Detection of carotid stenosis. From NASCET results to clinical practice.


BACKGROUND AND PURPOSE:Results from large multicenter studies have shown that carotid endarterectomy, performed with low perioperative morbidity and mortality, is beneficial for patients with symptomatic carotid stenosis > or = 70% as calculated according to strict angiographic criteria. To apply these results in clinical practice, individual institutions should determine whether locally implemented duplex ultrasonography adequately identifies patients with > or = 70% stenosis and whether the degree of stenosis reported by local angiographers correlates with strict angiographic measurements. METHODS:We compared estimates of carotid stenosis obtained by duplex ultrasonography and the radiologists' reports from conventional cerebral angiography with each other and with results obtained using North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. RESULTS:One hundred seventy-one vessels were available for review. In 155 (91%) of the cases, the reports from the ultrasound and angiogram were in agreement with regard to whether the stenosis was > or = 70% or < 70%. In 11 of the 16 cases where there was a disparity between the studies, the ultrasound was in closer agreement with measurements obtained using NASCET criteria. Nine of the angiography reports overestimated the degree of stenosis compared with NASCET measurements; twice angiography underestimated the stenosis. Twice the ultrasound underestimated the stenosis, and three times it overestimated the stenosis. CONCLUSIONS:Duplex ultrasonography was highly sensitive for detecting significant carotid stenosis at our institution; however, angiography reports often graded the degree of stenosis to be more severe than measurements obtained using NASCET criteria. Institutions that evaluate patients for carotid endarterectomy should investigate the correlation between their ultrasound and angiographic studies so that the results of carotid endarterectomy trials can be accurately applied.






Chang YJ,Golby AJ,Albers GW




Has Abstract


1995-08-01 00:00:00














  • Targeted Infarction of the Internal Capsule in the Rat Using Microstimulation Guidance.

    abstract::Background and Purpose- Lacunar strokes are subcortical infarcts with small size and high disability rates, largely due to injury of the corticospinal tract in the internal capsule (IC). Current rodent models of lacunar infarcts are created based on stereotactic coordinates. We tested the hypothesis that better unders...


    pub_type: 杂志文章


    authors: Wen TC,Sindhurakar A,Ramirez VC,Park H,Gupta D,Carmel JB

    更新日期:2019-09-01 00:00:00

  • Midazolam challenge reinduces neurological deficits after transient ischemic attack.

    abstract:BACKGROUND AND PURPOSE:A transient ischemic attack (TIA) in the brain is classically considered a syndrome lasting <24 hours. Having previously shown that an experimental challenge with the GABAA agonist midazolam in recovered stroke patients can reinduce the acute clinical state, we determined whether TIA patients wou...


    pub_type: 临床试验,杂志文章


    authors: Lazar RM,Fitzsimmons BF,Marshall RS,Mohr JP,Berman MF

    更新日期:2003-03-01 00:00:00

  • Ultrasonic Doppler assessment of hemodynamics in gradual carotid ligation.

    abstract::Hemodynamic changes were examined with an ultrasonic Doppler flowmeter and with a sound-spectrograph in 5 patients with internal carotid giant aneurysms or with recurrent laryngeal cancer undergoing gradual carotid occlusion. The ultrasonic Doppler technique was useful for preoperative assessment of intracranial cross...


    pub_type: 杂志文章


    authors: Moritake K,Handa H,Yonekawa Y,Takebe Y,Kishimoto S,Makimoto K

    更新日期:1981-03-01 00:00:00

  • Analysis of endoglin expression in normal brain tissue and in cerebral arteriovenous malformations.

    abstract:BACKGROUND AND PURPOSE:A high incidence of arteriovenous malformations (AVMs) is associated with hereditary hemorrhagic telangiectasia type 1. Endoglin, the gene mutated in this disorder, is expressed at reduced levels on blood vessels of these patients. Since endoglin is a component of the transforming growth factor-b...


