During cerebral vasospasm (CVS) due to ruptured aneurysm the retinal arteries were photographed and evaluated with angiographic studies at various stages to study any correlation between them. Among 60 cases with angiographic CVS, ophthalmoscopic retinal artery spasm (RAS) was detected in 29 cases. Photographic demonstration of the RAS was possible in 7 cases. In general, in a series of cases, the degree of RAS seems to correspond to the severity of CVS.
Carotid Artery Diseases/complications ; Human ; Intracranial Aneurysm/complications ; Ischemic Attack, Transient/complications* ; Ophthalmoscopy* ; Retinal Artery* ; Retinal Diseases/diagnosis

Atherosclerosis ; complications ; epidemiology ; Carotid Artery Diseases ; complications ; epidemiology ; Glucose Metabolism Disorders ; complications ; epidemiology ; Humans ; Tibet ; epidemiology

Carotid Artery Diseases ; surgery ; Carotid Stenosis ; surgery ; Endarterectomy, Carotid ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prosthesis Failure ; Stents ; adverse effects

Carotid Artery Diseases ; complications ; Fasciitis, Necrotizing ; complications ; Female ; Humans ; Middle Aged

A 44-year-old woman who showed recurrent vitreous hemorrhages with vascular tortuosity received CT angiography which revealed an internal carotid artery aneurysm. A case of internal carotid aneurysm was associated with a pattern of retinal arteriolar tortuosity pathognomic for familial retinal arterial tortuosity (fRAT), suggesting possible involvement of the cerebral circulation. We present a case of internal carotid aneurysm associated with a pattern of retinal arteriolar tortuosity pathognomic for fRAT.
Adult ; Aneurysm/*complications/radiography ; Angiography ; Carotid Artery Diseases/*complications/radiography ; *Carotid Artery, Internal ; Diagnosis, Differential ; Eye Abnormalities/complications/diagnosis/*genetics ; Female ; Follow-Up Studies ; Humans ; Retinal Artery/*abnormalities ; Tomography, X-Ray Computed ; Torsion Abnormality/complications/diagnosis/*genetics ; Visual Acuity

Carotid Artery Diseases ; drug therapy ; Carotid Artery, Internal ; Child ; Female ; Humans ; Injections ; Leukemia, Promyelocytic, Acute ; complications ; Rupture, Spontaneous ; Thrombin ; administration & dosage ; Ultrasonography, Interventional

BackgroundNonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases with a high prevalence in the general population. The association between NAFLD and cardiovascular disease has been well addressed in previous studies. However, whether NAFLD is associated with carotid artery disease in a community-based Chinese population remained unclear. The aim of this study was to investigate the association between NAFLD and carotid artery disease.

MethodsA total of 2612 participants (1091 men and 1521 women) aged 40 years and older from Jidong of Tangshan city (China) were selected for this study. NAFLD was diagnosed by abdominal ultrasonography. The presence of carotid stenosis or plaque was evaluated by carotid artery ultrasonography. Logistic regression was used to analyze the association between NAFLD and carotid artery disease.

ResultsParticipants with NAFLD have a higher prevalence of carotid stenosis (12.9% vs. 4.6%) and carotid plaque (21.9% vs. 15.0%) than those without NAFLD. After adjusting for age, gender, smoking status, income, physical activity, diabetes, hypertension, triglyceride, waist-hip ratio, and high-density lipoprotein, NAFLD is significantly associated with carotid stenosis (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.45-2.91), but the association between NAFLD and carotid plaque is not statistically significant (OR: 1.10, 95% CI: 0.8-1.40).

ConclusionA significant association between NAFLD and carotid stenosis is found in a Chinese population.

Adult ; Carotid Artery Diseases ; complications ; Carotid Intima-Media Thickness ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; complications ; Prevalence ; Risk Factors

