The Relationship Between NLRP3 Inflammasome and Its Downstream Inflammatory Factors in Obstructive Sleep Apnea Patients with Carotid Atherosclerosis Under Cigarette Exposure

Aim:To study the relationship between NLRP3(nucleotide oligomerization domain[NOD]-,leucine-rich repeats[LRR]-,and pyrin domain-containing protein 3)inflammasome and its downstream inflammatory factors in obstructive sleep apnea(OSA)patients with carotid atherosclerosis(CAS)under cigarette exposure,further exploring the risk factors of CAS in OSA patients.Methods:A total of 109 adult males who underwent polysomnography and carotid artery ultrasonography in our hospital from October 2019 to December 2021 were selected.According to the detection results,they were divided into the OSA group,the CAS group,and the OSA combined CAS group;additionally,29 healthy subjects who underwent a physical examination were also included.According to whether they were smoking,the groups were further divided into smoking and non-smoking groups.The age,body mass index(BMI),blood pressure,apnea-hypopnea index(AHI),lowest blood oxygen saturation(LSaO2),carotid intima-media thickness(CIMT),levels of blood sugar,blood low-density lipoprotein cholesterol(LDLc),and serum NLRP3,interleukin-1β(IL-1β),and interleukin-18(IL-18)of all subjects were recorded.Results:The OSA combined CAS group had higher LDLc levels and AHI and lower LSaO2 than the OSA group and CAS group.The levels of serum NLRP3,IL-1β,and IL-18 in the OSA group were higher than those in the normal control group(P<0.05);and those in the OSA combined CAS group were higher than the OSA group and CAS group(P<0.05),regardless of cigarette exposure.Considering cigarette exposure,serum NLRP3,IL-1β,and IL-18 levels were higher in the OSA,CAS,and OSA combined CAS smoking groups than those in the non-smoking group(P<0.05).Under cigarette exposure,AHI,LDLc,NLRP3,IL-1β,and IL-18 were significantly positively correlated(P<0.05),and LSaO2 was negatively correlated with CAS in OSA(P<0.05).AHI,LSaO2,LDLc,NLRP3,and IL-1βare the risk factors for OSA combined with CAS.Conclusion:LSaO2,AHI,LDLc,NLRP3,and IL-1βare the important risk factors for OSA combined with CAS under cigarette exposure,and their levels can be used to predict the occurrence of CAS in OSA.

Research progress on the influence of local hemodynamics on carotid atherosclerosis

The reasons for the formation of atherosclerosis are diverse and complex,and atherosclerosis as a kind of systemic disease has the characteristics of focal selectivity,which occurs in the carotid bifurcation.The feature enables a large number of studies have found that the severe local hemodynamic characteristics has a great influence to the occurrence of this disease.This paper briefly reviews the related research on the local hemodynamics of carotid bifurcation.The relevant parameters of local hemodynamics were sorted out and summarized,and the effects of wall shear force and its derived parameters on the generation,progression and rupture of carotid atherosclerosis and their clinical applications were reviewed,in order to provide mechanical information for the early warning of carotid plaque rupture.At the same time,this paper describes the transformation of local hemodynamics research in the clinical application of carotid atherosclerosis disease,in order to provide personalized selection and basis for the clinical treatment of this disease.

Relationship between Carotid Atherosclerosis and Cerebral Infarction

Objective To study the relationship between carotid atherosclerosis and cerebral infarction (CI). Methods Between 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 mm≤intima-media thickness (IMT) <1.5 mm and that of carotid 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. Results In 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). Conclusions Carotid 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.

Association between Metabolic Syndrome and Carotid Atherosclerosis: A Cross-sectional Study in Northern China

Objective Increased carotid artery intima-media thickness(CIMT)and carotid plaque as manifestations of carotid atherosclerosis have been used as markers of cardiovascular disease(CVD).The components of metabolic syndrome(Met S)are linked to CVD,but the association between Met S and CVD is controversial.Methods A total of 8,933 Chinese adults aged 40 years or older from 2010 to 2014 were selected from the Jidong and Kailuan communities.Met S was defined by the International Diabetes Federation criteria.CIMT and carotid plaque were measured using color Doppler ultrasound.Logistic regression models were used to assess the association of Met S with carotid plaque and CIMT.Results Met S was found among 3,461(3,461/8,933)participants.The odds ratio and 95%confidence internal(CI)for carotid plaques in participants with Met S was 1.16(1.03-1.30).The risk of carotid plaques increased with the number of Met S components.The average CIMT was higher in participants with Met S(β=0.020,95%CI,0.014-0.027)and in participants with more Met S components.Conclusion Individuals with Met S are at an increased risk for carotid atherosclerosis compared to those without MetS.