    pub_type: 杂志文章


    authors: Matsubara S,Bourdeau A,terBrugge KG,Wallace C,Letarte M

    更新日期:2000-11-01 00:00:00

  • Carotid arterial remodeling: a maladaptive phenomenon in type 2 diabetes but not in impaired glucose metabolism: the Hoorn study.

    abstract:BACKGROUND AND PURPOSE:Deteriorating glucose tolerance is associated with an increased cardiovascular disease (CVD) risk. The underlying mechanisms remain unclear. Arterial remodeling is the change in structural properties through time in response to atherogenic and/or hemodynamic alterations and aims to maintain circu...


    pub_type: 杂志文章


    authors: Henry RM,Kostense PJ,Dekker JM,Nijpels G,Heine RJ,Kamp O,Bouter LM,Stehouwer CD

    更新日期:2004-03-01 00:00:00

  • Watershed infarcts in transient ischemic attack/minor stroke with > or = 50% carotid stenosis: hemodynamic or embolic?

    abstract:BACKGROUND AND PURPOSE:Watershed ischemia is a significant cause of stroke in severe carotid disease, but its pathophysiology is unsettled. Although hemodynamic compromise has long been regarded as the main mechanism-particularly with deep watershed infarction-there is some contradictory evidence from clinical and path...


    pub_type: 杂志文章


    authors: Moustafa RR,Izquierdo-Garcia D,Jones PS,Graves MJ,Fryer TD,Gillard JH,Warburton EA,Baron JC

    更新日期:2010-07-01 00:00:00

  • Neurovascular compression at the ventrolateral medulla in autosomal dominant hypertension and brachydactyly.

    abstract:BACKGROUND AND PURPOSE:Autosomal dominant hypertension with brachydactyly features severe hypertension that causes stroke usually before the age of 50 years. We recently characterized the hypertension as featuring normal renin, aldosterone, and catecholamine responses and mapped the gene responsible to chromosome 12p. ...


    pub_type: 杂志文章


    authors: Naraghi R,Schuster H,Toka HR,Bähring S,Toka O,Oztekin O,Bilginturan N,Knoblauch H,Wienker TF,Busjahn A,Haller H,Fahlbusch R,Luft FC

    更新日期:1997-09-01 00:00:00

  • Prognostic value and determinants of first-day mean arterial pressure in spontaneous supratentorial intracerebral hemorrhage.

    abstract:BACKGROUND AND PURPOSE:The onset of spontaneous intracerebral hemorrhage (ICH) is often accompanied by transient blood pressure (BP) elevation. The prognostic value and the determinants of this BP reaction have not entirely been solved, and the present study was focused on these questions. METHODS:From 1985 to 1991 in...


    pub_type: 杂志文章


    authors: Fogelholm R,Avikainen S,Murros K

    更新日期:1997-07-01 00:00:00

  • Abnormal responses of the human cerebral microcirculation to papaverin during aneurysm surgery.

    abstract:BACKGROUND AND PURPOSE:The role of the cerebral microcirculation in delayed ischemia after subarachnoid hemorrhage remains obscure. To test the hypothesis that cerebral arterioles have a reduced capacity to dilate after subarachnoid hemorrhage, we studied the microvascular responses to papaverine (PPV) in patients unde...


    pub_type: 信件


    authors: Pennings FA,Albrecht KW,Muizelaar JP,Schuurman PR,Bouma GJ

    更新日期:2009-01-01 00:00:00

  • Cyclosporine A reduces cerebral vasospasm after subarachnoid hemorrhage in dogs.

    abstract::The double subarachnoid hemorrhage canine model was used to test the prophylactic value of immunosuppression in the prevention of cerebral vasospasm after subarachnoid hemorrhage. Dogs treated with cyclosporine A following the regimen prescribed for organ transplant procedures in patients showed a significant reductio...


    pub_type: 杂志文章


    authors: Peterson JW,Nishizawa S,Hackett JD,Bun T,Teramura A,Zervas NT

    更新日期:1990-01-01 00:00:00

  • Prestroke Disability Predicts Adverse Poststroke Outcome: A Registry-Based Prospective Cohort Study of Acute Stroke.

