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PloS One 2018Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference...
Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography.
INTRODUCTION
Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference values of vessel diameters and assessed prevalence of stenosis and arterial variations of the lower limb arteries in a healthy male population sample.
METHODS
Gadolinium-enhanced magnetic resonance angiography at 1.5 Tesla was performed in 756 male participants (median age = 52 years, range = 21-82 years) of the population-based Study of Health in Pomerania. Vessel diameters were measured in 9 predefined segments of the pelvic and leg arteries and 95th percentiles were used for upper reference values of means of left and right side arteries.
RESULTS
Reference values of vascular diameters decreased from proximal to distal arteries: common iliac = 1.18cm; internal iliac = 0.75cm; external iliac = 1.03cm; proximal femoral = 1.02cm; distal femoral = 0.77cm; popliteal = 0.69cm; anterior tibial = 0.42cm; posterior tibial = 0.38cm; fibular = 0.40cm. Body-surface area indexed reference values increased with age in all segments. A number of 53 subjects (7.0%) had at least one stenosis, mainly in the lower leg arteries anterior tibial (n = 28, 3.7%), posterior tibial (n = 18, 2.4%) and fibular (n = 20, 2.6%). The risk of stenosis increased considerably with age (odds ratio = 1.08; p<0.001). The most common arterial variant was type I-A in both legs (n = 620, 82%).
CONCLUSION
We present reference values for different pelvic and leg artery segment diameters in men that decrease from proximal to distal and increase with age. Stenoses were most prevalent in lower leg arteries and type I-A was the most common variant in the lower leg.
Topics: Adult; Aged; Angiography, Digital Subtraction; Arterial Occlusive Diseases; Arteries; Blood Vessels; Constriction, Pathologic; Contrast Media; Gadolinium; Humans; Lower Extremity; Magnetic Resonance Angiography; Male; Middle Aged; Reference Values
PubMed: 29924802
DOI: 10.1371/journal.pone.0197559 -
Journal of Integrative Neuroscience Jan 2022The relationship between the severity of intracranial atherosclerotic disease and the circle of Willis integrity is unclear. In this brief report, we investigate the...
The relationship between the severity of intracranial atherosclerotic disease and the circle of Willis integrity is unclear. In this brief report, we investigate the associations between symptomatic intracranial atherosclerotic disease and the integrity of the circle of Willis. Patients with symptomatic intracranial atherosclerosis were enrolled and underwent intracranial artery magnetic resonance vessel wall imaging and time-of-flight angiography. The presence or absence of an intracranial atherosclerotic plaque and its maximum wall thickness and stenosis were evaluated. The presence or absence of the A1 segment of the bilateral anterior cerebral arteries (from the internal carotid artery to the anterior communicating artery segment is called anterior cerebral artery A1 segment), and anterior communicating artery, the P1 segment of the bilateral posterior cerebral arteries (The P1 segment of the posterior cerebral artery is a horizontally outward segment), and bilateral posterior communicating arteries were determined. The associations of the intracranial plaque features with the integrity of the circle of Willis were analyzed. Of the 110 recruited subjects (57.2 ± 11.1 years; 65% males), 51 had intracranial plaques, and 44 had stenosis. In patients with bilateral A1 and P1 segments (n = 85), intracranial stenosis was more severe in patients with an anterior communicating artery than those without an anterior communicating artery (19.7% ± 21.7% vs. 1.4% ± 3.3%, = 0.046). In patients with bilateral A1 and P1 segments and an anterior communicating artery (n = 79), intracranial stenosis was more severe in patients with posterior communicating arteries than those without posterior communicating arteries (27.9% ± 23.7% vs. 13.5% ± 17.9%, = 0.007). The odds ratio of intracranial stenosis was 1.214 (95% confidence interval (CI), 1.054-1.398; = 0.007) in discriminating for the presence of posterior communicating arteries in patients with bilateral A1 and P1 segments and an anterior communicating artery after adjusting for confounding factors. The severity of intracranial atherosclerosis was independently associated with the presence of posterior communicating arteries in patients with a complete anterior part of the circle of Willis.
