Introduction Extracranial carotid artery aneurysms (ECAA) are rare in comparison with atherosclerotic occlusive disease in the same location. ECAA can occur as a result of atherosclerosis, trauma, dissection, local infection, or after carotid endarterectomy (CEA). These aneurysms occur less frequently…
Introduction Carotid artery dissection (CAD) usually occurs secondary to a tear in the intimal layer disrupting the integrity of the arterial wall, which allows blood to leak and accumulate between arterial wall layers. CAD can occur at any age, but…
Abbreviations and Acronyms ASPECTS, Alberta Stroke Program Early CT Score; ASTER, Contact Aspiration vs. Stent Retriever for Successful Revascularization; CAST, Committee on Subspecialty Training; COMPASS, Comparison of Direct Aspiration vs. Stent Retriever as a First Approach; CPSSS, Cincinnati Prehospital Stroke…
Introduction The concept of endovascular therapy for treatment of carotid artery stenosis was first proposed in 1977 by Mathias, who reported successful results of carotid artery angioplasty using peripheral arterial angioplasty technology. , Balloon-expandable stents for the treatment of cerebrovascular…
First performed in the 1950s, carotid endarterectomy (CEA) experienced remarkable growth in the 1970s and 1980s after several studies demonstrated that carotid stenosis was an important risk factor for disabling stroke and death, and a randomized multicenter trial published in…
Carotid Disease And Stroke The management of symptomatic and asymptomatic carotid disease has been the subject of six randomized controlled trials (RCTs) comparing carotid endarterectomy (CEA) with optimal medical therapy (OMT), whereas 20 RCTs have compared CEA with either carotid…
Diagnostic Tools Duplex Ultrasound Duplex ultrasound (DU) refers to two modes of ultrasound, namely B mode that obtains gray-scale imaging, and Doppler that evaluates the velocity and direction of blood flow in the vessel. DU determines the degree of carotid…
Introduction A decline in cognitive function from ischemic, hypoperfused or hemorrhagic brain lesions has been termed “vascular cognitive impairment” (VCI). While memory dysfunction is an important correlate of classic dementias, VCI is generally associated with dysfunction in executive function and…
Introduction Carotid artery disease is highly prevalent, with approximately 12.5% of men and 6.9% of women over the age of 70 years in the United States having asymptomatic carotid disease. The association between atherosclerotic disease of the carotid artery and…
Background Until fairly recently, stroke was largely believed to be a result solely of intracranial pathology. William Osler attributed stroke mainly to intracranial hemorrhage or vasospasm and made no mention of carotid or vertebral artery occlusive disease. Yet the relationship…