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291 results for “carotid artery”
Macrophage heterogeneity in human carotid artery atherosclerotic plaques: identification of novel markers for M1 and M2 that are independent of the activation status
GEO Series GSE22543. Homo sapiens. 2 samples. Type: Expression profiling by array.
Expression data from IRF4 KO mouse carotid arteries in response to wire-injury
GEO Series GSE88930. Mus musculus. 6 samples. Type: Expression profiling by array.
Data set from Varga A, Di Leo G, Banga PV, Csobay-Novák C, Kolossváry M, Maurovich-Horvat P, Hüttl K. Multidetector CT angiography of the Circle of Willis: association of its variants with carotid artery disease and brain ischemia. Eur Radiol. 2019 Jan;29(1):46-56. doi: 10.1007/s00330-018-5577-x. Epub 2018 Jun 19. PMID: 29922933; PMCID: PMC6291432.
<p>Data set from the article Data set from Varga A, Di Leo G, Banga PV, Csobay-Novák C, Kolossváry M, Maurovich-Horvat P, Hüttl K. Multidetector CT angiography of the Circle of Willis: association of its variants with carotid artery disease and brain ischemia. Eur Radiol. 2019 Jan;29(1):46-56. doi: 10.1007/s00330-018-5577-x. Epub 2018 Jun 19. PMID: 29922933; PMCID: PMC6291432.</p> <p>This is the abstract</p> <p><strong>Purpose: </strong> (1) to estimate the prevalence of Circle of Willis (CoW) variants in patients undergoing carotid endarterectomy, (2) to correlate these variants to controls and (3) cerebral ischemia depicted by computed tomography (CT).</p> <p><strong>Materials and methods: </strong> After Institutional Review Board approval, data of 544 carotid endarterectomy patients (331 males, mean age 69±8 years) and 196 controls (117 males, mean age 66±11 years) who underwent brain CT and carotid CT angiography (CTA) were retrospectively analysed. Two observers independently classified each CoW segment as normal, hypoplastic (diameter <0.8 mm) or non-visualized. Four groups of CoW variants based on the number of hypoplastic/non-visualized segments were correlated with clinical data (ANOVA, χ<sup>2</sup> and multivariate logistic regression analysis). Intra- and inter-observer agreement was estimated using Cohen κ statistics.</p> <p><strong>Results: </strong> High prevalence of CoW variants (97%) and compromised CoW (81%) was observed in the study group and significant difference was found in the distribution of CoW variants compared to controls (p<0.001), internal carotid artery (ICA) stenosis being the only independent predictor of CoW morphology (p<0.001). Significant correlation was found between CoW configuration and brain ischemia in the study group (p=0.002). ICA stenosis of ≥90% was associated to higher rate of ipsilateral A1 hypoplasia/non-visualization (p<0.001). Intra- and inter-observer agreement was from substantial to almost perfect (Cohen κ=0.75-1.0).</p> <p><strong>Conclusion: </strong> Highly variable CoW morphology was demonstrated in patients undergoing endarterectomy compared to controls. Likely compromised CoW in relation to cerebral ischemia was observed in a large cohort of carotid endarterectomy subjects.</p> <p><strong>Key points: </strong> • CoW variant distribution significantly differed in the study and control groups (p<0.001). • ICA stenosis was the only independent predictor of CoW morphology (p<0.001). • Severely compromised CoW configuration showed significant association with brain ischemia (p=0.002).</p>
Data set from the article Settembrini AM, Mazzaccaro D, Modafferi A, Righini P, Malacrida G, Nano G. Carotid artery stenting in the elderly. Are there differences between open and closed cell stents? Ann Ital Chir. 2019;90:106-110. PMID: 31182697.
