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Absence Of Microemboli On Transcranial Doppler Identifies Low-Risk Patients With Asymptomatic Carotid Stenosis Who Do Not Warrant Endarterectomy Or Stenting, J. David Spence, Arturo Tamayo, Stephen P. Lownie, Wai P. Ng, Gary G. Ferguson
Absence Of Microemboli On Transcranial Doppler Identifies Low-Risk Patients With Asymptomatic Carotid Stenosis Who Do Not Warrant Endarterectomy Or Stenting, J. David Spence, Arturo Tamayo, Stephen P. Lownie, Wai P. Ng, Gary G. Ferguson
Department of Medicine Publications
Background and Purpose - Carotid endarterectomy clearly benefits patients with symptomatic severe stenosis (SCS), but the risk of stroke is so low for asymptomatic patients (ACS) that the number needed to treat is very high. We studied transcranial Doppler (TCD) embolus detection as a method for identifying patients at higher risk who would have a lower number needed to treat. Methods - Patients with carotid stenosis of ≥60% by Doppler ultrasound who had never been symptomatic (81%) or had been asymptomatic for at least 18 months (19%) were studied with TCD embolus detection for up to 1 hour on 2 …
3d Ultrasound Measurement Of Change In Carotid Plaque Volume: A Tool For Rapid Evaluation Of New Therapies, Craig D. Ainsworth, Christopher C. Blake, Arturo Tamayo, Vadim Beletsky, Aaron Fenster, J. David Spence
3d Ultrasound Measurement Of Change In Carotid Plaque Volume: A Tool For Rapid Evaluation Of New Therapies, Craig D. Ainsworth, Christopher C. Blake, Arturo Tamayo, Vadim Beletsky, Aaron Fenster, J. David Spence
Department of Medicine Publications
Background and Purpose - New therapies are being developed that are antiatherosclerotic but that lack intermediate end points, such as changes in plasma lipids, which can be measured to test efficacy. To study such treatments, it will be necessary to directly measure changes in atherosclerosis. The study was designed to determine sample sizes needed to detect effects of treatment using 3D ultrasound (US) measurement of carotid plaque. Methods - In 38 patients with carotid stenosis >60%, age±SD 69.42±7.87 years, 15 female, randomly assigned in a double-blind fashion to 80 mg atorvastatin daily (n=17) versus placebo (n=21), we measured 3D plaque …
Vitamin B12, Homocysteine And Carotid Plaque In The Era Of Folic Acid Fortification Of Enriched Cereal Grain Products, Julie Robertson, Francesco Iemolo, Sally P. Stabler, Robert H. Allen, J. David Spence
Vitamin B12, Homocysteine And Carotid Plaque In The Era Of Folic Acid Fortification Of Enriched Cereal Grain Products, Julie Robertson, Francesco Iemolo, Sally P. Stabler, Robert H. Allen, J. David Spence
Department of Medicine Publications
Background: Carotid plaque area is a strong predictor of cardiovascular events. High homocysteine levels, which are associated with plaque formation, can result from inadequate intake of folate and vitamin B12. Now that folic acid fortification is widespread in North America, vitamin B12 has become an important determinant of homocysteine levels. We sought to determine the prevalence of low serum levels of vitamin B12, and their relation to homocysteine levels and carotid plaque area among patients referred for treatment of vascular disease since folic acid fortification of enriched grain products. Methods: We evaluated 421 consecutive new patients with complete data whom …
Intra-Arterial Thrombolysis Of Embolic Middle Cerebral Artery Using Collateral Pathways, Max K. Kole, David M. Pelz, Donald H. Lee, Vivek Jain, J. David Spence, Stephen P. Lownie
Intra-Arterial Thrombolysis Of Embolic Middle Cerebral Artery Using Collateral Pathways, Max K. Kole, David M. Pelz, Donald H. Lee, Vivek Jain, J. David Spence, Stephen P. Lownie
Department of Medicine Publications
Background and purpose: Cervical internal carotid artery (ICA) occlusion associated with middle cerebral artery (MCA) embolic occlusion requires prompt revascularization to prevent devastating stroke. With the advent of endovascular techniques for chemical and mechanical thrombolysis, the clinical outcome of patients with major arterial occlusions will improve. Finding the most expedient pathway to the site of end organ occlusion for thrombolysis is important. Methods: We present two cases of acute stroke secondary to thrombotic occlusion of the cervical ICA associated with MCA embolic occlusion treated with intra-arterial thrombolysis via catheter navigation through the posterior communicating artery to the site of MCA …
Ct Perfusion Imaging In Cerebral Ischemia, Ting Yim Lee, Vadim Belesky, Paul Kalapos, Donald Lee, Vladimir Hachinski, David Spence, Richard E. Latchaw
Ct Perfusion Imaging In Cerebral Ischemia, Ting Yim Lee, Vadim Belesky, Paul Kalapos, Donald Lee, Vladimir Hachinski, David Spence, Richard E. Latchaw
Department of Medicine Publications
No abstract provided.