    abstract::Background and Purpose- Information on what effect disability before stroke can have on stroke outcome is lacking. We assessed prestroke disability in relation to poststroke hospital outcome. Methods- Analysis of prospectively collected data from the Sentinel Stroke National Audit Programme. A total of 1656 men (mean ...


    pub_type: 杂志文章


    authors: Han TS,Fry CH,Gulli G,Affley B,Robin J,Irvin-Sellers M,Fluck D,Kakar P,Sharma S,Sharma P

    更新日期:2020-02-01 00:00:00

  • Methionine sulfoximine reduces cortical infarct size in rats after middle cerebral artery occlusion.

    abstract::The methionine analogue methionine sulfoximine was administered to 10 rats 24 hours before occlusion of the proximal left middle cerebral artery. Three days later the rats were decapitated and the brain infarct volumes were compared with those in 10 control rats that received saline before middle cerebral artery occlu...


    pub_type: 杂志文章


    authors: Swanson RA,Shiraishi K,Morton MT,Sharp FR

    更新日期:1990-02-01 00:00:00

  • Stroke and stroke care in China: huge burden, significant workload, and a national priority.

    abstract::At the same time as the world recognizes the rapid economic development in China, Chinese healthcare system has also had significant improvement. However, this nation of 1.4 billion faces tough challenges in treating stroke, the leading cause of death in China. The recently completed Chinese National Stroke Registry h...


    pub_type: 杂志文章,评审


    authors: Liu L,Wang D,Wong KS,Wang Y

    更新日期:2011-12-01 00:00:00

  • Differential changes in alpha- and beta-adrenoceptors in the cerebral cortex and hippocampus of the Mongolian gerbil after unilateral brain ischemia.

    abstract:BACKGROUND AND PURPOSE:Changes in adrenoceptors in the cerebral cortex and hippocampus of Mongolian gerbils after brain ischemia were investigated. METHODS:Twenty-four hours after unilateral occlusion of the common carotid artery, alpha 1-, alpha 2-, and beta-receptors of the membrane fraction of the cerebral cortex o...


    pub_type: 杂志文章


    authors: Mizuki T,Kobayashi H,Ueno S,Nakashima Y,Kuroiwa A,Izumi F

    更新日期:1995-12-01 00:00:00

  • Which time-to-peak threshold best identifies penumbral flow? A comparison of perfusion-weighted magnetic resonance imaging and positron emission tomography in acute ischemic stroke.

    abstract:BACKGROUND AND PURPOSE:In acute ischemic stroke, the hypoperfused but viable tissue is the main therapeutic target. In clinical routine, time-to-peak (TTP) maps are frequently used to estimate the hemodynamic compromise and to calculate the mismatch volume. We evaluated the accuracy of TTP maps to identify penumbral fl...


    pub_type: 杂志文章


    authors: Sobesky J,Zaro Weber O,Lehnhardt FG,Hesselmann V,Thiel A,Dohmen C,Jacobs A,Neveling M,Heiss WD

    更新日期:2004-12-01 00:00:00

  • Proportional Motor Recovery After Stroke: Implications for Trial Design.

    abstract:BACKGROUND AND PURPOSE:Recovery of upper-limb motor impairment after first-ever ischemic stroke is proportional to the degree of initial impairment in patients with a functional corticospinal tract (CST). This study aimed to investigate whether proportional recovery occurs in a more clinically relevant sample including...


    pub_type: 杂志文章


    authors: Stinear CM,Byblow WD,Ackerley SJ,Smith MC,Borges VM,Barber PA

    更新日期:2017-03-01 00:00:00

  • Emboli formation rather than inflammatory mediators are responsible for increased cerebral water content after conventional and assisted beating-heart myocardial revascularization in a porcine model.

    abstract:BACKGROUND AND PURPOSE:Emboli and proinflammatory mediators are suspected of generating cerebral edema after coronary surgery. In contrast to cardiopulmonary bypass (CPB), off-pump coronary artery bypass surgery (OPCAB) reduces microemboli count and proinflammatory mediator release but carries the risk of hemodynamic i...