Topics: Adult; Aged; Circle of Willis; Constriction, Pathologic; Female; Humans; Intracranial Arteriosclerosis; Ischemic Attack, Transient; Ischemic Stroke; Magnetic Resonance Imaging; Male; Middle Aged
PubMed: 35164438
DOI: 10.31083/j.jin2101002 -
Scientific Reports Nov 2023Early neurological deterioration (END) in lenticulostriate artery (LSA) infarction is associated with perforating artery hypoperfusion. As middle cerebral artery (MCA)... (Review)
Review
Early neurological deterioration (END) in lenticulostriate artery (LSA) infarction is associated with perforating artery hypoperfusion. As middle cerebral artery (MCA) tortuosity may alter hemodynamics, we investigated the association between MCA tortuosity and END in LSA infarction. We reviewed patients with acute LSA infarction without significant MCA stenosis. END was defined as an increase of ≥ 2 or ≥ 1 in the National Institutes of Health Stroke Scale (NIHSS) total or motor score, respectively, within first 72 h. The MCA tortuosity index (actual /straight length) was measured. Stroke mechanisms were categorized as branch atheromatous disease (BAD; lesions > 10 mm and 4 axial slices) and lipohyalinotic degeneration (LD; lesion smaller than BAD). Factors associated with END in LD and BAD were investigated. END occurred in 104/390 (26.7%) patients. A high MCA tortuosity index (adjusted odds ratio, aOR 10.63, 95% confidence interval [2.57-44.08], p = 0.001) was independently associated with END. In patients with BAD, high initial NIHSS score (aOR 1.40 [1.03-1.89], p = 0.031) and presence of parental artery disease (stenosis < 50%; aOR 10.38 [1.85-58.08], p = 0.008) were associated with END. In patients with LD, high MCA tortuosity (aOR 41.78 [7.37-237.04], p < 0.001) was associated with END. The mechanism causing END in patients with LD and BAD may differ.
Topics: United States; Humans; Middle Cerebral Artery; Constriction, Pathologic; Stroke; Infarction
PubMed: 37963951
DOI: 10.1038/s41598-023-47281-8 -
Clinical Neurology and Neurosurgery Sep 2022Patients with intracranial aneurysms treated with stent-assisted coil embolization (SACE) require radiological and clinical follow-up in view of in-stent stenosis (ISS)....
BACKGROUND AND PURPOSE
Patients with intracranial aneurysms treated with stent-assisted coil embolization (SACE) require radiological and clinical follow-up in view of in-stent stenosis (ISS). The aim of the study was to evaluate transcranial Doppler (TCD) as an alternative to more invasive digital subtraction angiography (DSA) in monitoring patients with SACE.
METHODS
Over the course of 72 months, from January 2016 to December 2021, we analyzed 49 patients treated with SACE because of internal carotid artery (ICA) aneurysms (C6 ophthalmic segment or C7 communicating segment). DSA was performed in all patients at 24-months and TCD was examined preoperatively and at 3, 6, 12, and 24-months postoperatively. The degree of stenosis found on TCD was compared with the results of DSA. Preoperative and postoperative blood flow velocities, including peak systolic blood flow velocity (Vs), end diastolic velocity (Vd), and mean velocity (Vm), were compared and the optimal cutoff velocities for detecting stenosis were calculated.
RESULTS
Pre-embolization middle cerebral artery (MCA) and intracranial terminal internal cerebral arteries (TICA) velocities and pulsatility index (PI) did not significantly differ between the ipsilateral and contralateral sides. The blood flow velocities, Vs, Vd, and Vm, on the operation side significantly increased after SACE (P < 0.05). Over the 24-month study period, 7 of the 49 patients (14.3%) exhibited angiographic ISS. ISS of TCD and DSA results at 24-months were compared and found to correlate well; the Cohen's κ coefficient was 0.851 (95% CI 0.651-1.051). The optimal cutoff velocity for detecting ISS was MCA Vs = 173.5 cm/s.
CONCLUSIONS
TCD is a potentially useful adjunct for evaluating ISS after SACE.
Topics: Blood Flow Velocity; Constriction, Pathologic; Humans; Middle Cerebral Artery; Stents; Ultrasonography, Doppler, Transcranial
PubMed: 35841863
DOI: 10.1016/j.clineuro.2022.107347 -
Circulation. Cardiovascular Imaging Mar 2022Whether information on carotid plaque composition contributes to prediction of incident atherosclerotic cardiovascular disease (ASCVD) remains to be investigated. We...
BACKGROUND
Whether information on carotid plaque composition contributes to prediction of incident atherosclerotic cardiovascular disease (ASCVD) remains to be investigated. We determined the sex-specific added value of carotid plaque components for predicting incident ASCVD events, beyond traditional cardiovascular risk factors.
METHODS
Between 2007 and 2012, participants from the population-based Rotterdam Study with asymptomatic carotid wall thickening >2.5 mm on ultrasonography were invited for carotid magnetic resonance imaging. Among 1349 participants (mean age: 72 years [SD±9.3], 49.5% women) without cardiovascular disease, we assessed plaque thickness, luminal stenosis (>30%), presence of intraplaque hemorrhage, lipid-rich necrotic core, and calcification. Follow-up for ASCVD was complete until January 1, 2015. Using Cox proportional hazards models, we fitted sex-specific prediction models including traditional cardiovascular risk factors (base model). We extended the base model by single and simultaneous additions of plaque characteristics and calculated improvement of model performance by the statistics.