Feature selection and machine learning approach for carotid atherosclerosis in asymptomatic adults

Objective:The presence of carotid atherosclerosis reflects the overall atherosclerotic load and may predict cardiovascular and cerebrovascular accidents.Studies have reported risk factors for carotid atherosclerosis.However,few practical models have been established to predict carotid atherosclerosis risk.Thus,this study was conducted to investigate important features of carotid atherosclerosis and to propose a machine learning-based method for predicting carotid atherosclerosis in asymptomatic adults.Methods:Cross-sectional study was conducted using routine medical check-up data of individuals from January 2019 to January 2020.Pearson’s correlation analysis was performed to correlate the features.Then,features were selected by python’s feature-selection library and analyzed through three algorithms.Multiple machine learning algorithms,including Decision Tree,Random Forest and Logistic Regression(LR)were used to predict the risk of carotid atherosclerotic plaques and compared their precision,accuracy,recall,F1-score and area under the curve.Results:A total of 150 individuals were enrolled in this study,30(20%)of them were found with carotid atherosclerotic plaques.Sex,age,body mass index,total cholesterol,Systolic blood pressure(SBP),and carbohydrate antigen 724(CA724)were independently correlated to carotid atherosclerosis.Pepsinogen Ⅰ and pepsinogen Ⅱ serum levels had no correlations with Carotid intima-media thickness and pulse wave velocity.SBP,diastolic blood pressure age,low-density lipoprotein,Pepsinogen I,pepsinogen II,body mass index,Waist,CA724,and Uric Acid contribute to the cumulative importance of 0.9,and SBP was the most crucial feature for carotid atherosclerosis.LR algorithm has the precision(0.92),values of recall(0.91),F1(0.9),and area under the curve(0.95),and showed the optimal performance to predict the presence or absence of carotid atherosclerosis in asymptomatic adults.The code for analysis in this article was uploaded to GitHub(https://github.com/ganbingliangyi/machine-learning).Conclusions:SBP was the most crucial feature in ranking features,the LR algorithm showed the optimal performance to predict the presence or absence of carotid atherosclerosis in asymptomatic adults.

Research Progress of Traditional Chinese Medicine in the Treatment of Carotid Atherosclerosis

Carotid atherosclerosis is a partial manifestation of arteriosclerosis of organism.In recent years,its incidence rate is increasing year by year.Traditional Chinese medicine(TCM)has a broad prospect in the clinical development of CAS treatment by holism concept and the principle of treatment based on syndrome differentiation.This paper reviews the etiology,pathogenesis,TCM dialectics and TCM treatment of carotid atherosclerosis,in order to provide theoretical guidance for TCM treatment of CAS patients.

Pathological Mechanism of “Phlegm, Blood stasis, Toxin ”in a Rabbit Model of Carotid Atherosclerosis Based on Gut Microbiota-host Metabolism Interactions