<p>data set from the article Settembrini AM, Mazzaccaro D, Modafferi A, Righini P, Malacrida G, Nano G. Carotid artery stenting in the elderly. Are there differences between open and closed cell stents? Ann Ital Chir. 2019;90:106-110. PMID: 31182697.</p> <p>This is the abstract</p> <p><strong>Introduction: </strong>We reviewed our experience of carotid artery stenting (CAS) in patients older than 75 years treated with open or closed cell stents. The aim of our paper is to evaluate if there are differences between the two groups in term of clinical outcomes, neurological impairment and survival.</p> <p><strong>Material and methods: </strong>CAS consecutively performed from March 2000 and December 2016 in elderly patients were rectrospectively collected. We classified them into two groups: closed cells (group A) and open cells stent (group B). Perioperative and long term events were observed (death, major cerebrovascular and cardiovascular events, in-stent restenosis).</p> <p><strong>Results: </strong>We collected 429 CAS, 259 (60.37%) male with median age of 79 years (range 77-82). Group A collects 247 (57.98%) patients, 142 (33.3%) in group B. The other 40 patients were treated with hybrid stents or just ballooning. In perioperative period we had not death but 2 patients (0.8%) in group A had a transient ischemic attack (TIA) due to immediate stent thrombosis, 2 patients (1 per group) had an ipsilateral major stroke and 8 patients had a TIA (3 in group A and 5 in group B). Median follow up was 686 days (IQR 267-1299 days). Freedom from complications at 12, 36 and 60 months was 99.4 ± 0.5%, 97 ± 1.5% and 90.08 ± 4.3% respectively. Survival at 12, 36 and 60 months was 77.4 ± 7.5%, 51.6 ± 8.9% and 16.1± 6.6% respectively.</p> <p><strong>Conclusion: </strong>Our data show CAS as a safe procedure also for people older than 75 years in terms of perioperative and long term complications and cerebral events without any significant difference between the different type of stent. Further studies are requested to better clarify its role in symptomatic patients.</p>
Supplementary material for "Identification of Protein Networks and Biological Pathways Driving the Progression of Atherosclerosis in Human Carotid Arteries through Mass Spectrometry-Based Proteomics"
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Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting
<p>Dataset from Marrocco-Trischitta MM, Vitale R, Nava G, Baroni I, Boveri S, Nano G, Secchi F. Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting. J Vasc Surg. 2021 Apr;73(4):1277-1281. doi: 10.1016/j.jvs.2020.08.142. Epub 2020 Sep 25. PMID: 32987147.</p> <p>Abstract</p> <p><strong>Objective: </strong>The type III arch configuration has been inconsistently reported as a stroke risk factor during carotid artery stenting. However, at least three different methods for the definition of type III arch can be identified in the literature, related to the level of the origin of the innominate artery (IA). According to Casserly's definition, a type III arch presents with an origin of the IA below the horizontal plane of the inner curvature. According to Madhwal's definition, a type III arch has a distance greater than twice the diameter of the left common carotid artery between the highest point of the arch and the origin of the IA. According to MacDonald's definition, a type III arch presents with a distance of ≥2 cm between the highest point of the arch and the origin of the IA. Our aim was to assess the level of concordance between these different methods.</p> <p><strong>Methods: </strong>Anonymized thoracic computed tomography scans of 100 healthy patients were reviewed. Two of us independently stratified the selected cases as a type I to III arch, according to the three considered definitions. The interobserver level of concordance for each type III arch classification and level of concordance among the three definitions were assessed.</p> <p><strong>Results: </strong>The 100 selected patients (64% male) were 76 ± 7 years old. For each definition, the interobserver repeatability was almost perfect for all three (Madhwal, κ = 0.81; 95% confidence interval [CI], 0.71-0.99; MacDonald, κ = 0.82; 95% CI, 0.72-0.92; Casserly, κ = 0.84; 95% CI, 0.74-0.93). The level of concordance among the different definitions was very low (Madhwal vs MacDonald, 85% [P = .002]; 33% for type III arch; Madhwal vs Casserly, 60% [P < .0001]; 12% for type III arch; MacDonald vs Casserly, 75% [P < .0001]; 12% for type III arch).</p> <p><strong>Conclusions: </strong>The three definitions of the type III arch have a very low level of concordance, which might account for the varying clinical relevance of this configuration. Our findings have relevant implications for risk prediction for carotid artery stenting based on the presence of a type III arch, for comparisons of the results from different studies, and for comparisons of different datasets from multicenter trials.</p>
Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting
<p>Dataset from Marrocco-Trischitta MM, Vitale R, Nava G, Baroni I, Boveri S, Nano G, Secchi F. Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting. J Vasc Surg. 2021 Apr;73(4):1277-1281. doi: 10.1016/j.jvs.2020.08.142. Epub 2020 Sep 25. PMID: 32987147.</p> <p>Abstract</p> <p><strong>Objective: </strong>The type III arch configuration has been inconsistently reported as a stroke risk factor during carotid artery stenting. However, at least three different methods for the definition of type III arch can be identified in the literature, related to the level of the origin of the innominate artery (IA). According to Casserly's definition, a type III arch presents with an origin of the IA below the horizontal plane of the inner curvature. According to Madhwal's definition, a type III arch has a distance greater than twice the diameter of the left common carotid artery between the highest point of the arch and the origin of the IA. According to MacDonald's definition, a type III arch presents with a distance of ≥2 cm between the highest point of the arch and the origin of the IA. Our aim was to assess the level of concordance between these different methods.</p> <p><strong>Methods: </strong>Anonymized thoracic computed tomography scans of 100 healthy patients were reviewed. Two of us independently stratified the selected cases as a type I to III arch, according to the three considered definitions. The interobserver level of concordance for each type III arch classification and level of concordance among the three definitions were assessed.</p> <p><strong>Results: </strong>The 100 selected patients (64% male) were 76 ± 7 years old. For each definition, the interobserver repeatability was almost perfect for all three (Madhwal, κ = 0.81; 95% confidence interval [CI], 0.71-0.99; MacDonald, κ = 0.82; 95% CI, 0.72-0.92; Casserly, κ = 0.84; 95% CI, 0.74-0.93). The level of concordance among the different definitions was very low (Madhwal vs MacDonald, 85% [P = .002]; 33% for type III arch; Madhwal vs Casserly, 60% [P < .0001]; 12% for type III arch; MacDonald vs Casserly, 75% [P < .0001]; 12% for type III arch).</p> <p><strong>Conclusions: </strong>The three definitions of the type III arch have a very low level of concordance, which might account for the varying clinical relevance of this configuration. Our findings have relevant implications for risk prediction for carotid artery stenting based on the presence of a type III arch, for comparisons of the results from different studies, and for comparisons of different datasets from multicenter trials.</p>
Intracranial carotid artery calcification morphology differs in patients with lacunar and non-lacunar acute ischemic strokes
<p><strong>Introduction. </strong>This database includes the raw data linked with the paper "Intracranial carotid artery calcification morphology differs in patients with lacunar and non-lacunar acute ischemic strokes".</p> <p>In this paper, we reported the association of diverse pattern of intracranial carotid artery calcifications (ICAC) and etiologic subtypes of ischemic stroke.</p> <p><strong>Methods.</strong> We retrospectively analyzed a single center cohort of patients admitted for ischemic stroke with known etiology. Patients with a first ischemic stroke with lacunar, cardioembolic or atherothrombotic large artery disease etiology were included. Each carotid artery was evaluated separately on NCCT scans to define the ICAC pattern. The association of ICAC patterns and stroke etiology was investigated using two logistic regression models adjusting for confounders.</p> <p><strong>Results.</strong> A total of 300 patients were included in the analysis, mean age 78 years (+-10), 158 (53%) female, median NIHSS 6 (IQR 9). Prevalence of medial, intimal, and mixed calcification was: 73%, 17% and 11% in cardioembolic stroke, 66%, 25% and 9 % in large artery atherosclerosis stroke and 37%, 44% and 19% in lacunar stroke (p<0.001). After adjustment for confounders, intimal pattern (OR=2.14; 95%CI=1.07-4.30), and medial pattern (OR=0.33; 95CI%=0.16-0.67) remained independently associated with lacunar stroke etiology. In conclusion, our study suggests that intimal ICAC pattern is associated with lacunar stroke, and, if validated in further studies, it may serve as a marker for lacunar stroke etiology.</p>
Clopidogrel Resistance and Ticagrelor Replacement in Dual Antiplatelet Therapy for Carotid Artery Stenting
<p>Mazzaccaro D, Giannetta M, Ranucci M, Righini P, Di Dedda U, Baryshnikova E, Milani V, Nano G. Clopidogrel Resistance and Ticagrelor Replacement in Dual Antiplatelet Therapy for Carotid Artery Stenting. Ann Vasc Surg. 2022 Oct 19:S0890-5096(22)00640-9. doi: 10.1016/j.avsg.2022.09.063. Epub ahead of print. PMID: 36270550.</p> <p>Abstract</p> <p><strong>Backgrounds: </strong>Resistance to the pharmacological effect of clopidogrel in patients undergoing dual antiplatelet therapy for carotid stenting may increase the risk of periprocedural neurological events. The purpose of the study was to describe the phenomenon of clopidogrel resistance in a series of patients undergoing carotid stenting.</p> <p><strong>Methods: </strong>Data of patients who consecutively underwent carotid stenting from November 2016 to December 2020 for a significant stenosis and who underwent a dual antiplatelet therapy using acetyl-salicylic acid and clopidogrel were prospectively collected. Patients who were already taking a different thienopyridine were excluded. The effectiveness of antiplatelet drugs was assessed by the impedance aggregometry test. Primary endpoint was to evaluate the incidence of clopidogrel resistance and the effectiveness of ticagrelor as alternative therapy. P values < 0.05 were considered statistically significant.