RESULTS
During a median follow-up of 4.8 years, 60 men and 48 women developed ASCVD. In women, presence of intraplaque hemorrhage was associated with incident ASCVD (adjusted hazard ratio, 3.37 [95% CI, 1.81-6.25]). The statistic (95% CI) improved from 0.73 (0.66-0.79) to 0.76 (0.70-0.83) after single addition of intraplaque hemorrhage to the base model. Simultaneous addition of plaque components, plaque thickness, and stenosis did not change the results. In men, only carotid stenosis was statistically significantly associated with incident ASCVD (adjusted hazard ratio, 1.75 [95% CI, 1.00-3.08]); yet, the association diminished after the addition of other plaque characteristics, and no improvements were observed in statistics.
CONCLUSIONS
Presence of intraplaque hemorrhage contributes to the prediction of incident ASCVD in women, beyond traditional cardiovascular risk factors, other plaque components, plaque size, and stenosis.
Topics: Aged; Atherosclerosis; Cardiovascular Diseases; Carotid Arteries; Carotid Stenosis; Constriction, Pathologic; Female; Hemorrhage; Humans; Magnetic Resonance Imaging; Male; Plaque, Atherosclerotic; Risk Factors
PubMed: 35196868
DOI: 10.1161/CIRCIMAGING.121.013602 -
NeuroImage. Clinical 2022We aimed to detect microstructural changes in the brains of patients with unilateral middle cerebral artery (MCA) stenosis and to assess the integrity of the fiber...
OBJECTIVE
We aimed to detect microstructural changes in the brains of patients with unilateral middle cerebral artery (MCA) stenosis and to assess the integrity of the fiber structure and the small-world networks using diffusion spectrum imaging (DSI).
METHODS
A total of 21 healthy controls and 48 patients with unilateral MCA stenosis underwent 3.0 T MRI examination using DSI technique. Differential tractography, diffusion connectometry, and structural networks were performed by using DSI software. The correlation between the stenosis and quantitative anisotropy (QA) were analyzed using multiple regression models in the correlation tractography.
RESULTS
Differential tractography analysis showed that the left or right MCA stenosis group had decreased fiber connectivity in the brain network compared with the control group. The correlation tractography analysis of the patients with MCA stenosis showed that QA was negatively correlated with stenosis in the bilateral arcuate fasciculus, bilateral corticostriatal and corticothalamic pathway, bilateral corticopontine and corticospinal tract, right superior longitudinal fasciculus, right cingulum, corpus callosum, and left frontal aslant tract. Statistically significant differences were shown between the MCA stenosis groups and control group in graph density, global efficiency, network path length, and rich club coefficient.
CONCLUSION
DSI revealed that stroke-free patients with unilateral MCA stenosis have a disrupted structural network and damaged white matter fibers. Furthermore, the fiber connection disruption is more severe in the ipsilateral hemisphere and less prominent in the contralateral hemisphere in patients with unilateral MCA stenosis. Therefore, microstructural impairment has happened to patients with unilateral MCA stenosis even at a subclinical stage.
Topics: Humans; Constriction, Pathologic; Middle Cerebral Artery; Diffusion Magnetic Resonance Imaging; White Matter; Anisotropy; Brain
PubMed: 35973283
DOI: 10.1016/j.nicl.2022.103133 -
Percutaneous transluminal angioplasty and stenting of post-irradiated stenosis of subclavian artery.Journal of the Formosan Medical... Jun 2022The therapeutic efficacy of percutaneous transluminal angioplasty and stenting (PTAS) of post-irradiated stenosis of subclavian artery (PISSA) was not well clarified....
BACKGROUND/PURPOSE
The therapeutic efficacy of percutaneous transluminal angioplasty and stenting (PTAS) of post-irradiated stenosis of subclavian artery (PISSA) was not well clarified. This retrospective study was designed to evaluate the technical safety and outcome of the patients of severe symptomatic PISSA accepted PTAS.
METHODS
Between 2000 and 2019, 16 cases with 17 lesions of symptomatic and medically refractory PISSA accepted PTAS were included. We evaluated their technical success, peri-procedural complications and diffusion-weight imaging (DWI) of brain magnetic resonance imaging (MRI), results of symptom relief, and long-term stent patency.
RESULTS
The stenosis of the 17 stenotic lesions were 81.2 ± 11.1%. The most common symptom of the 16 patients was dizziness (14/16, 87.5%). All successfully accepted PTAS without neurological complication and had symptom relief after PTAS (17/17, 100%). Of the 12 patients accepted pre-procedural and early post-procedural MRI follow-up, 2 patients had an asymptomatic tiny acute embolic infarct in the territory of vertebrobasilar system. In a 51.9 ± 54.9 months follow-up, all patients had no severe restenosis and no recurrent vertebrobasilar ischemic symptoms.
