Arterial thrombosis, carotid artery.
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Arteries↗
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Results for “CAROTID ARTERY THROMBOSIS”
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On-table diagnosis of incipient carotid artery thrombosis during carotid endarterectomy by transcranial Doppler scanning.
We present a case where transcranial Doppler ultrasound monitoring of a carotid endarterectomy enabled us to detect the incipient thrombosis of the operated artery before reversal of anesthesia. The use of transcranial Doppler ultrasound monitoring in carotid endarterectomy has the potential to detect this complication before serious neurologic damage has occurred and therefore reduce the morbidity and mortality rates associated with the operation.
Aged↗
Collateral circulation of the external carotid artery and the internal carotid artery through the ophthalmic artery in cases of internal carotid artery thrombosis; report of five cases.
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Angiography↗
[Cerebral infarct following traumatic carotid artery thrombosis].
An autopsy case of a 45-year-old man is presented. The man had sustained a minor head injury in a traffic accident 11 years ago previously and 5 years later had a cerebral infarction due to thrombosis of the carotid artery. There was histological evidence of a traumatic lesion of the vessel wall. Several contradictory expert opinions were rendered regarding the questionable causal relationship between occlusion of the artery and the previous trauma. In the court of appeal, an agreement was arrived at between the widow of the deceased and the third-party insurance of the person responsible for the accident.
Adult↗
The role of oculopneumoplethysmography in detecting acute carotid artery thrombosis in patients with neurologic deficits after carotid endarterectomy.
BACKGROUND: This study analyzes the role of oculopneumoplethysmography (OPG/Gee) in detecting acute carotid thrombosis (CAT) after carotid endarterectomy (CEA) in a timely fashion for immediate exploration, and minimizing unnecessary surgery. PATIENTS AND METHODS: Fifty-three patients with neurologic deficits that were noticed after CEA in the operating or recovery room had immediate OPG/Gee. Patients with a positive OPG underwent immediate exploration. Patients with a negative OPG had a duplex ultrasound (DU), and if positive for >/=50% stenosis, the patient underwent exploration. If the DU was negative, the patient underwent cerebral computed tomography scanning and angiography. RESULTS: Thirty-one of 53 (58%) had a positive OPG, 30 (97%) of whom had CAT on exploration. Twenty-two of 53 (42%) with a negative OPG had a DU, 4 of whom had >/=50% stenosis (1 thrombosis) that was confirmed by exploration. The remaining 18 patients had a negative DU that was confirmed by angiography. OPG had an overall accuracy of 96% in detecting acute CAT, with a sensitivity of 97%, specificity of 95%, positive predictive value (PPV) of 97%, and a negative predictive value (NPV) of 95%. Combined OPG and selective DU had an overall accuracy of 98% in detecting surgically correctable lesions, with 100% sensitivity, 95% specificity 97% PPV, and 100% NPV. Mandatory exploration in all 53 patients would have resulted in 19 (36%) unnecessary surgeries versus 1 of 53 (2%) if exploration had been done based on OPG with selective DU (P <0.05). Even if exploration was done based only on the OPG, 30 of 34 surgical lesions would have been explored within a few minutes; only 4 would have been delayed until a DU was performed. CONCLUSIONS: OPG/Gee is very sensitive and timely in detecting acute CAT, and carotid exploration in these patients can improve the results of CEA. It also minimizes unnecessary explorations. Patients with a negative OPG should undergo DU, and if positive, they should undergo exploration.
Acute Disease↗
Internal carotid artery thrombosis in a child secondary to intraoral trauma.
A case of intraoral trauma leading to thrombosis of the internal carotid artery in a child is reported. Presentation, evaluation, and treatment of this entity are reviewed. Sequelae of this injury include delayed neurological deficits and death.
Accidental Falls↗
Bilateral carotid artery thrombosis in a young man.
Carotid artery thrombosis in young patients without evidence of premature atherosclerosis prompts investigation of unusual forms of carotid disease in addition to a workup for cardiac and arch vessel sources for emboli. Noninvasive imaging and conventional angiographic techniques play an important part in the diagnostic evaluation looking for potential vascular sources. Physicians should also be aware that, in addition, hypercoagulable conditions may predispose to carotid thrombosis. One such patient is presented with bilateral carotid thrombosis and stroke. The management of the problem is reviewed, as well as the investigation of potential hypercoagulable conditions, with a primary focus on qualitative and quantitative platelet abnormalities.
Adult↗
Carotid artery thrombosis associated with lupus anticoagulant.
A young man with cerebral infarction and circulating lupus anticoagulants was found to have a partially occluding intraluminal thrombosis in the left internal carotid artery. Immediate thrombectomy and medical therapy was followed by gradual partial clinical improvement. Pathologic examination revealed an organized thrombus with diffuse hypersensitivity vasculitis of the small arteries in a skin and muscle biopsy specimen. Increased physician awareness may lead to more prompt diagnosis and treatment of this unusual clinical syndrome.