Background:In Traditional Chinese Medicine(TCM)theory,"phlegm,blood stasis and toxin"are the pathogenesis of carotid atherosclerosis(CAS).The rabbit carotid atherosclerosis(CAS),which is induced by high-cholesterol diet combined with carotid artery balloon injury,is a classic model for studying CAS.Many studies indicate that gut microbiota and host metabolic disorders are involved in the pathogenesis of rabbit CAS.However,the TCM pathological features and syndromes of this classic rabbit CAS model have not been reported.Objective:To explore the pathogenesis of the rabbit CAS model and its TCM syndrome types from the perspective of"phlegm,blood stasis,and toxin".Methods:Twelve male New Zealand white rabbits were randomly divided into NC group and CAS group according to their body weight,followed by feeding of basic feed and a 1%high cholesterol diet,respectively.After two weeks,the rabbits in the CAS group underwent common carotid artery(CCA)balloon injury,while the rabbits in the NC group underwent only CCA separation without balloon injury.The two groups received differential feed postoperatively for six more weeks,after which,changes in lipids,hemorheology,inflammation,oxidative stress,and CAS phenotypes were analyzed.In addition,the colon contents and serum were collected for 16S rRNA sequencing and ^(1)H-NMR metabonomic analysis.Results:The CAS rabbits were observed to form noticeable abnormalities in lipid metabolism and blood rhe-ology,a sharp increase in oxidative stress levels,excessive release of inflammatory factors and apparent CAS plaque formation.Furthermore,10 specific gut microbiota(such as Akkermansia muciniphila,Barnesiellaceae and Faecalibacterium)and 14 characteristic metabolites(such as trimethylamine oxide,acetic acid and L-carnitine)were identified in the CAS rabbits,which were significantly related to the CAS phenotypes.The pathway func-tion analysis showed that the gut microbiota and its metabolites mainly affected cholesterol metabolism,energy metabolism,inflammation and oxidative stress.Conclusion:The rabbit CAS model conforms to the“phlegm,blood stasis and toxin damage”theory.The gut microbiota and host metabolic disorders of the CAS rabbits interact and promote internal and external toxins,aggravating the progression of CAS.Our study provided experimental evidence for the application of this model in the TCM-based research of CAS.

Association between Fundus Atherosclerosis and Carotid Arterial Atherosclerosis

Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2020 and December 2022 were randomly selected. Fundus atherosclerosis and carotid arterial atherosclerosis were evaluated by fundus photography and carotid artery ultrasonography, respectively. Results: Among the 516 physical examination patients, 198 (38.4%) had normal fundus examination, and 318 (61.6%) had fundus arteriosclerosis. Among them, 166 cases were of grade I (32.2%), 86 cases were of grade II (16.7%), and 66 cases were of grade III (12.8%). There were 286 cases (55.4%) without carotid atherosclerosis, 201 cases (38.9%) with carotid atherosclerotic plaque, and 33 cases (6.4%) with carotid stenosis. Fundus arteriosclerosis is independently associated with carotid artery intima-media thickness, vulnerable plaques, plaque scores, and carotid artery stenosis (P Conclusion: In summary, there is a close relationship between carotid artery disease and the degree of arteriosclerosis in the eyeground. Fundus photography is a simple, non-invasive, and easily acceptable method of inspection. The results obtained from it are useful in determining the severity of carotid atherosclerosis and guiding early detection and intervention in clinical cases. This can help reduce the incidence of cardiovascular and cerebrovascular diseases.

Carotid Atherosclerosis and Cognitive Impairment in Nonstroke Patients

Objective： As a vascular risk factor, carotid atherosclerosis is crucial to cognitive impairment. While carotid intima-media thickness, carotid artery plaque, and carotid stenosis can reflect carotid atherosclerosis in different stages, this review aimed to explore researches on the role of carotid intima-media thickness, carotid artery plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and tried to illustrate the possible mechanisms. Data Sources： We searched the PubMed database for recently published research articles up to July 2017, with the key words of ＂carotid atherosclerosis,＂ ＂carotid intima-media thickness,＂ ＂carotid plaque,＂ ＂carotid stenosis,＂ ＂nonstroke,＂ and ＂cognitive impairment.＂Study Selection： Articles were obtained and reviewed to analyze the role of carotid atherosclerosis such as carotid intima-thickness, carotid plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and the possible mechanisms. Results： In recent years, most studies proved that by evaluating carotid atherosclerosis with ultrasonography, carotid atherosclerosis accounts for the development of cognitive decline in nonstroke patients. Carotid atherosclerosis not only impairs the subtle general cognitive function but also decreases the specific domains of cognitive function, such as memory, motor function, visual perception, attention, and executive function. But, it is still controversial. The possible mechanisms of cognitive impairment in nonstroke patients with carotid atherosclerosis can be classified as systemic global cerebrovascular function, small-vessel diseases, and the mixed lesions. Conclusions： Carotid atherosclerosis can be used to predict the risk of cognitive impairment. Furthermore, diagnosing and treating carotid atherosclerosis at early stage might help clinicians prevent and treat vascular cognitive impairment in nonstroke patients.