CONCLUSION
For patients with PISSA and medically refractory ischemic symptoms, PTAS can be an effective alternative management.
Topics: Angioplasty; Constriction, Pathologic; Humans; Retrospective Studies; Stents; Subclavian Artery; Treatment Outcome
PubMed: 34481727
DOI: 10.1016/j.jfma.2021.08.021 -
Journal of the American College of... May 1989Coronary angioplasty as it is now performed has several limitations, including abrupt early arterial closure and delayed restenosis. To obviate these problems and to... (Review)
Review
Coronary angioplasty as it is now performed has several limitations, including abrupt early arterial closure and delayed restenosis. To obviate these problems and to enhance the safety of the technique, several intracoronary stenting devices have been developed and are under investigation. This report reviews the scientific rationale behind stenting, the results of stenting in animal models and the early results in humans. In early clinical investigation, restenosis appears uncommon but abrupt, presumably thrombotic, occlusion has been reported despite aggressive anticoagulation. As long as the potential for this problem remains and the long-term consequences of placing these devices into arteries of great functional importance remain unknown, stent placement must be undertaken with great caution and should be performed under carefully monitored circumstances with meticulous patient follow-up.
Topics: Angioplasty, Balloon; Constriction, Pathologic; Coronary Disease; Coronary Vessels; Equipment Design; Humans; Intubation; Prostheses and Implants; Recurrence
PubMed: 2522960
DOI: 10.1016/0735-1097(89)90323-9 -
Journal of the Royal Society, Interface Apr 2021One-dimensional (1-D) arterial blood flow modelling was tested in a series of idealized vascular geometries representing the abdominal aorta, common carotid and iliac...
One-dimensional (1-D) arterial blood flow modelling was tested in a series of idealized vascular geometries representing the abdominal aorta, common carotid and iliac arteries with different sizes of stenoses and/or aneurysms. Three-dimensional (3-D) modelling and measurements were used as ground truth to assess the accuracy of 1-D model pressure and flow waves. The 1-D and 3-D formulations shared identical boundary conditions and had equivalent vascular geometries and material properties. The parameters of an experimental set-up of the abdominal aorta for different aneurysm sizes were matched in corresponding 1-D models. Results show the ability of 1-D modelling to capture the main features of pressure and flow waves, pressure drop across the stenoses and energy dissipation across aneurysms observed in the 3-D and experimental models. Under physiological Reynolds numbers (), root mean square errors were smaller than 5.4% for pressure and 7.3% for the flow, for stenosis and aneurysm sizes of up to 85% and 400%, respectively. Relative errors increased with the increasing stenosis and aneurysm size, aneurysm length and , and decreasing stenosis length. All data generated in this study are freely available and provide a valuable resource for future research.
Topics: Aneurysm; Aorta, Abdominal; Constriction, Pathologic; Hemodynamics; Humans; Models, Cardiovascular
PubMed: 33849337
DOI: 10.1098/rsif.2020.0881 -
American Journal of Transplantation :... May 2021Graft artery stenosis can have a significant short- and long-term negative impact on renal graft function. From the beginning of the COVID-19 pandemic, we noticed an...
Graft artery stenosis can have a significant short- and long-term negative impact on renal graft function. From the beginning of the COVID-19 pandemic, we noticed an unusual number of graft arterial anomalies following kidney transplant (KTx) in children. Nine children received a KTx at our center between February and July 2020, eight boys and one girl, of median age of 10 years. Seven presented Doppler features suggesting arterial stenosis, with an unusual extensive pattern. For comparison, over the previous 5-year period, persistent spectral Doppler arterial anomalies (focal anastomotic stenoses) following KTx were seen in 5% of children at our center. We retrospectively evidenced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in five of seven children with arterial stenosis. The remaining two patients had received a graft from a deceased adolescent donor with a positive serology at D0. These data led us to suspect immune postviral graft vasculitis, triggered by SARS-CoV-2. Because the diagnosis of COVID-19 is challenging in children, we recommend pretransplant monitoring of graft recipients and their parents by monthly RT-PCR and serology. We suggest balancing the risk of postviral graft vasculitis against the risk of prolonged dialysis when considering transplantation in a child during the pandemic.
Topics: Adolescent; Arteries; COVID-19; Child; Constriction, Pathologic; Female; Humans; Kidney; Kidney Transplantation; Male; Pandemics; Retrospective Studies
PubMed: 33346946
DOI: 10.1111/ajt.16464