• Title/Summary/Keyword: Carotid atherosclerosis

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The role of carotid screening by duplex sonography in patients with coronary artery disease (관동맥 우회술 환자에서의 경동맥 협착을 진단하기 위한 Duplex sono 선별검사의 의의)

  • Chung, Cheol-Hyun;Chae, Hurn;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.833-837
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    • 1993
  • In an effort to reduce the stroke rate of patients after coronary artery bypass, many authors have studied the prevalence of the extracranial carotid disease and its role in determining neurologic morbidity and mortality rates. From April 1992 to August 1993, Seventy-five patients undergoing coronary artery bypass were preoperatively evaluated for presence of carotid and femoral stenosis by Duplex sono. Among them, fourteen patients was positive by Duplex sono and overall prevalence of carotid or femoral stenosis was 18.7%. And significant carotid stenosis [ > 60% ] had proved to be in 3 patients [ 4.0% ].Prophylatic bilateral carotid endarterectomy was performed in one patient, at 5 months prior to and , 1 week prior to coronary artery bypass respectively. Their mean age was 57.6 years [ ranged from 40 to 70 years] and were composed of 10 males and 4 females. There was no postoperative morbidiry and mortality related to neurologic complications. Our data, although small, suggest that preoperative carotid screening is helpful to determine patients at high risk of stroke, and significant simultaneous carotid and coronary atherosclerosis should be corrected in selected patients by staged operations when feasible.

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Elastic Motion of the Blood Vessel and Wall Shear Stress in Carotid Artery with Stenosis (협착된 경동맥 내의 벽전단응력 및 혈관의 탄성적 거동)

  • Kim Chang Nyung;Oh Taek Yeol;Choi Myung Jin;Jung Sam Doo
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.9 s.174
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    • pp.179-187
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    • 2005
  • The characteristics of blood flow and the interaction between the blood vessel and blood flow play important roles in plaque cap rupture and the growth of atherosclerosis which may lead directly to a heart attack or a stroke. In this study, carotid arteries with different stenoses have been numerically simulated to investigate the wall shear stress(WSS) and the elastic motion of the vessel. Blood flow has been treated as physiological, laminar and incompressible flow. To model the shear thining behavior of the blood, the Carreau-Yasuda model has been employed but the viscoelasticity of blood has not been considered. The results show that the WSS of $severe(75\%)$ stenosis is much higher than those of $25\%\;and\;50\%$ stenosis in the region of stenosis. With the increase in the stenosis thickness, the expansion ratio of the center of the stenosis decreases while the expansion ratio of the upstream region of the stenosis increases.

Relationship between tooth loss and carotid intima-media thickness in Korean adults

  • Chin, Ui-Jung;Ji, Suk;Lee, Su-Young;Ryu, Jae-Jun;Lee, Jung-Bok;Shin, Chol;Shin, Sang-Wan
    • The Journal of Advanced Prosthodontics
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    • v.2 no.4
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    • pp.122-127
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    • 2010
  • PURPOSE. The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS. The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS. With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION. This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.

Significance of Hemodynamic Effects on the Generation of Atherosclerosis

  • Suh Sang-Ho;Roh Hyung-Woon;Kim Dong-Joo;Kwon Hyuck-Moon;Lee Byoung-Kwon
    • Journal of Mechanical Science and Technology
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    • v.19 no.3
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    • pp.836-845
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    • 2005
  • Atherosclerosis, which is a degenerative vascular disease, is believed to occur in the blood vessels due to deposition of cholesterol or low density lipoprotein (LDL). Atherosclerotic lumen narrowing causes reduction of blood flow due to hemodynamic features. Several hypothetical theories related to the hemodynamic effects have been reported : high shear stress theory, low shear stress theory, high shear stress gradient theory, flow separation and turbulence theory, and high pressure theory. However, no one theory clearly explains, the causes of atherosclerosis. The objective of the present study was to investigate the mechanism of the generation of atherosclerosis. In the study, the database of Korean carotid and coronary arteries for geometrical and hemodynamic clinical data was established. The atherosclerotic sites were predicted by the computer simulations. The results of the computer simulation were compared with the in vivo experimental results, and then the pathogenesis of atherosclerosis by using the clinical data and several hypothetical theories were investigated. From the investigation, it was concluded carefully that the mechanism of the generation of atherosclerosis was related to the hemodynamic effects such as flow separation and oscillatory wall shear stress on the vessel walls.

A Case Report of a Tremor Patient with Stenosis of the Left Carotid Artery (머리 떨림 환자에 대한 한방 치험 1례)

  • Park, Seo-hee
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.1096-1100
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    • 2017
  • The carotid artery is one of the main vessels supplying blood to the brain. Carotid artery stenosis is mostly caused by atherosclerosis, a disease where cholesterol is deposited in the arterial blood vessels. Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many diseases, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy, and alcohol withdrawal. Tremors may be classified as postural, rest, and action tremors. Tremor of a patient with stenosis of the left carotid artery decreased with acupuncture treatment. The acupoints were GB20, TE17, GV8 and GV11. This case shows that the acupuncture treatment is effective against tremor.