ASSESSMENT OF AUTOPSIC SAMPLES OF CAROTID ATHEROSCLEROSIS IN THE AGED BY INTRAVASCULAR ULTRASOUND

To assess the value of intravascular ultrasound in detecting carotid atherosclerosis,we compared the ultrasound images of 48 carotid artery segments from autopsies with their histological findings.The results showed that by intravascular ultrasonography one could distinguish between elastic and

Effects of apolipoprotein A polymorphism on plasma levels of lipids, progression of carotid atherosclerosis and response to statin therapy

Background Studies have shown that the apt （a） gene （LPA） rs3798220 polymorphism is associated with thelevels of lipids and the curative effect of statin therapy for carotid atherosclerosis （CAS）. Whether carriers ofan apt （a） variant benefit more from statin remains unclear. Methods One hundred and three patients with CAS were recruited from April 2012 to April 2013 in the Shunde First People＇s Hospital Affiliated to Southern Medical University in Foshan. All patients were administered atorvastatin 20 mg/d and were followed-up for 2 years, with the levels of plasma Lp （a）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein （HDL）, low density lipoprotein （LDL）. LPA rs3798220 genotypes of all patients were analyzed. Results Statin treatment significantly reduced the levels of IMT, TC, TG, LDL and increased the level of HDL, but statin treatment did not reduce the level ofLp （a）. According to the curative effect of statin therapy in patients with CAS, rs3798220 polymorphism had a certain influence on LDL and TC levels, but not on the improvement of the IMT, TG, HDL and Lp （a）. Conclusion Rs 3798220 polymorphism has a certain impact on the curative effects of statin, on LDL and TC levels.

Carotid lesions in outpatients with nonalcoholic fatty liver disease

AIM:To ascertain whether carotid lesions are more prevalent in outpatients with incidental findings of nonalcoholic fatty liver disease (NAFLD) at abdominal ultrasound (US).METHODS: One hundred and fifty-four consecutive outpatients (age range 24-90 years, both sexes) referred by general practitioners for abdominal US, and drinking less than 20 g alcohol/day, underwent carotid US for an assessment of carotid intima-media thickness (c-IMT) and carotid plaque prevalence. Hepatic steatosis, visceral fat thickness and subcutaneous fat thickness were also assessed at ultrasonography.RESULTS: Higher c-IMT values were found in the presence of NAFLD (90 patients), even after adjustment for indices of general and abdominal obesity and for the principal cardiovascular risk factors (0.84±0.10 mm vs 0.71±0.10 mm, P<0.001). The prevalence of carotid plaques was 57.8% in the patients with NAFLD vs 37.5% in the patients without this condition (P=0.02). The adjusted relative risk of having carotid plaques for patients with NAFLD was 1.85 (95% CI:1.33-2.57, P<0.001).CONCLUSION: An incidental finding of hepatic steatosis may suggest the presence of silent carotid atherosclerotic lesions.

Interplay between chronic hepatitis B and atherosclerosis:Innovative perspectives and theories

Elaboration of carotid atherosclerosis in the setting of hepatitis B virus(HBV)infection should emphasize the significance of extrahepatic manifestations of the infection pathogenesis.Diverse processes comprise the pathoevolution of HBV infection,rendering it a multi-systemic disease in its essence.Our work not only exemplified atherosclerosis as an often-underestimated contributor to the severity of HBV infection but has also highlighted the bidirectional relationship between the two.Therefore,it is suggested that HBV-induced inflammation is one of the root causes of atherosclerosis,which in turn has a consequent effect on the severity of the chronic infection disease state,creating a vicious cycle.Additionally,we coupled prior data with the current concepts of HBV infection to postulate intriguing perspectives and theories.

