OBJECTIVE: The technical and clinical outcome of endovascular revascularization was analyzed in patients with suspicion of chronic splanchnic syndrome (CSS). METHODS: Medical history, duplex, angiography and exercise gastric tonometry suggested CSS in 97 patients. Twenty-seven of them were treated endovascular (one patient had 3-vessel, 12 patients had 2-vessels, 14 patients ...

OBJECTIVE: Endoscopic aqueductoplasty is an option in the treatment of obstructive hydrocephalus caused by aqueductal stenoses. We report on our experience with this endoscopic technique, focussing on indications, operative technique, and results. METHODS: A series of 39 endoscopic aqueductoplasties was performed in 33 patients harbouring a hydrocephalus caused by aqueductal ...

The humoral immune response to endothelium has a pivotal role in the development of atherosclerosis. Using a molecular method, we sought to identify endothelial autoantigens in carotid atherosclerosis. Immunoscreening of a HUAEC expression library with IgG from a pool of two sera from patients with carotid atherosclerosis identified a clone ...

We performed an observational study on 137 patients undergoing carotid endarterectomy (CEA). Patients on statins were less likely to have had symptoms in the 4 weeks before CEA (p = 0.0049) and were less likely to have spontaneous cerebral embolization detected by transcranial Doppler (p = 0.0459). Carotid plaques retrieved ...

BACKGROUND: Little is known about long-term cognitive functioning and quality of life (QoL) in patients with symptomatic carotid artery occlusion who do not undergo revascularization surgery. OBJECTIVE: To assess the course of cognitive impairment and changes in QoL in these patients and whether impaired cerebral metabolism predicts the course of ...

OBJECTIVE: In order to confirm a possible link, as suggested by a recent study, between atherosclerosis and tympanosclerosis, and which could theoretically open new frontiers in the early diagnosis of vascular atherosclerotic diseases starting from a rather simple and rapid examination such as otoscopy, we further investigated this hypothesis in ...

BACKGROUND: Although stent assisted angioplasty is an effective treatment for coronary and peripheral arterial disease, its efficacy in intracranial arteriosclerotic disease has not been verified. OBJECTIVES: To assess the radiographic and clinical outcome of stent assisted angioplasty for symptomatic middle cerebral artery (MCA) stenosis. METHODS: We attempted stent assisted angioplasty ...

PURPOSE: To determine the incidence of symptomatic and asymptomatic cerebral ischemic lesions found on diffusion-weighted magnetic resonance imaging (DW-MRI) after carotid interventions. METHODS: A prospective study was conducted to assess new cerebral ischemic lesions using DW-MRI in symptomatic patients with carotid artery disease undergoing protected carotid artery stenting (CAS) or ...

PURPOSE: To investigate the pattern of catecholamine response in patients undergoing carotid endarterectomy (CEA) or carotid artery stenting (CAS). METHODS: Adrenaline, noradrenaline, and renin levels were measured at 5 time points in 12 patients undergoing 13 CEAs (1 bilateral) and 13 patients undergoing unilateral CAS. Arterial blood samples were taken ...

The aim of this work is to assess the association between vasculogenic erectile dysfunction (ED) and coronary artery disease in men above the age of 40 y. The study included 40 patients above 40 y of age with vasculogenic ED of more than 3 months duration. A dynamic duplex study ...

BACKGROUND AND PURPOSE: The aim of this study was to compare the concentration of osteoprotegerin (OPG), receptor activator of nuclear factor kappaB ligand (RANKL), and osteopontin (OPN) in stable (asymptomatic) and unstable (symptomatic) carotid atherosclerosis. In addition, we were interested in the effect of angiotensin II blockade on the secretion ...

The goal of this study was to evaluate the efficacy of endovascular therapy for acute thrombotic occlusion. Six patients with acute thrombotic occlusion in the middle cerebral or basilar arteries underwent treatment with intra-arterial thrombolysis, followed by assessment of residual stenosis. If residual stenosis was greater than 70%, percutaneous transluminal ...

