Common Carotid Artery Diameter Research Articles

Assessment of changes in the diameters of common carotid arteries and thickness of the intima-media complex in the Evens of the Arctic zone of the Republic Sakha (Yakutia) in the age and gender aspects during ultrasonic measurements

Assessment of changes in the diameters of common carotid arteries and thickness of the intima-media complex in the Evens of the Arctic zone of the Republic Sakha (Yakutia) in the age and gender aspects during ultrasonic measurements

Personalized brain revascularization: computer modeling of the reconstruction zone for carotid endarterectomy

To develop a technique of computer modeling of hemodynamics before conventional CEE. Classical CEE is performed according to conventional patch technique. Duplex parameters of stenosis and blood flow velocity in the carotid arteries were analyzed by using of a linear transducer 7-7.5 MG (Acuson 128XP scanner, Acuson, USA). Multispiral computed tomography with angiography and subsequent processing of data using the Clear canvas software were performed to visualize the main geometric characteristics of the carotid arteries and features of atherosclerotic plaque. Blood flow hemodynamics is essential in the occurrence of postoperative restenosis. Therefore, computer simulation of blood flow using CFD (Computational Fluid Dynamics) methods based on particular patient's data makes it possible to assess localization of zones with high risk of restenosis. CFD approach implies construction of blood flow parameters at absolutely every point of the vessel considering geometric shape of the vessel and flow characteristics at the entrance and exit from the vessel. Pressure curves at the inlet and outlet are constructed using blood flow velocity curves. Pressure curves are subsequently used in the CFD model. The result of blood flow CFD modeling is non-stationary three-dimensional fields of pressure and velocity in the investigated area. Visual analysis of blood flow dynamics in these fields makes it possible to judge possible problem areas along the blood flow and on the inner wall of the vessel. Patch technique of classical CEE is characterized by great risk of parietal thrombosis and hyperproliferation of neointima that explains more frequent development of restenosis. Computer modeling is valuable to consider some important technical aspects in implementation of various surgical techniques for carotid artery reconstruction. This result demonstrates an importance of achieving the optimal ratio of the diameter of common, internal and external carotid arteries. Modification of patch based on computer simulation is required for these purposes.

Carotid artery plaques and unilateral spatial neglect in the elderly.

The causes for falls in the elderly are varied, and visual spatial neglect could be 1 contributing factor. Further, the presence of a carotid artery plaque, especially on the right side, might influence the visual spatial attention of the elderly.Our aim was to identify the intrinsic association between carotid plaques and lateralization of spatial attention in the elderly. Further, we sought to understand and potentially prevent the consequences of unilateral spatial neglect such as injury from falls.Participants aged 64 to 93 years were divided into a group with carotid artery plaque(s) of the right side or both sides (BOTH, n = 38; and 9/ 38 were right side only) and a group without right-side carotid artery plaque(s) (LEFT, n = 53). Participants were asked to perform a line bisection task and undergo doppler ultrasonography examinations.Contrary to expectations, compared to LEFT, the mean index and net scores of the line bisection errors in BOTH were significantly less leftward, but the mean diameter of the right-side common carotid artery in BOTH was significantly larger.Our results indicate that the presence of carotid plaque(s) might be linked to increased risk of falls in the elderly. The attenuated spatial neglect in participants with right-side carotid artery plaque(s) might be due to compensatory carotid artery dilatation.

THE ULTRASONIC EVALUATION OF THE DIAMETER OF COMMON CAROTID ARTERIES AND THE THICKNESS OF THE INTIMA-MEDIA COMPLEX IN EVENKS OF THE ARCTIC ZONE OF THE REPUBLIC SAKHA (YAKUTIA)

By ultrasonography was study the anatomical structure of the common carotid arteries and the total thickness of their inner and middle membranes (intima-media complex) in Evenks in the Arctic zone of the Republic of Sakha (Yakutia), depending on age and gender. It were studied 210 patients aged 21 to 74 years, the average age was 47 years. The thickness of the intima-media complex was measured on the back (relative to the sensor) vessel wall 1-1,5 cm proximal to the bifurcation. In the presence of thickening of the complex, the measurement was performed in the zone of maximum visual thickening. It was found that the diameter of the left common carotid artery is larger than the diameter of the right; an increase in the total thickness of the inner and middle membranes of the common carotid arteries with age occurs more on the left side, regardless of gender. The average age at which there is a thickening of the intima-media complex to 1,0 mm or more in general for all groups was 58,73 years, which is 5,2 years later than among residents of Central Russia.