Adult↗
[Internal carotid artery thrombosis in the course of rheumatic disease. Report of a case].
The case of a 21 years old man with hemiplegia and hyperthermia of sudden onset is reported. The angiographic study showed thrombosis of the distal portion of the internal carotid artery. Laboratorial studies revealed positive rheumatic tests. The authors think that the rheumatic arteritis may be responsible for this ischemic cerebral accident. Differential diagnosis with the embolic accidents caused by the rheumatic disease is discussed.
Adult↗
[Common carotid artery thrombosis--clinical and radiological evaluation].
Common carotid artery thrombosis (CCAT) is not common. We studied 4 patients with CCAT to clarify the clinical and radiological features of this disorder. Case 1 had only episodes of TIA. Case 2 was diagnosed by chance as having CCAT at the time of admission due to cerebellar infarction. On the contrary, Cases 3 and 4 were admitted because of disturbance of consciousness and hemiparesis. Case 4 died soon after his stroke because of complications. We evaluated cases 1, 2 and 3 using head CT, head MRI, neck MRI, MR angiography, SPECT and cerebral angiography. Case 4, who was evaluated with head CT and cerebral angiography, was autopsied to confirm the occlusion of the common carotid artery. The clinical severity of CCAT varies from asymptomatic to severe, because each differs in the time taken for complete occlusion of the common carotid artery; the development of collateral circulation; and hemodynamics of the brain. As for the collaterals their contribution is variable; for example, the thyrocervical and other arteries function as the bypass. We can diagnose CCAT easily and noninvasively using MR angiography and neck MRI based on disappearance of the flow void in the common carotid artery or internal carotid artery. On physical examination, it is important to detect faded pulsation of the superficial temporal artery that is ipsilateral to the occluded common carotid artery.
Aged↗
Serotonin release into plasma during common carotid artery thrombosis in rats.
BACKGROUND AND PURPOSE: We have tested the hypothesis that platelet-derived serotonin is released into the bloodstream during cerebrovascular thrombosis. METHODS: Nonocclusive common carotid artery thrombosis was produced photochemically in 22 anesthetized adult male Wistar rats using the photosensitizing dye rose bengal and irradiation with an argon-pumped dye laser. Plasma serotonin levels were recorded before, during, and after photothrombosis by intra-arterial in vivo microdialysis with the probe placed distal to the site of thrombosis. RESULTS: During and immediately after the common carotid artery thrombosis, serotonin levels increased significantly to a peak value of 781 nmol/l (p less than 0.001 by analysis of variance), representing a 15-fold increase compared with baseline levels. The increased serotonin levels gradually decreased but remained significantly elevated for 90 minutes. Ultrastructural analysis of the carotid thrombi identified a dense mass of aggregated platelets at various stages of degranulation. CONCLUSIONS: These results are the first to demonstrate directly that serotonin accumulation occurs in plasma during and after the acute phase of common carotid artery thrombosis. Increased plasma serotonin levels may play a major role in the cerebral blood flow and blood-brain barrier abnormalities previously documented in this model of large-vessel thrombotic stroke.
Animals↗
[A CONTRIBUTION TO THE DIAGNOSIS OF INTERNAL CAROTID ARTERY THROMBOSIS].
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Carotid Artery Thrombosis↗
Prevention of carotid artery thrombosis after oral administration of the glycoprotein IIb/IIIa antagonist CRL42796.
This study investigates the effect of the glycoprotein IIb/IIIa receptor antagonist CRL42796 in a canine model of carotid artery thrombosis. Both carotid arteries developed occlusive thrombosis in each of the five control animals (time to occlusion: right carotid artery, 92.6 minutes; left carotid artery, 89.0 minutes). A single oral dose of CRL42796 (3 mg/kg) prevented occlusive thrombosis in 4 of 6 vessels and increased time to thrombosis, albeit not significantly (right carotid artery, 134.1 minutes; left carotid artery, 145.0 minutes). When the initial dose of CRL42796 was followed by a second oral dose (3 mg/kg) 2 hours later, 10 of 10 carotid arteries remained patent throughout the period of electrolytic injury. CRL42796 reduced thrombus weight in both treatment protocols. Ex vivo platelet aggregation with arachidonic acid (AA) or adenosine diphosphate (ADP) was reduced at 120, 240, and 360 minutes after two doses of CRL42796. A single oral dose reduced ADP-induced responses at 240 and 360 minutes, but significant effects were not observed with AA. Bleeding time increased 360 minutes after two oral doses of CRL42796, but not at 120 minutes. Bleeding time was unchanged with the single dose of CRL42796. The results demonstrate that oral administration of CRL42796 prevents carotid artery thrombosis in response to deep vessel wall injury and may have potential value to be characterized in extended preclinical and clinical study.