BACKGROUND: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications. We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the carotid endarterectomy. MATERIAL AND METHOD: We analyzed retrospectively the medical records of 74 patients (76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. RESULT: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were 23.48+/-10.04 mmHg in 25 cases with changes in electroencephalography (group A) and 47.16+/-16.04 mmHg in 51 cases without changes in electroencephalography (group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups (p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. CONCLUSION: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroencephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper airway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.
Airway Obstruction ; Angioplasty ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Carotid Stenosis* ; Cerebral Hemorrhage ; Cerebral Infarction ; Constriction ; Electroencephalography ; Endarterectomy ; Endarterectomy, Carotid ; Female ; Hematoma ; Hemorrhage ; Humans ; Hypoglossal Nerve Diseases ; Laryngeal Edema ; Male ; Medical Records ; Mortality ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND: Laminin, the main non-collagenous constituent of vascular basement membranes, can be changed by alteration of metabolism and distribution in diabetic microangiopathy. The serum laminin levels are known to reflect these histological changes. The aim of present study was to investigate whether the serum laminin levels are related to carotid atherosclerosis and diabetic complications, and to assess what clinical variables influence on the serum laminin levels in type 2 diabetes. METHODS: The subjects were 103 type 2 diabetic patients (51 in the no complication group and 52 in the complication group) and 39 controls. We evaluated the intima-media thickness (IMT) and plaques in both carotid arteries by duplex scan. and the serum laminin levels were measured. RESULTS: The serum laminin levels were higher in the group with complications complication group compared to the no complication group (p<0.01), and in the no complication group compared to the control group (plt;0.01). There were no differences in the carotid parameter values between the complication group and the no complication group. The correlations between the serum laminin levels and the measured IMT values were not significant.However, there were significant correlations between the serum laminin levels and the plaque counts and scores (r=0.24, plt;0.05). The presence of diabetic complications, the waist hip ratio, plaque score and apo B affected the elevation of the serum laminin levels (plt;0.05). CONCLUSIONS: The serum laminin levels were related to the presence of diabetic complications. Such levels may be a risk factor for plaque progression rather than the initiation of plaque formation or IMT thickening in the carotid atherosclerosis of type 2 diabetic patients.
Apolipoproteins B ; Basement Membrane ; Carotid Arteries ; Carotid Artery Diseases ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Diabetic Angiopathies ; Humans ; Laminin* ; Metabolism ; Risk Factors ; Waist-Hip Ratio

PURPOSE: Ruptured abdominal aortic aneurysm still carries high operative mortality, but the operative mortality of elective operation for abdominal aortic aneurysm has been reduced to less than 5 percent due to an adequate management of severe influential factors:treatment of preventable coronary and carotid artery disease, intraoperative prevention of hypotension and reperfusion injury, and postoperative intensive surveilance of cardiopulmonary function. METHOD: Seventy-six AAAs patients who were treated in our vascular division between January 1996 to December 2000 were prospectively investigated in regard to clinical manifestations, operative finding, and other factors affecting the outcomes. RESULT: The male-to-female ratio was 65:11 and the mean age was 63.1 years. The ruptured AAA to unruptured AAA ratio was 30:46, and suprarenal to infrarenal AAA was 5:71. The mean maximal diameter was 6.8 (4~15) cm. The AAA associated with iliac artery aneurysm was observed in 56 patients and with occlusive arterial disease was observed 15 patients. All patients for elective surgery had a preoperative thallium myocardial perfusion scan and color duplex carotid scan, Nine of them had a coronary occlusive lesion and six of these nine patients had preoperative coronary angioplasty (3) or coronary bypass procedure (3). One of them who had carotid artery stenosis received a carotid endarterectomy after the AAA resection. The treatment were aorto-iliac bifurcation graft (80.2%), straight graft interposition of aorta (11.8%), aorto-bifemoral bypass (5.3%), and stented graft (2.6%). Two stented graft case were excluded from mortality and morbidity calculation. The postoperative complications were pulmonary complication (9.4%), renal complication (4.0%), wound infection (2.7%), small bowel obstruction (2.7%). The operative mortality of elective AAA resection was 14.5%, and elective was 2.3% (1/44). Mortality of ruptured AAA was 33.3% (10/30) in which intraperitoneal rupture (free rupture) was 85.7% (6/7) operative mortality and retroperitoneal contained rupture was 17.4% (4/23). Age was not a independent risk factor. CONCLUSION: Mortality of elective AAA resection has been reduced with careful pre-operative assessment of the patient and proper management of the risk factors. Intrapritoneal free rupture still carries unacceptably high mortality. Thus elective operation before the rupture of AAA is emphasized again.
Aneurysm ; Angioplasty ; Aorta ; Aortic Aneurysm, Abdominal* ; Carotid Artery Diseases ; Carotid Stenosis ; Endarterectomy, Carotid ; Humans ; Hypotension ; Iliac Artery ; Mortality ; Perfusion ; Postoperative Complications ; Prospective Studies ; Reperfusion Injury ; Risk Factors ; Rupture ; Stents ; Thallium ; Transplants ; Wound Infection