Cerebroprotective Effect against Cerebral Ischemia of the Combined Extract of Oryza sativa and Anethum graveolens in Metabolic Syndrome Rats.

The novel strategy against ischemic stroke in metabolic syndrome (MetS) targeting at oxidative stress and inflammation has gained attention due to the limitation of the current therapy. Due to the antioxidant and anti-inflammation of the combined extract of Oryza sativa and Anethum graveolens, the cerebroprotective effect against cerebral ischemia in MetS condition has been focused. Since no data were available, this study was set up to determine the effects of the combined extract of Oryza sativa L. and Anethum graveolens Linn. against ischemic stroke in the animal model of metabolic syndrome. The possible underlying mechanism was also further investigated. Male Wistar rats (180-220 g) were fed with high-carbohydrate high-fat diet (HCHF diet) to induce metabolic syndrome-like condition. Then, MetS rats were subjected to reperfusion injury at the right middle cerebral artery. The combined extract of O. sativa and A. graveolens (OA extract) at doses of 0.5, 5, and 50 mg/kg BW was fed once daily for 21 days. Neurological assessment was performed every 7 days throughout the experimental period. At the end of study, brain infarction volume, neuron and glial fibrillary acidic protein- (GFAP-) positive cell density, the oxidative stress status, the expressions of proinflammatory cytokines (NF-κB, IL-6), and eNOS in the cortical area together with the expression of VCAM-1 and the histological changes of common carotid artery were determined. It was found that OA extract decreased brain infarction, neurological score, oxidative stress status, and inflammatory mediators but increased eNOS expression in the cortical area; the increased VCAM-1 and intima-media thickness together with the reduction of lumen diameter of common carotid artery of MetS eats with MCAO were also mitigated by OA extract. These data suggest the cerebroprotective effect of OA, and the underlying mechanism may occur partly via the improvement of oxidative stress status, inflammation, and brain blood supply.

Anti-phospholipid antibody prevalence and association with subclinical atherosclerosis and atherothrombosis in the general population

BackgroundThere is no agreement on the prevalence of anti-phospholipid antibodies (aPLs) and the correlation with atherosclerosis and cardiovascular (CV) events in the general population. MethodsWe performed a cross-sectional study on 1712 randomly enrolled subjects from a Northern Italian city to investigate the presence of aPLs and the association with subclinical atherosclerosis (using the carotid artery intima media thickness measured as inter-adventitia common carotid artery diameters - ICCAD) and retrospectively collected CV factors and events (i.e. acute myocardial infarction, stroke, and peripheral obliterans arterial vasculopathy) using physician-assisted questionnaires. We tested serum IgG, IgM, and IgA anti-cardiolipin, anti-beta2glycoprotein I (aGPI), and anti-phosphatidylserine-prothrombin antibodies. ResultsPositive aPLs were found in 15.1% of the subjects, with no differences between sex but with higher rates in older subjects. Carotid subclinical atherosclerosis was more frequent in aPL positive subjects; more specifically, aGPI IgA were associated with higher ICCAD average (adjusted beta 0.51, 95% confidence interval (CI)0.17–0.84; p = 0.003). A positive history of CV events was also more frequent in aPL positive subjects (odds ratio (OR) 1.67, 95%CI 1.08–2.54; p = 0.012), particularly peripheral obliterans arterial vasculopathy (OR 2.02; 95%CI 1.14–3.57; p = 0.015). Among subjects with a Framingham risk score >20, and/or diabetes, and/or body mass index >35 kg/m2, aPL positivity was associated to the highest risk of CV events (OR 2.52, 95%CI 1.24–5.11; p = 0.011). ConclusionsAPL prevalence in the general population is higher than previously reported. CV events and subclinical atherosclerosis are more frequent in the presence of aPL, particularly when a high CV risk coexists.