OBJECTIVES: The study defined the incidence of cerebral hyperperfusion syndrome and intracranial hemorrhage (ICH) and the risk factors for their development following carotid artery stenting (CAS). BACKGROUND: Hyperperfusion syndrome and ICH can complicate carotid revascularization, be it endarterectomy or CAS. Although extensive effort has been devoted to reducing the incidence ...

Doppler sonography has been used to assess global cerebral circulation time (CCT) in healthy volunteers and a small number of patients with cerebral arteriovenous malformations. We evaluated the effect of arteriovenous shunts on global CCT in patients with dural arteriovenous fistulas (DAVFs) by using this Doppler echo contrast-bolus tracking test. ...

HYPOTHESIS: Aggressive screening, early angiographic diagnosis, and prompt anticoagulation for blunt carotid artery injuries (CAIs) improves neurologic outcome. DESIGN: From January 1, 1996, through December 31, 2002, there were 13 280 blunt trauma admissions to our level I center, of which 643 underwent screening angiography for blunt CAI on the ...

AIMS: To assess if a clinically orientated approach improves screening for latent autoimmune diabetes in adults (LADA) in patients developing diabetes over age 50. METHODS: From a clinic-based cohort of 3327 patients with Type 2 DM diagnosed over age 50 we recruited those with at least one feature suggestive of ...

OBJECTIVES: To evaluate the correlation between antiretroviral therapy (ART) and lesions of the carotid vessels using an ultrasound colour-Doppler technique. DESIGN: A total of 293 HIV-1 infected patients underwent epiaortic vessel ultrasonography: 105 on treatment with protease inhibitors (PI) (group I), 125 PI-naive patients treated with a non-nucleoside reverse transcriptase ...

OBJECTIVES: The degree of preoperative cerebrovascular disease in patients undergoing cardiovascular surgery has not been well studied. Thus, the purpose of this study was to evaluate the prevalence and severity of cerebrovascular disease in such patients. METHODS: The subjects were 91 patients who underwent cardiovascular surgery. We investigated the prevalence ...

AIM: To compare conventional digital subtraction x-ray angiography (DSA) and contrast-enhanced magnetic resonance angiography (MRA) of the carotid arteries in terms of patient satisfaction and preferences. METHODS: One hundred and sixty-seven patients with symptomatic carotid artery disease, who underwent both DSA and MRA, were prospectively recruited in this study. Patients' ...

OBJECTIVES: Neurological deficit defines the outcome of Carotid Endarterectomy (CEA) that is mainly caused by cerebral ischemia. Diffusion-weighted imaging (DWI) is a sensitive method for demonstrating even small ischemic lesions. The aim of this study was to evaluate the frequency, clinical significance and course of ischemic lesions after CEA using ...

We investigated the characteristics of erectile dysfunction (ED) in ambulatory Saudi patients. A total of 680 male patients were assessed for ED using IIEF. Patients were also interviewed for sociodemographic data, medical history and risk factors for ED. Assessment for penile vasculature using color Doppler ultrasonography and rigidometer was performed. ...

Patients with recently symptomatic carotid stenosis require effective medical treatment, and some require surgical removal of the carotid plaque. Randomized controlled trials have shown that endarterectomy reduces the overall risk of stroke in patients with severe carotid stenosis and, to a lesser extent, in patients with moderate stenosis. However, operating ...

Angioplasty and stenting of the atheromatous internal carotid artery (ICA), besides in patients with a high surgical risk, may be indicated in specific cases such as contralateral occlusion, acute stroke clinical signs, or atherosclerotic pseudo-occlusion (APO). APO of the ICA is an underrecognized condition due to diagnostic difficulties both with ...

PURPOSE: To compare neurologic outcome after elective internal carotid artery (ICA) stents have been placed in patients with and in patients without contralateral ICA obstructions. MATERIALS AND METHODS: This study included 471 consecutive patients from a registry database who underwent elective ICA stent placement without cerebral protection for high-grade (greater ...

