OBJECTIVETo study the correlation between carotid atherosclerosis (CAS) and hypertension.

METHODSColor Doppler ultrasonography data of CAS were observed in 150 hypertension patients [as the hypertension group, including 70 patients in the phlegm-stasis syndrome (PSS) group and 80 in the non-PSS group] and 30 non-hypertension patients (as the control group). The difference of the CAS occurrence was compared among the three groups.

RESULTSThe incidence of CAS was higher in the PSS group and the non-PSS group than in the control group, showing statistical difference (P<0.01). Of them, it was higher in the PSS group than in the non-PSS group (P<0.05). Hard plaque dominated in the CAS plaque constitution in both the PSS group and the non-PSS group. Of them the soft plaque ratio was higher in the PSS group than in the non-PSS group, showing statistical difference (41.9% vs 11.4%, P<0.05). The CAS plaque distribution positions among the three groups (P>0.05). The inner diameters of the left and right common carotid artery, and the resistant indices of the left and right common carotid artery, the left internal carotid artery, and the left vertebral artery in the PSS group and the non-PSS group were higher than in the control group (P<0.05).

CONCLUSIONSHypertension patients are often accompanied with CAS of various degrees. Especially the soft plaque ratio of the CAS plaque was higher in those of PSS, indicating the possibility of target organs damage such as cerebral infarction was higher.

Carotid Artery Diseases ; complications ; diagnosis ; diagnostic imaging ; Female ; Humans ; Hypertension ; complications ; diagnosis ; diagnostic imaging ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Ultrasonography, Doppler, Color

OBJECTIVETo explore the diagnosis and treatment of delayed traumatic epistaxis and put forward a concept of arteriola pseudoaneurysmal epistaxis originated from maxillofacial medium-sized artery.

METHODSThe clinical data of 53 patients who had the typical symptoms of delayed traumatic epistaxis and received digital subtraction angiography examination and treated in recent 10 years were retrospectively analyzed.

RESULTSAmong the 53 patients, 8 patients suffered from interval carotid artery pseudoaneurysm. For these 8 patients, 1 died of massive epistaxis before embolization, 7 received transcatheter arterial embolization( 6 cured and 1 died). Twenty patients suffered from traumatic carotid cavernous fistula, all were cured with endovascular occlusion by detachable balloon. Twenty-five patients suffered from maxillofacial artery hemorrhage. For these 25 patients, 21 were treated by transcatheter arterial embolization with gelatin sponge and coils, 4 by anterior ethmoidal artery ligation. The followed-up ranged from 6-72 months (median 5 years). All patients were successfully treated without serious complications and recurrent hemorrhage, except one patient who had recurred hemorrhage three weeks after transcatheter arterial embolization. This patient was again successfully treated by artery ligation.

CONCLUSIONSInterval carotid artery pseudoaneurysm, carotid cavernous fistula and maxillofacial medium-sized artery and arteriola pseudoaneurysm are the main causes of delayed traumatogenic epistaxis. Early diagnosis by digital subtraction angiography examination and transcatheter arterial embolization or artery ligation are the useful methods to treat delayed traumatic epistaxis and pseudoaneurysm.

Adolescent ; Adult ; Aneurysm, False ; complications ; diagnostic imaging ; therapy ; Angiography, Digital Subtraction ; Carotid Artery Diseases ; complications ; diagnostic imaging ; therapy ; Embolization, Therapeutic ; Epistaxis ; diagnostic imaging ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUND/AIMS: The CHADS2 score, used to predict the risk of ischemic stroke in atrial fibrillation (AF) patients, has been reported recently to predict ischemic stroke in patients with coronary heart disease, regardless of the presence of AF. However, little data are available regarding the relationship between the CHADS2 score and cardiovascular outcomes. METHODS: This was a retrospective study on 104 patients admitted for acute coronary syndrome (ACS) who underwent coronary angiography, carotid ultrasound, and transthoracic echocardiography. RESULTS: The mean age of the subjects was 60.1 +/- 12.6 years. The CHADS2 score was as follows: 0 in 46 patients (44.2%), 1 in 31 (29.8%), 2 in 18 (17.3%), and > or = 3 in 9 patients (8.7%). The left atrial volume index (LAVi) showed a positive correlation with the CHADS2 score (20.8 +/- 5.9 for 0; 23.2 +/- 6.7 for 1; 26.6 +/- 10.8 for 2; and 30.3 +/- 8.3 mL/m2 for > or =3; p = 0.001). The average carotid total plaque area was significantly increased with CHADS2 scores > or = 2 (4.97 +/- 7.17 mm2 vs. 15.52 +/- 14.61 mm2; p = 0.002). Eight patients experienced cardiovascular or cerebrovascular (CCV) events during a mean evaluation period of 662 days. A CHADS2 score > or = 3 was related to an increase in the risk of CCV events (hazard ratio, 14.31; 95% confidence interval, 3.53 to 58.06). Furthermore, LAVi and the severity of coronary artery obstructive disease were also associated with an increased risk of CCV events. CONCLUSIONS: The CHADS2 score may be a useful prognostic tool for predicting CCV events in ACS patients with documented coronary artery disease.
Acute Coronary Syndrome/complications/*diagnostic imaging ; Aged ; Carotid Arteries/*diagnostic imaging ; Carotid Artery Diseases/complications/*diagnostic imaging ; Cerebrovascular Disorders/diagnosis/*etiology ; *Coronary Angiography ; Coronary Artery Disease/complications/*diagnostic imaging ; *Decision Support Techniques ; *Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic ; Predictive Value of Tests ; Prognosis ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Time Factors