Embolus Transport Simulations with Fully Resolved Particle Surfaces.

There has been interest in recent work in using computational fluid dynamics with Lagrangian analysis to calculate the trajectory of emboli-like particles in the vasculature. While previous studies have provided an understanding of the hemodynamic factors determining the fates of such particles and their relationship to risk of stroke, most analyses have relied on a particle equation of motion that assumes the particle is "small" e.g., much less than the diameter of the vessel. This work quantifies the limit when a particle can no longer be considered "small". The motion of embolus-like particles are simulated using an overset mesh technique. This allows the fluid stresses on the particle surface to be fully resolved. Consequently, the particles can be of arbitrary size or shape. The trajectory of resolved particles and "small" particles are simulated through a patient-specific carotid artery bifurcation model with particles 500, 1000, and 2000μm in diameter. The proportions of particles entering the internal carotid artery are treated as the outcome of the particle fate, and statistical comparisons are made to ascertain the importance of non-small particle effects. For the 2000μm embolus, the proportion of particles traveling to the internal carotid artery is 74.7 ± 1.3% (mean±95% confidence margin) for the "small" particle model and is 85.7±5.4% for a resolved particle model. The difference is statistically significant, [Formula: see text], based on the binomial test for the particle outcomes. No statistically discernible differences are found for the smaller diameter particles. Quantitative differences are observable for the 2000μm trajectories between the "small" and resolved particle models which is a particle diameter 27% relative to the common carotid artery diameter. A fully resolved particle model ought to be considered for emboli trajectory simulations when the particle size ratio is ≳20%.

Dimensional ultrasonographic relationship of the thyroid gland with associated anatomic landmarks in clinically normal dogs

Estimation of the size of the thyroid gland is considered to be important for diagnosis of several pathologic conditions in animals including dogs. Two-dimensional ultrasonography is used as a noninvasive simple method for determination of the size of thyroid gland. The purpose of the present study was to investigate the relationship among the dimensions of the thyroid gland with that of the associated anatomic landmarks of clinically normal dogs using ultrasonography. Ultrasonographic examinations were performed on 15 mixed breed dogs using an ultrasound scanner (MyLab30vet, Esaote, Genoa, Italy) with a linear-array transducer (Esaote LA 522, Esaote, Genoa, Italy).The maximal diameter and the length of the thyroid lobe were compared with that of the diameter of the common carotid artery and the trachea. The correlation between each thyroid parameter and the dimensions of the anatomic landmarks were assessed using linear regression analysis and Pearson's correlation coefficient test. According to the results, a significant linear correlation was observed between the maximum diameter of the thyroid lobe and the diameter of common carotid artery (P = 0.02, Pearson's correlation coefficient = 0.188). The coefficient of determinations (R2) for the maximum diameter of the thyroid lobe with that of common carotid artery diameter was 0.367, indicating that the strengths of the association were weak. The mean ratio between the maximum thyroid lobe diameter and the common carotid artery diameter was 1.74 ± 0.40 (range 1.11 - 2.43). However, there was no significant dimensional relationship with other selected anatomic landmarks. On the basis of the data obtained in this study, calculating the ratio between the maximum thyroid lobe diameter and the diameter of common carotid artery by using two-dimensional ultrasonography will be a useful and simple method for evaluating the size of the thyroid gland in dogs in clinical practice.