Association of Carotid Intraplaque Hemorrhage and Territorial Acute Infarction in Patients with Acute Neurological Symptoms Using Carotid Magnetization-Prepared Rapid Acquisition with Gradient-Echo

  • Park, Jung Soo;Kwak, Hyo Sung;Lee, Jong Myong;Koh, Eun Jeong;Chung, Gyung Ho;Hwang, Seung Bae
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.94-99
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    • 2015
  • Objective : The purpose of our study was to assess prevalence of carotid intraplaque hemorrhage (IPH) and associations between territorial acute infarction and IPH on magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) in patients with acute neurologic symptoms. Methods : 83 patients with suspected acute neurologic symptoms were evaluated with both brain diffusion weighted imaging (DWI) and carotid MPRAGE sequences. Carotid plaque with high signal intensity on MPRAGE of >200% that of adjacent muscle was categorized as IPH. We analyzed the prevalence of IPH and its correlation with territorial acute infarction. Results : Of 166 arteries, 39 had a carotid artery plaque. Of these arteries, 26 had carotid artery stenosis less than 50%. In all carotid arteries, MR-depicted IPH was found in 7.2% (12/166). High-signal intensity on DWI was found in 17.5% (29/166). Combined lesion with ipsilateral high-signal intensity on DWI and IPH on carotid MPRAGE sequence was found in 6 lesions (6/166, 3.6%). Of patients with carotid artery plaque, MR-predicted IPH was found in 30.8% (12/39) and match lesions with high-signal intensity on DWI and MPRAGE was found in 15.4% (6/39). MR-predicted IPH was significantly higher prevalence in high-grade stenosis group (p=0.010). Relative risk between carotid MPRAGE-positive signal and ipsilateral high-signal intensity on DWI in arteries with carotid artery plaques was 6.8 (p=0.010). Conclusion : Carotid MPRAGE-positive signal in patients was associated with an increased risk of territorial acute infarction as detected objectively by brain DWI. The relative risk of stroke was increased in high-grade stenosis categories.

Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

  • Choi, Hoon Sik;Jeong, Bae Kwon;Jeong, Hojin;Song, Jin Ho;Kim, Jin Pyeong;Park, Jung Je;Woo, Seung Hoon;Kang, Ki Mun
    • Radiation Oncology Journal
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    • v.34 no.1
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    • pp.26-33
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    • 2016
  • Purpose: To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Materials and Methods: Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Results: Recurrence was not observed in any patients during the follow-up period. $V_{95%}$ for PTV showed no significant difference between IMRT and LAFT plans, while $V_{100%}$ was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median $V_{5Gy}$ (90.0%), $V_{25Gy}$ (13.5%), and $V_{50Gy}$ (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Conclusion: Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

The Comparison of Carotid Artery Intima-media Thickness and Plaque Characteristics between Patients with ST-elevation Myocardial Infarction and Coronary Artery Chronic Total Occlusion

  • Choi, Sun Young;Park, Jong Sung
    • Biomedical Science Letters
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    • v.21 no.4
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    • pp.198-207
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    • 2015
  • ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) of coronary artery are well-known atherosclerotic vascular diseases. However, the difference of intima-media thickness and plaque characteristics of carotid arteries between STEMI and CTO patients were not directly compared in previous studies. Medical records of a total of 158 (101 STEMI, 57 CTO) patients, who underwent carotid artery ultrasonography, were selected for the analysis. The baseline characteristics, ultrasonography findings, and clinical outcomes of the two groups were compared. The prevalence of hypertension, diabetes mellitus, and dyslipidemia was significantly higher in CTO patients. Carotid intima-media thickness ($0.97{\pm}0.13$ vs. $0.78{\pm}0.17cm$, P < 0.0001) and number of plaques ($2.2{\pm}1.0$ vs. $1.7{\pm}1.2$, P < 0.0001) were greater in CTO than STEMI patients. Multiple (${\geq}3$) or echogenic plaques were more frequently observed in CTO patients. During the median follow-up duration of 27 months, major adverse cardiovascular events occurred in 31% of CTO and 14% of STEMI patients (P = 0.008). We found that, compared with STEMI, CTO patients have higher burden of carotid artery atherosclerosis associated with more comorbid diseases and poor clinical outcomes.

C-reactive Protein and Carotid Intima-media Thickness in a Population of Middle-aged Koreans (일부 농촌 지역 성인에서 C-reactive protein농도와 경동맥 내중막 두께)

  • Suh, Min-A;Lee, Joo-Young;Ahn, Song-Vogue;Kim, Hyeon-Chang;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.1
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    • pp.29-34
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    • 2009
  • Objectives : This study was performed to evaluate the relationship between C-reactive protein(CRP) and carotid intima-media thickness(carotid IMT) in a population of middle-aged Koreans. Methods : A total of 1,054 men and 1,595 women(aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause(women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. Results : Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women(p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men(p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women(p for trend=0.017), but not in men(p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55(95% CI=1.06-2.26) in women, but only 1.05(95% CI=0.69-1.62) in men. Conclusions : CRP and carotid IMT levels appear to be directly related in women, but not in men.

SE-LSTMNet Model Using Polar Conversion for Diagnosis of Atherosclerosis (죽상동맥경화증 진단을 위한 극좌표 변환과 SE-LSTMNet 모델)

  • Na, In-ye;Park, Hyunjin
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.294-296
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    • 2022
  • Atherosclerosis is a chronic vascular inflammatory disease in which plaque builds up in the arteries and impairs blood flow. This can lead to heart disease and stroke. Since most people do not have any symptoms until the artery is severely narrowed, early detection of atherosclerosis is critical. In this paper, in order to effectively detect atherosclerotic lesions in tube-shaped blood vessels, polar conversion is applied to MRI images based on the vessel center. We then propose a SE-LSTMNet model using continuous signal information for each angle of a polar coordinate image. The trained model showed classification performance of 0.9194 accuracy, 0.9370 sensitivity, 0.8796 specificity, 0.8700 F1 score, and 0.9719 AUC on the validation data.

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