INTRODUCTIONThe aim of the study was to evaluate cerebral microangiopathy in type 2 noninsulin- dependent diabetes mellitus (NIDDM) patients and to establish potentially conducive factors.

MATERIALS AND METHODSA group of 34 patients with NIDDM and 31 gender- and agematched normal controls (NC) were assessed by extracranial Doppler ultrasound, in order to evaluate the pulsatility index (PI) and the resistance index (RI) in the internal carotid arteries (ICAs); transcranial Doppler was utilised to assess the same parameters in the middle cerebral arteries (MCAs). All patients underwent screening for favouring factors for cerebral vascular remodelling.

RESULTSOf the 34 NIDDM patients, 21 patients (61.76%) (subgroup A) presented with microangiopathic complications [of these, 19 patients (90.46%) had diabetic nephropathy (DN)] versus 13 NIDDM patients (38.24%) (subgroup B) without complications. In subgroup A, 16 patients (76.19%) had PI >1 and RI >0.7 in the ICAs and MCAs (changes consistent with cerebral microangiopathy) versus 5 patients (35.46%) in subgroup B, and no modifications in NC. Of the 19 patients with DN, 14 patients (73.68 %) had impaired haemodynamic indices. Univariate regression analysis showed the following risk factors for the cerebral haemodynamics changes: fibrinogen (F) (OR = 3.11), C-reactive protein (CRP) (OR = 2.40), duration of DM (OR = 2.40), proteinuria (OR = 1.80), serum creatinine (OR = 1.66). Multivariate regression analysis showed as predictors for impaired haemodynamic indices: duration of DM (HR =1.70), proteinuria (HR = 1.70). The haemodynamic indices in the ICAs correlated with duration of DM (r = 0.87, P <0.0001), F (r = 0.86; P <0.0001), CRP (r = 0.80; P <0.0001); in the MCAs with the duration of DM (r = 0.66, P <0.0001), F (r = 0.38; P <0.0001), CRP (r = 0.88; P <0.0001).

CONCLUSIONCerebral microangiopathy has a high prevalence in NIDDM patients. These cerebral vascular changes correlate with the duration of DM, parameters of inflammation, and proteinuria.

Carotid Artery Diseases ; diagnostic imaging ; epidemiology ; etiology ; Carotid Artery, Internal ; diagnostic imaging ; pathology ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; Diabetic Angiopathies ; diagnostic imaging ; epidemiology ; etiology ; Female ; Humans ; Inflammation ; Male ; Middle Aged ; Prevalence ; Prognosis ; Risk Assessment ; Risk Factors ; Romania ; Time Factors ; Ultrasonography, Doppler, Pulsed

OBJECTIVETo study the relationship between carotid atherosclerosis and cerebral infarction (CI).

METHODSBetween November 2008 and March 2009, 147 CI patients (CI group) and 48 patients with non-cerebrovascular diseases (control group) were enrolled from inpatients of Neurology Department of our hospital. The diagnostic criterion of thickened carotid intima was set as 1.0 mmcarotid plaque was as IMT 1.5 mm. Carotid atherosclerosis was divided into three levels: normal intima, thickened intima, and plaque formation. The color Doppler ultrasonography data of carotid arteries in all patients were analyzed and the severity of carotid atherosclerosis was compared between the two groups.