Novel associations between sex hormones and diabetic vascular complications in men and postmenopausal women: a cross-sectional study

BackgroundAssociations between sex hormones and vascular remodeling have been extensively studied, but the results vary widely among different races and sex. We aimed to investigate whether total testosterone (TT), estrogen (E2), and dehydroepiandrosterone (DHEA) associate with macrovascular complications and diabetic kidney disease (DKD) among community-dwelling patients with diabetes.MethodsA total of 4720 participants with type 2 diabetes were recruited from Shanghai, China. Common carotid artery (CCA) plaques and diameter were assessed by ultrasound. Cardiovascular disease (CVD) was defined by prior diagnosis of coronary heart disease, myocardial infarction or stroke. DKD was defined according to the ADA Guidelines.Results(1) In men, TT was negatively associated with CCA diameter (regression coefficient (β) − 0.044, 95% CI − 0.087, 0). E2 levels were positively associated with CVD and CCA plaque prevalence (OR 1.151, 95% CI 1.038, 1.277 and OR 1.13, 95% CI 1.017, 1.255, respectively). DHEA was negatively associated with CVD (OR 0.809, 95% CI 0.734, 0.893). In postmenopausal women, TT levels were negatively associated with CCA diameter (β − 0.046, 95% CI − 0.083, − 0.010) and positively associated with CVD (OR 1.154, 95% CI 1.038, 1.284). (2) In both men and postmenopausal women, TT levels were negatively associated with the albumin/creatinine ratio and DKD (β − 0.098, 95% CI − 0.154, − 0.043 and OR 0.887, 95% CI 0.790, 0.997 vs. β − 0.084, 95% CI − 0.137, − 0.031 and OR 0.822, 95% CI 0.731, 0.924, respectively) and DHEA levels were positively associated with DKD (OR 1.167, 95% CI 1.038, 1.313 vs. OR 1.251, 95% CI 1.104, 1.418, respectively).ConclusionsOur study indicates that macrovascular complications were associated with low TT, DHEA and high E2 in men and with high TT in postmenopausal women. DKD was associated with low TT and high DHEA levels in both genders. Sex hormone replacement therapy requires careful and comprehensive consideration.Trial registration ChiCTR1800017573, http://www.chictr.org.cn. Registered 04 August 2018

The Relation Between Common Carotid Artery Diameter and Central Venous Pressure for Assessment of Intravascular Fluid Status After Major Surgeries: An Observational Study

The Relation Between Common Carotid Artery Diameter and Central Venous Pressure for Assessment of Intravascular Fluid Status After Major Surgeries: An Observational Study

Greater Height Is Associated with a Larger Carotid Lumen Diameter.

Background: Previous studies link tall stature with a reduced ischemic stroke risk. One theory posits that tall people have larger cerebral artery lumens and therefore have a lower plaque occlusion risk than those who are short. Previous studies have not critically evaluated the associations between height and cerebral artery structure independent of confounding factors. Methods: The hypothesis linking stature with cerebral artery lumen size was tested in 231 adults by measuring the associations between height and common carotid artery diameter (CCAD) and intima–media thickness (IMT) after controlling for recognized vascular influencing factors (e.g., adiposity, blood pressure, plasma lipids, etc.). Results: Height remained a significant CCAD predictor across all developed multiple regression models. These models predict a ~0.03 mm increase in CCAD for each 1-cm increase in height in this sample. This magnitude of CCAD increase with height represents over a 60% enlargement of the artery’s lumen area across adults varying in stature from short (150 cm) to tall (200 cm). By contrast, IMT was non-significantly correlated with height across all developed regression models. Conclusions: People who are tall have a larger absolute CCAD than people who are short, while IMT is independent of stature. These observations potentially add to the growing cardiovascular literature aimed at explaining the lower risk of ischemic strokes in tall people.

MON-036 Lead Exposure Is Related to Macro- and Microvascular Diabetic Complications