    pub_type: 杂志文章


    authors: Bierbach B,Meier M,Kasper-König W,Heimann A,Alessandri B,Horstick G,Oelert H,Kempski O

    更新日期:2008-01-01 00:00:00

  • Ischemia in broca area is associated with broca aphasia more reliably in acute than in chronic stroke.

    abstract:BACKGROUND AND PURPOSE:We aimed to determine if ischemia involving Broca area predicts Broca aphasia more reliably in acute or chronic stroke. METHODS:We included consecutive right-hand-dominant patients with left hemisphere ischemic stroke (<48 hours from onset for acute stroke or >6 months after stroke for chronic s...


    pub_type: 杂志文章


    authors: Ochfeld E,Newhart M,Molitoris J,Leigh R,Cloutman L,Davis C,Crinion J,Hillis AE

    更新日期:2010-02-01 00:00:00

  • Dietary vitamin E levels affect outcome of permanent focal cerebral ischemia in rats.

    abstract:BACKGROUND AND PURPOSE:A supraphysiological amount of vitamin E in the standard diet of laboratory animals may provide partial protection against cerebral ischemic damage in stroke models. The aim of the present study was to test the effect of dietary vitamin E on infarct volume in rats subjected to permanent focal cer...


    pub_type: 杂志文章


    authors: van der Worp HB,Bär PR,Kappelle LJ,de Wildt DJ

    更新日期:1998-05-01 00:00:00

  • Regional cerebral blood flow decreases during chronic and acute hyperglycemia.

    abstract::The presence of hyperglycemia prior to stroke or cardiac arrest can increase neuronal damage caused by brain ischemia. Acute hyperglycemia shows this effect in animal models of stroke. However, chronic hyperglycemia and chronic hyperglycemia with additional acute elevation of blood glucose are more common premorbid st...


    pub_type: 杂志文章


    authors: Duckrow RB,Beard DC,Brennan RW

    更新日期:1987-01-01 00:00:00

  • Effects of some guanidino compounds on human cerebral arteries.

    abstract:BACKGROUND AND PURPOSE:Accumulation of endogenous guanidino-substituted analogues of L-arginine in chronic renal failure might contribute to some of the vascular and neurological disorders of this pathology. We tested the hypothesis that in human cerebral arteries, some guanidino compounds may increase vascular tone, t...


    pub_type: 临床试验,杂志文章


    authors: Segarra G,Medina P,Ballester RM,Lluch P,Aldasoro M,Vila JM,Lluch S,Pelligrino DA

    更新日期:1999-10-01 00:00:00

  • Prospective study of major and minor ST-T abnormalities and risk of stroke among Japanese.

    abstract:BACKGROUND AND PURPOSE:The association between minor ST-T abnormalities and stroke incidence has not been well elucidated. We sought to examine the relationship between nonspecific minor or major ST-T abnormalities and the incidence of stroke among Japanese men and women. METHODS:A 15.4-year prospective study was cond...


    pub_type: 杂志文章


    authors: Ohira T,Iso H,Imano H,Kitamura A,Sato S,Nakagawa Y,Naito Y,Sankai T,Tanigawa T,Yamagishi K,Iida M,Shimamoto T

    更新日期:2003-12-01 00:00:00

  • Thrombolysis in stroke mimics: frequency, clinical characteristics, and outcome.

    abstract:BACKGROUND AND PURPOSE:Intravenous thrombolysis for acute ischemic stroke is usually based on clinical assessment, blood test results, and CT findings. Intravenous thrombolysis of stroke mimics may occur but has not been studied in detail. METHODS:We determined frequency, clinical characteristics, and outcome of mimic...


    pub_type: 杂志文章


    authors: Winkler DT,Fluri F,Fuhr P,Wetzel SG,Lyrer PA,Ruegg S,Engelter ST

    更新日期:2009-04-01 00:00:00

  • Transient aortic arch syndrome with dysphasia due to ergotism.