</p> <p><strong>Results: </strong>Two-hundred patients (80 females, 40%) underwent stenting for carotid stenosis (94% asymptomatic). The phenomenon of clopidogrel resistance was observed in 38 patients (19%), in whom clopidogrel was replaced by ticagrelor (90 mg/bis in die) with 100% effectiveness at aggregometry test. Platelet counts was associated to clopidogrel resistance (P = 0.001). There was no stent thrombosis at 30 days, neither major hemorrhagic events; a total of 12/200 major adverse cardiovascular events occurred (6%), including 1 in the group of patients who took ticagrelor and 11 in group of patients under clopidogrel (2.6% versus 6.7%, P = 0.55).</p> <p><strong>Conclusions: </strong>Clopidogrel was ineffective in 19% of patients undergoing carotid stenting. Platelet count seemed to affect this phenomenon. In these patients, clopidogrel was effectively replaced by ticagrelor.</p>
Association between neutrophil to lymphocyte ratio and carotid artery wall thickness in healthy pregnant women
<p>Raw data related to the article.</p> <p>Abstract</p> <p><strong>Objective: </strong>Pregnancy may elicit a state of mild inflammation that might affect, either directly or indirectly, haematological parameters associated with systemic inflammation. In particular, both Neutrophil-to-lymphocyte ratio (NLR) and Red blood cells Distribution Width (RDW) have been found to be elevated in complicated pregnancy. However, data regarding the association of these haematological parameters with common carotid artery (CCA) intima-media thickness (IMT) in healthy pregnancy are scanty. Aim of this study was to evaluate possible changes in CCA-IMT during normal pregnancy and in the postpartum period, and to correlate these changes with NLR and RDW.</p> <p><strong>Study design: </strong>Between October 2019 and February 2020, a prospective study was carried out on 73 consecutive healthy pregnant women (32.8 ± 4.9 yrs/old). Women underwent obstetric assessment, complete blood cell counts with calculation of NLR and RDW, two-dimensional transthoracic echocardiography and carotid Doppler ultrasonography.</p> <p><strong>Results: </strong>During normal pregnancy, both NLR and RDW progressively increased (p < 0.0001); likewise, parameters of carotid dimensions also significantly increased (p < 0.0001). Hematological and morphological changes all decreased in postpartum period. By univariable logistic regression, the variables which showed the greatest independent association with CCA-IMT (defined as CCA-IMT ≥0.55 mm) were: age (HR 1.33, 95% CI 1.15-1.53, p < 0.0001), pre-pregnant BMI (HR 2.75, 95% CI 1.72-4.41, p < 0.0001), third trimester E/e' ratio (HR 1.64, 95% CI 1.34-2.02, p < 0.0001), and third trimester NLR (HR 3.00, 95% CI 1.64-5.50, p < 0.0001). Multivariable logistic regression analysis demonstrated that third trimester NLR was the only variable that retained statistical significance (HR 2.49, 95% CI 1.35-4.59, p = 0.003). An NLR ≥ 2 reached 83% of sensitivity and 99% of specificity in identifying a CCA-IMT ≥0.55 mm (AUC = 0.95). A strong linear correlation of both third trimester NLR and RDW with CCA-IMT was observed (r = 0.89 and 0.83, respectively).</p> <p><strong>Conclusions: </strong>Pregnancy is a state of chronic mild inflammation and the progressive increase in NLR and RDW during normal pregnancy is significantly associated with CCA intimal-medial thickening.</p> <p><strong>Keywords: </strong>common carotid artery intima-media thickness; healthy pregnancy; neutrophil to lymphocyte ratio.</p>
Non-Invasive assessment of arterial stiffness: pulse wave velocity, pulse wave analysis and carotid cross sectional distensibility. Comparison between methods
<p>Background: The stiffening of large elastic arteries is currently estimated in research and clinical practice by propagative and non-propagative models, as well as parameters derived from aortic pulse waveform analysis. Methods: Common carotid compliance and distensibility were measured by simultaneously recording the diameter and pressure changes during the cardiac cycle. The aortic and upper arm arterial distensibility was estimated by measuring carotid–femoral and carotid–radial pulse wave velocity (PWV), respectively. The augmentation index and blood pressure amplification were derived from the analysis of central pulse waveforms, recorded by applanation tonometry directly from the common carotid artery. Results: 75 volunteers were enrolled in this study (50 females, average age 53.5 years). A significant inverse correlation was found between carotid distensibility and carotid–femoral PWV (r = −0.75; p < 0.001), augmentation index (r = −0.63; p < 0.001) and central pulse pressure (r = −0.59; p < 0.001). A strong correlation was found also between the total slope of the diameter/pressure rate carotid curves and aortic distensibility, quantified from the inverse of the square of carotid–femoral PWV (r = 0.67). No correlation was found between carotid distensibility and carotid–radial PWV. Conclusions: This study showed a close correlation between carotid–femoral PWV, evaluating aortic stiffness by using the propagative method, and local carotid cross-sectional distensibility.</p>
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