Background Lead, is one of the world’s highest-volume heavy metals in use today and remains ubiquitous in natural environment. High blood lead level (BLL) was associated with cardiovascular disease (CVD) and decline in renal function in general population. Considering CVD and diabetic kidney disease (DKD) has become top 2 in diabetic mortality rate, studies about their association with BLL in diabetic individuals were rather limited. We aimed to investigate whether higher BLL exposure associates with CVD and DKD in diabetic adults. We believe that this field of work may enable us to identify a novel risk factor for diabetic vascular complications. Methods 4,234 diabetic participants were enrolled from seven communities in Shanghai, China in 2018. Macrovascular measurements including common carotid artery (CCA) plaque and diameter were detected by ultrasound. CVD was defined as a composite measure including previous diagnosis of coronary heart disease, myocardial infarction, or stroke , which were recorded in the registration platform. DKD were defined according to ADA statement and KDOQI recommendation. Results Compared with first quartile, Odds ratios (ORs) (95% CI) of CCA plaque ranging from none to bilateral in ordinal regression associated with BLL was 1.23 (1.04, 1.46) for the fourth BLL quartile and the odds of having CVD was significantly increased 47% for participants in the fourth quartile (OR 1.47, 95% CI 1.22, 1.78) (P for trend <0.001). For DKD, the fourth BLL quartile increased the odds of DKD based on two definitions (ACR ≥30mg/g or eGFR <60 ml/min per 1.73 m2; ACR ≥300mg/g or ACR 30-299mg/g plus eGFR ≥30ml/min per 1.73 m2) by 55% (OR 1.55; 95%CI 1.25, 1.93) and 44% (OR 1.44; 95%CI 1.15, 1.80), respectively, compared with the first quartile. In non-diabetic participants, the association of BLL with CVD and eGFR was insignificant. Conclusions BLL was positively associated with CCA plaque, CVD and DKD in the Chinese middle-aged and elderly with diabetes and these associations were more prone to affect diabetic but not non-diabetic participants. Lead exposure is probably a major new modifiable risk factor for diabetic vascular complications, which suggest reducing lead exposure may be critical for primary or even secondary intervention.

Anatomic eligibility for transcarotid artery revascularization and transfemoral carotid artery stenting

ObjectiveTranscarotid artery revascularization (TCAR) has emerged as an alternative to transfemoral carotid artery stenting (tfCAS). We investigated the proportion of carotid arteries undergoing revascularization procedures that would be eligible for TCAR based on anatomic criteria and how many arteries at high anatomic risk for tfCAS would be amenable to TCAR. MethodsWe performed a retrospective review of consecutive patients who underwent carotid endarterectomy or carotid stenting between 2012 and 2015. Patients were excluded if computed tomography angiography of the neck was not performed within 6 months of the procedure. We assessed TCAR eligibility on the basis of the instructions for use of the ENROUTE Transcarotid Neuroprotection System (Silk Road Medical, Sunnyvale, Calif) and high anatomic risk for tfCAS on the basis of anatomic factors known to make carotid cannulation more difficult or hazardous. ResultsOf the 118 patients and 236 carotid arteries identified, 12 carotid arteries were excluded for presence of an occluded internal carotid artery (ICA). Of the remaining 224 carotid arteries, 72% were eligible for TCAR on the basis of the instructions for use criteria; 100% had 4- to 9-mm ICA diameters, 100% had ≥6-mm common carotid artery (CCA) diameter, 75% had ≥5-cm clavicle to carotid bifurcation distance, and 96% lacked significant CCA puncture site plaque. In addition, 7% of carotid arteries had bifurcation anatomy unfavorable for stenting; thus, of the entire cohort of arteries examined, 68% were eligible for TCAR. Hyperlipidemia (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.7-26; P < .01), chronic obstructive pulmonary disease (OR, 3.5; 95% CI, 1.5-8.3; P < .01), and older age (OR, 1.1; 95% CI, 1.0-1.1; P < .01) were independently associated with TCAR ineligibility, whereas white race (OR, 0.2; 95% CI, 0.0-1.0; P = .048) and beta-blocker use (OR, 0.3; 95% CI, 0.1-0.7; P < .01) were independently associated with TCAR eligibility. In addition, 24% of carotid arteries were considered to be at high risk for tfCAS for the presence of a type III aortic arch (7.6%), severe aortic calcification (3.3%), tandem CCA lesions (7.1%), moderate to severe stenosis at the carotid ostium (8.9%), and tortuous distal ICA precluding embolic filter placement (4.5%). Active smoking (OR, 4.4; 95% CI, 1.9-10; P < .01), hyperlipidemia (OR, 4.0; 95% CI, 1.2-14; P = .03), and older age (OR, 1.1; 95% CI, 1.0-1.1; P = .02) were independently associated with tfCAS ineligibility, whereas preoperative aspirin (OR, 0.1; 95% CI, 0.0-0.4; P < .001) or clopidogrel (OR, 0.3; 95% CI, 0.1-0.8; P = .01) use was associated with tfCAS eligibility. Of the arteries that were considered to be at high risk for tfCAS, 69% were eligible for TCAR. ConclusionsThe majority of carotid arteries in individuals selected for revascularization meet TCAR eligibility, making TCAR a viable treatment option for many patients.