Inner Ear Disorders in the Elderly with Carotid Artery Disease Requiring Revascularization:Prevalence,Characteristics,and Association

Background:Aging is almost assocaited with inner ear disorders(InEarDs)by means of age-related hearing impairment(ARHI)or vertigo-anddizziness as well as the carotid artery disease requiring revascularization(CAD-R).Objective:The present study aimed to study the prevalence and characteristics of InEarDs in older adults diagnosed with CAD-R.The other aim was to determine if InEarDs in CAD-R patients is age-related or might be explained by a concomitant CAD-R.Method:A retrospective,case-control study was conducted at the Mayo Clinic,Florida.The study cohort includes 919 patients who had CAD-R.The control group consisted of 244 age-and gender-matched patients presenting with cardiac or peripheral artery disease.The InEarDs were assessed based on the diagnosis upon presentation to the Audiology Clinic and follow-up.Results:Of the 919,348 had ARHI that includes significant peripheral signs and central symptoms(24.9%),vertigo-and-dizziness events that are recurrent and persistent with normal objective vestibular testing(12.9%),or a combination of both(11.0%).These percentages were significantly higher in the study group relative to the control group.After adjustment for the vascular risk factors,the study group had significantly higher odds of ARHI(OR=1.94;95%CI:1.09-3.44;P<0.05).Conclusion:CAD-R patients had significantly higher InEarDs than the control group.CAD-R is more likely to be associated with ARHI rather than the vertigo-and-dizziness even after adjusting for the vascular risk factors.

Role of β2-microglobulin in uremic patients may be greater than originally suspected

The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined.

Correlation of carotid artery atherosclerosis with C-reactive protein and adiponectin in patient with metabolic syndrome

Background Metabolic Syndrome（MS） is a group of conditions included hypertension,hyperlipidemia,central obesity,impaired glucose tolerance and insulin resistance,which may contribute to risk factors for atherosclerosis syndrome.Insulin resistance is the core mechanism？ while the underlying mechanism is not clear.This article aims to study the correlation of carotid atherosclerosis with C-reactive protein and adiponectin in metabolic syndrome（MS） patients.Methods According to bilateral carotid artery atherosclerosis echocardiography,226 patients with metabolic syndrome were randomized to three groups,of which were non-carotid atherosclerosis plaque group（MS-1 group,n = 94）,carotid artery atherosclerosis plaque group（MS-2 group,n = 132）,and normal control group（n = 36）.Determination of serum insulin,high sensitivity C-reactive protein,adiponectin and bilateral carotid artery atherosclerosis ultrasonography and other indicators,semi-quantitative estimates of the extent and severity of plaque.Results ①In two MS groups,carotid artery atherosclerosis,intima-media thickness（IMT）,insulin resistance index（HOMA-IR） and high sensitive C-reactive protein（hs-CRP） were significantly higher than the control group（P 〈 0.01）,while adiponectin was lower than the control group（P 〈 0.01）;When MS-2 group was compared to MS-1 group,there were significant differences（P 〈 0.01）.②IMT was positively correlated with HOMA-IR and hs-CRP（P 〈 0.01） while negatively correlated with adiponectin（P 〈 0.01）.Conclusions C-reactive protein and adiponectin in MS patients were correlated with carotid atherosclerosis and insulin resistance,which may be used as the assessment of MS patients.

Research Progress on the Risk Factors and Outcomes of Human Carotid Atherosclerotic Plaques

Objective： Atherosclerosis is an inflamrnatory process that results in complex lesions or plaques that protrude into the arterial lumen. Carotid atherosclerotic plaque rupture, with distal atheromatous debris embolization, causes cerebrovascular events. This review aimed to explore research progress on the risk factors and outcomes of human carotid atherosclerotic plaques, and the molecular and cellular mechanisms of human carotid atherosclerotic plaque vulnerability for therapeutic intervention. Data Sources： We searched the PubMed database for recently published research articles up to June 2016, with the key words of＂risk factors＂, ＂outcomes＂, ＂＇blood components＂, ＂molecular mechanisms＂, ＂cellular mechanisms＂, and ＂human carotid atherosclerotic plaques＂. Study Selection： The articles, regarding the latest developments related to the risk factors and outcomes, atherosclerotic plaque composition, blood components, and consequences of human carotid atherosclerotic plaques, and the molecular and cellular mechanisms of human carotid atherosclerotic plaque vulnerability for therapeutic intervention, were selected. Results： This review described the latest researches regarding the interactive effects of both traditional and novel risk factors for human carotid atherosclerotic plaques, novel insights into human carotid atherosclerotic plaque composition and blood components, and consequences of human carotid atherosclerotic plaque. Conclusion： Carotid plaque biology and serologic biomarkers of vulnerability can be used to predict the risk ofcerebrovascular events. Furthermore, plaque composition, rather than lesion burden, seems to most predict rupture and subsequent thrombosis.

