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Carotid atherosclerotic disease: pathologic basis for by Giuseppe Sangiorgi, David R. Holmes, Kenneth Rosenfield, L.

By Giuseppe Sangiorgi, David R. Holmes, Kenneth Rosenfield, L. Nelson Hopkins, Luigi Spagnoli

Carotid Atherosclerotic affliction: Pathologic foundation for therapy studies the traditional historical past of carotid atherosclerotic plaque and descriptions diverse pathologic features of asymptomatic and symptomatic carotid plaque with the motive to provide a pathology-based purpose for overview, probability stratification and decision-making healing technique of sufferers plagued by carotid affliction. one other part additional illustrates - in a facts established drugs layout - the effect of carotid plaque imaging from high-resolution MRI to new Doppler imaging modalities and vasa vasorum detection to properly determine plaque threat stratification. the recent proposal of a adapted stent for various plaque morphologies and utilization of committed cerebral defense units in presence of specific plaque gains can be pointed up. The concluding part sheds gentle on destiny development in gene treatment and carotid arterial wall fix. This quantity bargains the reader the entire foundation essential to shift from the outdated notion of 'when' to regard - in line with easy luminal narrowing - to the hot suggestion of 'who will be taken care of' - in keeping with plaque and sufferer features.

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47. Gonzalez-Juanatey C, Llorca J, Testa A et al. Increased prevalence of severe subclinical atherosclerotic findings in longterm treated rheumatoid arthritis patients without clinically evident atherosclerotic disease. Medicine 2003; 82: 407–13. 48. Roman MJ, Shanker BA, Davis A et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 2003; 349: 2399–406. 49. Ishizaka N, Ishizaka Y, Takahashi E et al. Increased prevalence of carotid atherosclerosis in hepatitis B virus carriers.

2 Racial distribution of carotid disease Study/author Angiogram studies International Study of Extracranial to Intracranial Bypass21 Gorelick22 Population Results STA–MCA bypass MCA occlusive disease more common indication in Japan than in North America In asymptomatic vessels, black patients had more lesions of supraclinoid ICA, ACA stem, and MCA; white patients had more extracranial carotid disease Whites had more severe ICA origin disease; blacks had more severe MCA and supraclinoid ICA disease In symptomatic vascular territories, whites had more severe extracranial lesions, Chinese had more severe intracranial lesions The proportion of intracranial atherosclerosis by race: 1% of whites, 6% of blacks, and 11% of Hispanics.

Heyman A, Wilkinson WE, Heyden S et al. Risk of stroke in asymptomatic persons with cervical arterial bruits: a population study in Evans County, Georgia. N Engl J Med 1980; 302: 838–41. 60. Wiebers DO, Whisnant JP, Sandok BA, O'Fallon WM. Prospective comparison of a cohort with asymptomatic carotid bruit and a population-based cohort without carotid bruit. Stroke 1990; 21: 984–8. 61. Ingall TJ, Homer D, Whisnant JP et al. Predictive value of carotid bruit for carotid atherosclerosis. Arch Neurol 1989; 46: 418–22.

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