Peculiarities of organometric parameters of the coronary arteries in the perinatal period of ontogenesis

Formation of the structure and topography of the coronary arteries during the fetal and early neonatal periods of human ontogenesis is an essential constituent while making perinatal diagnosis and understanding real parameters of the norm and pathology. Objective of the study is to determine organometric parameters of the carotid arteries during the fetal and early neonatal periods of human ontogenesis. The study was conducted on 50 specimens of dead fetuses (from 4 to 10 months) and 9 neonates (5 isolated complexes of organs in particular) by means of adequate anatomical methods: macrodissection, injection of the blood vessels, making topographic-anatomical sections, morphometry, and statistical analysis. During perinatal period external diameters and lengths of the carotid arteries are found to be characterized by two periods of an accelerated development and the period of relatively slow development. For the external diameter of the right common carotid artery and the external diameter of the left internal carotid artery the periods from the 4th to 7th months of the intrauterine development and the period from the 9th month to the neonatal period are the periods of an accelerated development; the periods from the 7th to 9th months of development are the period of relatively slow development. The periods from the 4th to the 7th months of the intrauterine development and the period from the 10th month till neonatal period are the periods of an accelerated development for the external diameter of the left common carotid artery and external diameter of the right internal carotid artery; the period from the 7th to the 10th months of development is the period of relatively slow development. The periods from the 4th to the 7th months of the intrauterine development and from the 8th month of development till the neonatal period are the periods of an accelerated development for the external diameter of the right and left external carotid arteries; the period during 7-8th months is the period of relatively slow development. The length of the cervical part of the right and left carotid arteries is characterized by the two periods of an accelerated development – from the 4th to the 6th month and from the 7th month till the neonatal period; the period of relatively slow development is from the 6th to the 7th month of the intrauterine development. Comparison of the developmental periods of the carotid arteries with all the possible organometric parameters enables to affirm that practically similar enlargement of the external diameters of the common, external and internal carotid arteries both from the right and left sides is peculiar for the period of relatively slow development. The first period of an accelerated development of the carotid arteries is more specific for the external diameter and length of the left common and left external artery contrary to the second accelerated period of development of the carotid arteries. It is characterized by enlargement of the external diameters of the right common and right external carotid artery. A reliable difference of the mean values of the external diameters of the right and left common, external and internal carotid arteries is peculiar for the 4th, 7th, 10th months of development and for the neonatal period for the common carotid arteries; for the external carotid arteries – the 4th, 7th, 9th months of development and neonatal period; for the internal carotid arteries – for the whole months of development.

Sex differences in the circulatory responses to an isocapnic cold pressor test.