Neovascularization in the carotid atherosclerotic plaque is not associated with inflammatory cell aggregation

Background Monocytes and macrophages in atherosclerotic plaque lead to plaque instability.The aim of the study was to determine if plaque neovascularization led to inflammation.Methods Patients were consecutively enrolled if their carotid intimal media thickness was ＞2 mm,as revealed by duplex ultrasound.The patients then underwent dynamic contrast enhanced magnetic resonance imaging （DCE MRI） and fluorine-18 fluorodeoxyglucose （18F-FDG） positron emission tomography combined with computed tomography （PET CT）.A target to background ratio （TBR） of ＞1.25 or ＜1.25 served as the cutoff point for the presence and absence of inflammation,respectively.Results Twenty-six patients underwent bilateral carotid DCE MRI and 24 patients also underwent PET CT.One hundred and fifty-five plaques were evaluated by both DCE MRI and PET CT.There was no significant difference in plaque morphology between the TBR ＞1.25 （n=61） and TBR ＜1.25 （n=94） groups.No significant differences were found in plasma volume and transfer constant between the TBR ＞1.25 and TBR ＜1.25 groups.Conclusion Our study did not find a significant correlation between plaque neovascularization and the aggregation of inflammatory cells.

Percutaneous transluminal stenting in patients with carotid artery stenosis

Objective To assess the efficacy and safety of percutaneous transluminal stenting for patients with carotid artery stenosis.Methods Selective percutaneous transluminal stenting was performed for patients with symptomatic carotid artery stenosis(luminal narrowing ≥ 70%).Success rates and complications associated with the procedures were observed.During six months of follow-up,both recurrent symptom and restenosis rates were recorded.Results There were 17 bifurcating lesions among 27 stenoses in 26 patients,of whom 18 had concomitant coronary artery diseases.The acute procedural success rate was 96.3%(26/27),and the degree of stenosis was reduced from 88.6% ± 8.9%(range 70 - 100)to 0.4% ± 2.0%(range 0 - 10).Six patients developed severe bradycardia and hypotension,and 3 experienced transient loss of consciousness during balloon dilatation.During hospitalization,2 patients experienced loss of consciousness and convulsion,respectively,due to hyperperfusion,and both recovered 12 hours later.There were 2 minor stroke cases (7.4%)but no cases of major stroke or death.At the 6-month follow-up,there were no cases of TIA or new onset of stroke.There was no restenosis detected in 16 cases using angiography and in 10 cases using MRI in 6 to 16 months of follow-up.Conclusions Percutaneous transluminal stenting for patients with carotid artery stenosis has a high procedural success rate with few and acceptable complications.Few patients suffered from recurrent symptoms or showed restenosis in long-term follow-up.

Comparative study on hemodynamic environments around patient-specific carotid atherosclerotic plaques with different symmetrical features

Atherosclerotic plaque near the carotid sinus is a key risk factor for ischemic stroke.Although disturbed hemodynamic environments around atherosclerotic plaque had been investigated in many studies,the effect of their symmetrical features,especially longitudinal asymmetrical characteristics,had not been comparatively studied.In this study,three-dimensional carotid bifurcation models were established based on CT images of three patients with 50%stenosis and with different symmetrical features of carotid atherosclerotic plaques including concentric plaque,eccentric plaque,or eccentric longitudinal asymmetrical plaque.A healthy subject was chosen as the control.Wall shear stress(WSS)and oscillating shear index in the regions of upstream,downstream,downstream shoulders and regions around the point of maximum stenosis were analyzed.The results indicated that the maximum WSS around the eccentric longitudinal asymmetrical plaque were 8.6 times larger than that of the eccentric plaque and 1.9 times larger than that of the concentric plaque.And the distributions of WSS and OSI around the eccentric longitudinal asymmetric plaque were more disordered than those of the others.Our results highlighted the risk of the eccentric longitudinal asymmetrical plaque on plaque development and rupture and might provide a new index for evaluating the development of atherosclerosis.