In clinical practice, biological markers are not available to routinely assess the progression of atherosclerotic disease or the development of restenosis following endarterectomy or catheter based interventions. Endarterectomy procedures provide an opportunity to study mechanisms of restenosis and progression of atherosclerotic disease since atherosclerotic tissue is obtained. Athero-Express is an ...

OBJECTIVE: To examine the frequency and predictors of cerebrovascular accidents (CVA) in giant cell arteritis (GCA) patients from a defined population. METHODS: Retrospective study of biopsy-proven GCA patients diagnosed from 1981 through 2001 at the single hospital for the population of Lugo (Northwest Spain). RESULTS: Thirty (14.3%) of the 210 ...

Internal carotid artery dissection (ICAD) is a frequent etiology of stroke in the young. Immediate anticoagulation with unfractionated heparin is the most frequent treatment. A theoretical side effect of unfractionated heparin is an increase in the intramural hematoma resulting in hemodynamic cerebral infarction. We studied 20 patients with ICAD. All ...

OBJECTIVES: The aim of the study was to evaluate clinical outcome and patterns of disease progression relating to stenosis of the internal carotid artery (ICA) opposite to the operated side, using ultrasonographic risk score of ICA plaques. METHODS: 150 patients who underwent ICA endarterectomy for transient ischemic attack (TIA) between ...

PURPOSE: Extracorporeal shock wave therapy (ESWT) for Peyronie's disease is still a topic of debate. We evaluated the effects of ESWT in a large series of patients with Peyronie's disease via a prospective approach. MATERIALS AND METHODS: In a prospective study 114 patients with Peyronie's disease were treated with ESWT. ...

OBJECTIVES: Stroke puts a major financial burden on our healthcare system. However, carotid duplex scanning performed as a screening test for occult carotid artery stenosis (CAS) currently is not reimbursed by Medicare. The goals of this study were to develop a cost-effective stroke screening program, to determine the prevalence of ...

BACKGROUND AND PURPOSE: Transcranial Doppler (TCD) monitoring for asymptomatic cerebral emboli is currently limited to short recordings by equipment size, restricting its clinical usefulness. We have developed a first ambulatory TCD system, evaluated it in at-risk patient groups, and used it to study the pattern of embolization in patients with ...

BACKGROUND AND PURPOSE: Magnesium (Mg) deficiency is thought to be a risk factor for cerebrovascular atherosclerosis and complications. We investigated the prognostic impact of Mg serum levels with respect to the occurrence of neurological events in patients with advanced atherosclerosis. METHODS: We prospectively studied 323 patients with symptomatic peripheral artery ...

Increased levels of the gliofibrillar S100b protein can be detected during carotid endarterectomy (CEA). Whether the S100b protein increase is marker of brain ischemic sufferance and predictor of cognitive decline is controversial. Twenty-eight patients underwent clinical assessment and cranial computed tomography (CT) 24-48 hours before and 3 months after CEA. ...

OBJECTIVE: The risk of stroke and death associated with carotid endarterctomy is operator dependant. Data regarding risks of this procedure are not available in Pakistan and therefore it is difficult to make accurate risk benefit analysis for individual patients. Our objective was to determine safety of carotid endarterectomy at an ...

OBJECTIVE: Research investigating the benefits of carotid endarterectomy (CEA) on cognitive functioning remains inconclusive. This study sought to determine what patient characteristics affect cognitive functioning and whether changes in cognitive functioning occur following surgery after controlling for these characteristics. METHODS: In a prospective longitudinal study, 39 patients scheduled for CEA ...

Ultrasonographic measurements of the intima-media thickness (IMT) of common carotid arteries (CCA) were taken in 50 patients with familial hypercholesterolaemia (FH) and 57 patients with non-familial hypercholesterolemia (NFH). The lipid profile, body mass index (BMI) and waist-hip ratio (WHR) of each patient were recorded. In FH patients, the IMT was ...

AIM: to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. DESIGN: observational study. SETTING: teaching hospital. METHODS: we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexplained syncope, unexplained falls ...

PURPOSE: To determine if color Doppler ultrasonography is able to identify vascular abnormalities linked to ureteropelvic junction (UPJ) obstruction. PATIENTS AND METHODS: We used color Doppler scanning in 21 patients to determine whether there were aberrant vessels. RESULTS: The study detected 11 aberrant vessels, resulting in 10 true positives and ...

