a marker of hemorheology and the PI of CCA were measured using commercial devices, and their relationships to various clinical parameters were examined.ResultsA significant positive correlation was observed between WBPT and the PI of CCA (r = 0.49, P < 0.001). Furthermore, multivariate analysis revealed that patients with high WBPT (≥70 s) had significantly higher risk (odds ratio: 5.2; 95% confidence interval: 2.4 - 9.2; P < 0.001) of being detected with a high PI of CCA (≥ 2) than those with low WBPT (≤ 52.0 s).ConclusionThe results of this study indicated that WBPT was an important determination factor for the PI of CCA, suggesting that an increase in WBPT can potentially predict the incidence of ischemic stroke in patients with type 2 diabetes mellitus.

Endovascular recanalization of the common carotid artery in a patient with radio induced chronic occlusion

Recanalization of chronic occlusion of the common carotid artery (CCA) in patients with a history of neck irradiation is challenging, both for vascular surgeons and interventional neuroradiologists. We describe a...