Administration, Oral↗
Bilateral internal carotid artery thrombosis after closed head injury.
A case of bilateral internal carotid artery thrombosis after blunt injury to the head in a 54 years old male is described. The literature is reviewed and comment is made on the causes. Unilateral thrombosis of the internal carotid artery after closed or blunt injury to the head and neck is well known but not common. There is only one previously recorded case of bilateral internal carotid artery thrombosis after such an injury (Yashon et al. 1964).
Carotid Artery Diseases↗
[Bilateral internal carotid artery thrombosis (author's transl)].
Nineteen patients with bilateral internal carotid artery thrombosis were analysed with respect to long term clinical course from first onset to admission. The patients comprised 19.3% of all patients with occlusive cerebral disease treated in past three years at our clinic. In reviewing the symptoms and signs associated with bilateral carotid occlusions and the clinical course, several patterns became evident and in this report the patients are divided into 3 types: Apoplectic type, those who had severe neurological deficit acutely after occlusion, whose angiography showed impaired or absent collateral circulation, and whose CT scan demonstrated bilateral diffuse low density areas; Progressing type, those whose neurological signs and symptoms grew progressively serious, whose angiography showed moderate or adequate retrograde filling with collateral circulation through posterior cerebral arteries and whose CT scan demonstrated low density lesions in the bilateral frontal lobes; TIA . RIND repeated type, those who had transient ischemic attacks or reversible ischemic neurological deficits repeatedly, whose angiography showed good normograde filling of bilateral internal carotid artery with collateral circulation through posterior communicating arteries and whose CT scan demonstrated no abnormal low density areas except findings of brain atrophy.
Adult↗
Antithrombotic effects of a platelet fibrinogen receptor antagonist in a canine model of carotid artery thrombosis.
BACKGROUND AND PURPOSE: Platelet-fibrin thrombi in the lumen of atherostenotic carotid arteries may underlie transient ischemic attacks and cerebral infarction. For this reason, we investigated the antiplatelet and antithrombotic effects of a novel and potent platelet fibrinogen receptor (glycoprotein IIb/IIIa) antagonist (SK&F 106760). METHODS: The effects of 0.1-3.0 mg/kg i.v. SK&F 106760 on platelet aggregation were examined ex vivo in canine platelet-rich plasma (n = 20). In addition, the antithrombotic effects of SK&F 106760 were compared with those of aspirin in an acute canine model of extracranial carotid artery thrombosis with high-grade stenosis. Sham-operated (n = 4), vehicle-treated (n = 6), SK&F 106760-treated (n = 8), aspirin-treated (n = 9), and SK&F 106760+aspirin-treated (n = 5) dogs were examined. RESULTS: The intravenous administration of SK&F 106760 caused a dose-related inhibition of ex vivo platelet aggregation. In the carotid artery thrombosis model, an occlusive thrombus formed at stenotic sites in the region of the carotid bifurcation. The thrombogenic process caused a progressive reduction in carotid blood flow and reduced the cortical microvascular perfusion and electroencephalographic power. Based on nuclear magnetic resonance spectroscopy, the occlusive events depleted the stores of high-energy phosphates (adenosine triphosphate and phosphocreatine) and increased the lactate concentration in the forelimb somatosensory area of the parietal cortex. In this model, the administration of 1 mg/kg i.v. SK&F 106760 prevented thrombosis of the stenotic carotid artery. Consequently, neurophysiological, cerebral hemodynamic, and metabolic parameters were all improved significantly in the SK&F 106760-treated group. No dog receiving SK&F 106760 reoccluded during the 1-hour posttreatment observation period. In contrast, thrombosis of the carotid artery was associated with neurophysiological deterioration in six of the nine dogs treated with 5 mg/kg i.v. aspirin. Both spontaneous and evoked (increased carotid stenosis) aspirin-resistant thrombosis were abolished by SK&F 106760 treatment. CONCLUSIONS: These results suggest that antagonism of fibrinogen binding to platelet glycoprotein IIb/IIIa (the final common pathway for aggregation) may represent a new and more effective antithrombotic approach to the treatment of cerebral transient ischemic attacks and infarction associated with extracranial carotid artery disease.
Animals↗
Internal carotid artery thrombosis.
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Adult↗
Internal carotid artery thrombosis following manual strangulation.
Thrombosis of the internal carotid artery is an unusual complication of neck compression, and even more infrequently observed in manual strangulation. It is important in such cases to exclude spontaneous thrombosis which may result from atherosclerotic narrowing of the vessel.
Aged↗