What is the central question of this study? Do sex differences exist in the cardiorespiratory responses to an isocapnic cold pressor test (CPT)? What is the main finding and its importance? During the CPT, there were no sex differences in the respiratory response; however, females demonstrated a reduced mean arterial pressure and reduced dilatation of the common carotid artery. Given that the CPT is predictive of future cardiovascular events, these data have clinical implications for improving the utility of the CPT to determine cardiovascular health risk. Sex differences should be taken into consideration when conducting and interpreting a CPT. The cold pressor test (CPT) elicits a transient increase in sympathetic nervous activity, minute ventilation ( ), mean arterial pressure (MAP) and common carotid artery (CCA) diameter in healthy individuals. Although the extent of dilatation of the CCA in response to the CPT has been used as a clinical indicator of cardiovascular health status, the potential sex differences have yet to be explored. In response to a CPT, we hypothesized that elevations in and MAP and dilatation of the CCA would be attenuated in females compared with males. In 20 young, healthy participants (10 females), we measured the respiratory, cardiovascular and CCA responses during a CPT, which consisted of a 3min immersion of the right foot into 0-1 ice water. Blood pressure (via finger photoplethysmography), heart rate (via electrocardiogram) and CCA diameter and velocity (via Duplex ultrasound) were simultaneously recorded immediately before and during the CPT. During the CPT, while controlling end-tidal gases to baseline values, the main findings were as follows: (i) no sex differences were present in absolute or relative changes in (P=0.801 and P=0.179, respectively); (ii) the relative MAP and CCA diameter response were reduced in females by 51 and 55%, respectively (P=0.008 and P=0.029versus males, respectively); and (iii) the relative MAP responses was positively correlated with the dilatation of the CCA in males (r=0.42, P=0.019), in females (r=0.43, P=0.019) and in males and females combined (r=0.55, P<0.001). Given that the CPT is used as a clinical tool to assess cardiovascular health status, sex differences should be considered in future studies.

Classification of wall shear stress of human common carotid artery and ascending aorta on the basis of age

Wall shear stress is one of the major factors responsible for increase in cardiovascular disease. The present work calculate the level of wall shear stress in the common carotid artery (CCA) and aorta to see which artery has more chance of having cardiovascular diseases and at which age. Wall shear stress (WSS) is determined in the CCA and aorta of presumed healthy volunteers, having age between 10 and 60 years. A real 2D model of both aorta and common carotid artery is constructed for different age groups using computational fluid dynamics (CFD). WSS of both the arteries is calculated and compared for different age groups. It is found that with increase in diameter of common carotid artery and ascending aorta with advancing age wall shear stress decreases. WSS of aorta is found less than common carotid artery.

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.

Cerebral blood flow alteration following acute myocardial infarction in mice.

Heart failure is associated with low cardiac output (CO) and low brain perfusion that imposes a significant risk for accelerated brain ageing and Alzheimer’s disease (AD) development. Although clinical heart failure can emerge several years following acute myocardial infarction (AMI), the impact of AMI on cerebral blood flow (CBF) at early stages and up to 30 days following MI is unknown. Sixteen months old male mice underwent left anterior descending (LAD) coronary artery ligation. Hemodynamics analyses were performed at baseline and at days 1, 7, and 30 post-MI. Left ventricular (LV) ejection fraction (EF), LV volumes, CO, and right common carotid artery (RCCA) diameter were recorded by echocardiography. RCCA flow (RCCA FL) was measured by Doppler echocardiography. LV volumes consistently increased (P<0.0012) and LV systolic function progressively deteriorated (P<0.0001) post-MI. CO and RCCA FL showed a moderate but significant decrease over the course of MI with similar fluctuation pattern such that both variables were decreased at day 1, increased at day 7, and decreased at 30 days post-MI. Correlation and regression analyses between CO and RCCA FL showed a strong correlation with significance at baseline and day 30 post-MI (R = 0.71, P=0.03, and R = 0.72, P=0.03, respectively). Days 1 and 7 analyses between CO and RCCA FL showed moderate correlation with non-significance post-MI (R = 0.51, P=0.2, and R = 0.56, P=0.12, respectively). In summary, CBF significantly decreased following AMI and remained significantly decreased for up to 30 days, suggesting a potential risk for brain damage that could contribute to cognitive dysfunction later in life.

Effect of positive end-expiratory pressure on the cross-sectional area of the internal jugular vein and anatomic relationship between the internal jugular vein and the carotid artery in general anaesthesia of laryngeal mask airway