    abstract::A 55-year-old woman with an aortic arch syndrome of acute onset and dysphasia, resulting from the excessive administration of ergotamine tartrate suppositories, is described. Complete resolution of symptoms and return of upper limb and carotid artery pulses to normal occurred within four days of cessation of the ergot...


    pub_type: 杂志文章


    authors: Feneley MP,Morgan JJ,McGrath MA,Egan JD

    更新日期:1983-09-01 00:00:00

  • Identification of variations in blood-brain barrier opening after cerebral ischemia by dual contrast-enhanced magnetic resonance imaging and T 1sat measurements.

    abstract:BACKGROUND AND PURPOSE:Variations in blood-brain barrier (BBB) opening after ischemia have been suggested by some tracer and magnetization transfer studies, although direct in vivo proof is still lacking. Contrast-enhanced magnetic resonance imaging (MRI) is also often used to visualize BBB damage in stroke. We hypothe...


    pub_type: 杂志文章


    authors: Nagaraja TN,Karki K,Ewing JR,Croxen RL,Knight RA

    更新日期:2008-02-01 00:00:00

  • Eliciting information on differential sensation of heat in those with and without poststroke aphasia using a visual analogue scale.

    abstract:BACKGROUND AND PURPOSE:Aphasia can result in an inability to communicate the presence, location, or intensity of pain. Although visual analogue scales (VASs) exist, it is unknown whether they are useful in assessing pain in individuals with aphasia. The objective was to determine whether those with poststroke aphasia c...


    pub_type: 杂志文章


    authors: Korner-Bitensky N,Kehayia E,Tremblay N,Mazer B,Singer F,Tarasuk J

    更新日期:2006-02-01 00:00:00

  • Monitoring after the acute stage of stroke: a prospective study.

    abstract:BACKGROUND AND PURPOSE:In the early stage of stroke, the occurrence of neurologic and medical complications is associated with clinical deterioration. Previous studies were focused on the first week after stroke onset. The aim of this study was to evaluate the impact of complications on clinical outcome in patients wit...


    pub_type: 杂志文章


    authors: Rocco A,Pasquini M,Cecconi E,Sirimarco G,Ricciardi MC,Vicenzini E,Altieri M,Di Piero V,Lenzi GL

    更新日期:2007-04-01 00:00:00

  • Retinal microvascular signs may provide clues to the underlying vasculopathy in patients with deep intracerebral hemorrhage.

    abstract:BACKGROUND AND PURPOSE:Deep intracerebral hemorrhage (ICH) and lacunar infarcts are the result of small vessel disease, whereas nonlacunar infarcts are often caused by large artery atherosclerosis or cardiac embolism. We hypothesized that patients with deep ICH and lacunar infarcts have similar retinal microvascular si...


    pub_type: 杂志文章,多中心研究


    authors: Baker ML,Hand PJ,Liew G,Wong TY,Rochtchina E,Mitchell P,Lindley RI,Hankey GJ,Wang JJ,Multi-Centre Retinal Stroke Study Group.

    更新日期:2010-04-01 00:00:00

  • Epileptic seizures in cerebral arterial occlusive disease.

    abstract::The occurrence of epileptic seizures was investigated in 141 patients with angiographically proven carotid or MCA occlusive disease. Epileptic seizures occurred some time during the clinical course of the disease in 17.3% of carotid patients and in 10.8% of MCA patients, being mainly represented by partial motor seizu...


    pub_type: 杂志文章


    authors: Cocito L,Favale E,Reni L

    更新日期:1982-03-01 00:00:00

  • Blockade of ATP-sensitive potassium channels in cerebral arterioles inhibits vasoconstriction from hypocapnic alkalosis in cats.

    abstract:BACKGROUND AND PURPOSE:Recent studies have shown that the cerebral arteriolar dilation from hypercapnic acidosis is blocked by agents which inhibit KATP channels. These findings suggested that this response is due to opening of KATP channels. Because the repose to CO2 is a continuum, with hypercapnic acidosis causing v...


    pub_type: 杂志文章


    authors: Wei EP,Kontos HA

    更新日期:1999-04-01 00:00:00