RESULTSIn the CI group, 36 (24.5%) patients had normal carotid intima, 22 (15.0%) had thickened carotid intima, and 89 (60.5%) had carotid plaque. In the control group, 22 (45.8%) patients had normal carotid intima, 4 (8.3%) had thickened carotid intima, and 22 (45.8%) had carotid plaque. The severity of carotid atherosclerosis in the CI group was higher than that in the control group (P = 0.022). There was significant difference in the constitution of carotid plaque between the two groups (P = 0.001); the CI group mainly had the soft plaque (55/89, 61.8%), whereas the control group mainly had the hard plaque (17/22, 77.3%). The first three common locations of carotid plaque in both groups were carotid bifurcation (CI group: 73.7%; control group: 64.1%), common carotid artery (CI group: 20.4%; control group: 25.6%), and internal carotid artery (CI group: 5.9%; control group: 10.3%). The location of carotid plaque between the two groups was not significantly different (P = 0.438). There was no difference in the carotid inner diameter or resistance index between the two groups (P > 0.05).

CONCLUSIONSCarotid atherosclerosis is to some extent able to reveal the atherosclerotic condition of cerebral arteries and act as an important predictor for the risk of CI. The color Doppler ultrasonography of carotid arteries can provide a convenient way for the prevention and treatment of CI.

Adult ; Aged ; Aged, 80 and over ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Artery Diseases ; complications ; epidemiology ; pathology ; Cerebral Infarction ; epidemiology ; etiology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Ultrasonography, Doppler, Color

Aged ; Body Mass Index ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Artery Diseases ; diagnosis ; epidemiology ; etiology ; Cholesterol, HDL ; blood ; Fatty Liver ; complications ; diagnosis ; epidemiology ; Female ; Humans ; Insulin Resistance ; Intercellular Signaling Peptides and Proteins ; blood ; Male ; Metabolic Syndrome ; complications ; Middle Aged ; Obesity ; complications ; Risk Factors ; Triglycerides ; blood ; Tunica Intima ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo observe the effect of Wendan Xiezhuo method (WXM) on carotid arteriosclerosis and vascular endothelial diastolic function in essential hypertension (EH) patients with turbid-phlegm syndrome (TPS).

METHODSForty-three EH patients of medium and low risk with TPS were randomly assigned to two groups, the Wendan Tablet (WT) group (23 cases) and the placebo group (20 cases), they were treated with WT and placebo respectively on the base of amlodipine treatment to control the blood pressure. Carotid intimamedia thickness (IMT), atherosclerotic plaque score of carotid artery, endothelium-dependent dilation (EDD) and flow-mediated vasodilation (FMD) of brachial artery after taking nitroglycerin were detected with ultrasonography before and after 6 months of treatment.

RESULTSAs compared with those in the placebo group, in the WT group after treatment, scores of TPS and carotid plaque were better, area of carotid plaque was lesser and IMT was lower significantly (P<0.05 or P<0.01). There was a negative correlation between brachial artery EDD and carotid IMT in EH patients with TPS (r = - 0.596, P < 0.05). After treatment EDD was improved more significantly in the WT group than that in the placebo group, however, no significant difference was found in non-endothelium-dependent dilation between the two groups.

CONCLUSIONA negative correlation exists between brachial artery EDD and carotid IMT, and the latter could be aggravated by TPS in EH patients. WXM shows favorable effects in improving carotid plaque and EDD.

Aged ; Atherosclerosis ; complications ; pathology ; physiopathology ; Carotid Arteries ; diagnostic imaging ; drug effects ; physiopathology ; Carotid Artery Diseases ; complications ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; pathology ; physiopathology ; Female ; Humans ; Hypertension ; complications ; drug therapy ; pathology ; Male ; Middle Aged ; Phytotherapy ; Syndrome ; Treatment Outcome ; Ultrasonography

OBJECTIVETo investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).

METHODSSeventy-nine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally.

RESULTSBy the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P < 0.05).

CONCLUSIONGarlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.

Aged ; Allyl Compounds ; administration & dosage ; Antihypertensive Agents ; administration & dosage ; Blood Pressure ; drug effects ; C-Reactive Protein ; metabolism ; Carotid Artery Diseases ; complications ; diagnostic imaging ; drug therapy ; Coronary Artery Disease ; complications ; drug therapy ; Disulfides ; administration & dosage ; Female ; Fosinopril ; administration & dosage ; Humans ; Hypertension ; complications ; drug therapy ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Middle Aged ; Ultrasonography