Objective: To investigate the effect of positive end-expiratory pressure(PEEP) on the cross-sectional area (CSA) of the internal jugular vein (IJV) and anatomic relationship between the IJV and the common carotid artery (CCA) in general anaesthesia of laryngeal mask airway(LMA). Methods: Sixty American Society of Anesthesiologists (ASA) Ⅰ or Ⅱ grade patients undergoing elective operation received general anaesthesia using LMA from May to November 2017, aged 20-65, were included in this study and randomly divided into 4 groups: group P0 (PEEP: 0 cmH(2)O), group P5 (PEEP: 5 cmH(2)O), group P10 (PEEP: 10 cmH(2)O), group P15 (PEEP: 15 cmH(2)O). Following the induction of anesthesia, LMA was inserted, and mechanical ventilation was started while the right cervical vessels was imaged by ultrasonography after applying 4 different PEEPs in random order. Measurements were made after 1 min in each PEEP. The CSA, transverse diameter (TD), anteroposterior diameters (AD) of the IJV and the diameter, overlap distance and overlap index of CCA was measured. The arterial blood pressure, heart rate, and vasoactive drugs used were also recorded. Results: The CSA of group P0, P10 and P15 was (1.36±0.55), (1.80±0.54), (2.02±0.58) cm(2). The TD was (1.31±0.33), (1.61±0.49), (1.74±0.53) cm. The AD was (1.12±0.20), (1.33±0.30), (1.46±0.32) cm. Compared to group P0, the CSA, TD and AD of IJV in group P10 and P15 were significantly increased (P0/P10: t=7.81, 3.81, 4.30, all P<0.01; P0/P15: t=11.68, 5.40, 6.96, all P<0.01). There was no significant difference in the AD and TD of IJV between group P10 and P15 (all P>0.05), while the CSA of group P15 was bigger than that of group P10 (t=2.17, P<0.05). The overlap distance of group P0, P10 and P15 was (0.51±0.12), (0.62±0.16), (0.66±0.15) cm. The overlap index was (76.80±20.03)%, (91.10±26.13)%, (96.21±25.36)%. Compared to group P0, the overlap distance and overlap index in group P10 and P15 were significantly increased (P0/P10: t=4.49, 3.41, both P<0.01; P0/P15: t=5.91, 4.63, both P<0.01). There was no significant changes in the overlap distance and overlap index between group P10 and P15 (all P>0.05). The MAP of group P15 was lower than that of group P10 [(73.35±9.73 )vs (67.58±12.58) mmHg, t=2.745, P<0.05]. No patients were given atropine or norepinephrine. Conclusions: The application of PEEP effectively increases the CSA of IJV in general anaesthesia of LMA. At the same time, it also lead to higher overlap index between the IJV and CCA.Ten cmH(2)O PEEP provides the best balance between the increase of CSA and the stability of haemodynamics.

Carotid circumferential wall stress is not associated with cognitive performance among individuals in late middle age: The Maastricht Study

Background and aimsArterial remodelling aims at normalising circumferential wall stress (CWS). Greater CWS in the carotid artery has previously been associated with the prevalence and severity of cerebral small vessel disease, a major cause of ageing-related cognitive decline. Here we test the hypothesis that greater carotid CWS is associated with poorer cognitive performance. MethodsWe studied 722 individuals (60 ± 8 years, 55% men, 42.5% highly educated, blood pressure 137 ± 19/77 ± 11 mmHg, n = 197 with type 2 diabetes) who completed a neuropsychological assessment and underwent vascular ultrasound to measure the intima-media thickness (IMT) and interadventitial diameter (IAD) of the left common carotid artery at a plaque-free site. From IMT and IAD, lumen diameter (LD) was calculated. These structural measures were then combined with local carotid pulse pressure and brachial mean arterial pressure to obtain a measure of pulsatile (CWSpulsatile) and average (CWSmean) mechanical load on the vessel wall. Cognitive domains assessed were memory, executive function and attention, and processing speed. ResultsAfter adjustment for age, sex, and education, regression analyses showed that neither CWSpulsatile nor CWSmean were associated with measures of cognitive performance (p-values ≥0.31). This null association did not differ by age or educational level, and was observed in both individuals with and without carotid plaque, diabetes and/or hypertension. In addition, none of the individual measures of carotid structure (i.e. IMT, IAD, and LD) was related to cognitive performance. ConclusionsThe present cross-sectional study shows that carotid CWS is not associated with cognitive performance, at least not among relatively highly educated individuals in late middle age with adequately controlled cardiovascular risk factors.