We conducted the current study to search for subclinical atherosclerosis in patients with rheumatoid arthritis (RA) without clinically evident atherosclerosis or its complications who had been treated for a long duration, and to assess whether demographic or clinical factors affect the development of atherosclerotic disease. Forty-seven white patients fulfilling the ...

Although transient ischemic attacks (TIAs) by definition do not cause lasting neurological deficits, cognitive impairment has been suggested in patients with carotid artery disease who have suffered from a TIA. The purpose of our study was to assess whether patients with carotid artery disease and TIAs are cognitively impaired, to ...

Atherosclerotic diseases are thought to be less frequent in Asians compared with Caucasians. Unlike Caucasians, nearly half of Asians have a functional deficiency in the low Km aldehyde dehydrogenase (ALDH2), a key enzyme in alcohol metabolism, which potentially modifies the prevalence of atherosclerosis. This study examined the associations between ALDH2 ...

We examined the changes in cognitive function following carotid endarterectomy (CEA) in relation to the cerebral blood flow (CBF) in patients with high-grade carotid stenosis. The subjects consisted of 23 patients who underwent CEA and 17 controls matched by age and education. Single photon emission computed tomography (SPECT) and neuropsychological ...

OBJECTIVE: The purpose of this study was to determine the MRI features seen after uterine artery embolization and to evaluate the clinical response in patients with adenomyosis. MATERIALS AND METHODS: Thirty women with adenomyosis underwent uterine artery embolization and follow-up MRI for 1 year. Of the 30, 27 patients were ...

OBJECTIVE: To evaluate the outcomes of subglottic stenosis in patients with Wegener's granulomatosis. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective chart review was undertaken to review all patients evaluated in an otolaryngology-head and neck surgery department between 1993 and 2001 for active symptoms attributed to subglottic stenosis who had ...

OBJECTIVE: recent evidence suggests a strong association between socio-economic status and atherosclerosis. However, little information exists on the relationship between socio-economic status, symptomatic carotid disease and rates of carotid endarterectomy (CEA). The aim was to evaluate the Carstair Deprivation Score (CDS) of (1) patients admitted with symptomatic carotid disease, and ...

BACKGROUND AND PURPOSE: We tested the hypothesis that early diffusion- and perfusion-weighted MRI (DWI and PWI, respectively) allows the prediction of malignant middle cerebral artery (MCA) infarction (MMI). METHODS: Thirty-seven patients with acute MCA infarction and proximal vessel occlusion (carotid-T, MCA main stem) were studied by DWI, PWI, and MR ...

OBJECTIVE: To investigate the prevalence and clinical significance of carotid artery intima-media thickness (IMT) in patients with primary antiphospholipid syndrome (APS). METHODS: 28 patients with primary APS with at least a five year follow up, and 28 healthy subjects, matched by age and sex, were included in the study. Colour ...

BACKGROUND AND PURPOSE: We sought to report the occurrence and risk factors of intracranial hemorrhage during long-term follow-up of patients with internal carotid artery stenosis, with and without carotid endarterectomy. METHODS: From the prospective data of the North American Symptomatic Carotid Endarterectomy Trial, 3 types of intracranial hemorrhage were recognized: ...

BACKGROUND AND PURPOSE: Perfusion-weighted magnetic resonance imaging (PWI) is a reliable and semiquantitative method for estimating cerebral hemodynamics. We sought to evaluate the potential of PWI for assessing cerebral blood flow (CBF) and metabolism compared with positron emission tomography (PET) in patients with chronic occlusive carotid disease. METHODS: In 24 ...

OBJECTIVE: This retrospective study was designed to investigate changes of cervical dentin hypersensitivity (CDH) in response to occlusal equilibration. METHOD AND MATERIALS: Written records for 250 active-care patients were randomly selected and analyzed for associations between CDH, and its resolution following occlusal equilibration. Patients in group A (treatment) and B ...