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We compared intima-media thickness (IMT) and the prevalence of plaques in the common carotid artery (CCA) and common femoral artery (CFA) in apparently healthy participants. This multicenter study included 322 participants (59.9% female; age 20-78 years, mean 52.1 ± 15.3 years) who underwent Echo-color Doppler examination of the CCA and CFA bilaterally. Prevalence and composition of plaque were recorded. A significant (P < .01) difference between mean CCA-IMT and mean CFA-IMT was detected (0.70 vs 0.73 mm). Plaque prevalence was significantly higher in the CFA compared to the CCA (40.7% vs 30.4%). Atherosclerotic plaques were found in both CFA and CCA in 46% of the cases, solely in CFA in 38%, and in CCA alone in 17%. The observed difference in plaque prevalence was even greater when only fibrolipid isolated plaques were considered (CFA 39.4% vs CCA 22.1%). In a healthy general population, atherosclerotic plaques were present in the CFA but not in the CCA in over onethird of the cases. Further studies must confirm whether ultrasonography of the CFA might be introduced in the screening protocols for cardiovascular risk assessment. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the clinical role of the presence of external carotid artery (ECA) plaque on all-cause mortality in patients without internal carotid artery (ICA) or common carotid artery (CCA) plaque. The study is investigated by Doppler waveforms, ultrasonography, and statistical analysis. Results show that the presence of ECA plaque is considered an independent predictor of all-cause mortality.

Idiopathic carotidynia is a syndrome characterized by pain and tenderness over the carotid artery without an associated structural luminal abnormality. Controversy exists over whether this is a distinct disease entity or merely a symptom attributable to other causes of neck pain, such as carotid dissection or vasculitis. A 50-year-old woman presented with sudden-onset right neck pain. Imaging studies demonstrated transmural inflammation of the proximal internal carotid artery, without evidence of intraluminal pathology. The patient was placed on low-dose aspirin and ibuprofen. Her symptoms resolved within a week. At 3-month follow-up, her carotid artery appeared normal on duplex ultrasonography. [ABSTRACT FROM AUTHOR]

Osteoporosis and atherosclerosis share common risk factors and the association of low bone mass with increased cardio­vascular morbidity and mortality has been demonstrated in some studies. Nevertheless, most studies have been focused on women and only a few on individuals with type 2 diabetes mellitus (T2DM). The measurement of carotid intimal-medial thickness (CIMT) is able to detect early atherosclerotic changes and is a predictive marker of cardiovascular events. The aim of this study was to assess the CIMT and its relationship with bone mineral density (BMD) (in the femoral neck (FN) and lumbar spine (LS)) in men with T2DM. We conducted a cross-sectional study with 24 men with T2DM (aged 61 ± 6.4 years) and evaluated metabolic factors, bone densitom­etry values, and CIMT measured using B-mode Logic-E ultrasound machine. More than 5 years since the diagnosis of T2DM had passed in 75% of the patients, 41.6% were in statin use, mean body mass index (BMI) was 28.1 ± 3.4 kg/m2, abdominal circumference (AC) 97.8 ± 8.4 cm, systolic blood pressure (SBP) 143.8 ± 18.3 mmHg, diastolic blood pressure (DBP) 85.8 ± 12.3 mmHg, HbA1C 7.5% ± 1.3%, Triglycerides 141.7 ± 73 mg/dL, LDL-cholesterol 103.3 ± 35.9 mg/dL, HDL-cholesterol 41.6 ± 11.6 mg/dL. The patients were stratified into groups according to BMD. The group with normal BMD at FN had mean CIMT of 0.7 mm and the group with low bone mass (osteopenia or osteoporosis) had CIMT of 0.86 mm (P = 0.007). In addition, there were no significant differences between groups regarding age, duration of T2DM, BMI, AC, SBP, DBP, statin use, smoking, HbA1C, cholesterol, or triglycerides. Our data dem­onstrate a negative association between BMD at the FN and CIMT in type 2 diabetic men, which was unrelated to the traditional risk factors for atherosclerotic disease and degree of diabetes control. [ABSTRACT FROM AUTHOR]

The type of venous drainage of a direct carotid–cavernous fistula is an important issue to consider for the endovascular therapeutic decision. In case of an inadequate posterior drainage associated with a good anterior drainage, the facial vein is a useful alternative. The exclusive embolization with ethylene vinyl alcohol (EVOH Onyx), arterial and/or venous via the internal carotid artery (ICA) occlusion has been used successfully, in a few cases until now. Nevertheless, the use of this method through anterior transvenous approach has not been previously described. Presented here is the case of a 13-year-old female patient with left posttraumatic carotid–cavernous fistula, with predominant anterior drainage, as well as carrier of traumatic occlusion of the contralateral ICA. The treatment was by means of a transvenous approach with transient occlusion of the left ICA. [ABSTRACT FROM PUBLISHER]

We describe the case of a 37-year-old woman who presented with a complaint of recurrent headaches since childhood. Clinical examination revealed the presence of a reddish-bluish mass in the inferior half of the tympanic membrane in her right ear. Source and three-dimensional time-of-flight magnetic resonance angiography (MRA) detected a protruded right internal carotid artery (ICA) in the hypotympanum. The vertical segment of the ICA was absent, and the artery was narrowed and lateralized and had a "reverse 7" shape. Meanwhile, a persistent stapedial artery (PSA) was seen originating in the petrous portion of the ICA to form a middle meningeal artery. The A1 segment of the right anterior cerebral artery was hypoplastic. Based on these findings and on follow-up findings on computed tomography, the patient was diagnosed with a concomitant aberrant ICA and PSA. No intervention was undertaken. We review the management of this rare finding, and we discuss the role of MRA in its diagnosis. [ABSTRACT FROM AUTHOR]

We examined whether high-sensitivity C-reactive protein (hsCRP) ≥2.0 mg/L was associated with increased intima-media thickness (IMT), plaque burden, and plaque echolucency in carotid arteries. Women (n = 635) from a population sample of 64-year-old females with varying degrees of glucose tolerance underwent risk factor assessment, measurement of hsCRP, and ultrasound examinations of the carotid arteries. Participants with hsCRP levels ≥2.0 mg/L had elevated carotid bulb IMT independently of other cardiovascular risk factors compared with those with hsCRP <2.0 mg/L. The participants with plaques in the highhsCRP group had larger total plaque area compared to those with plaque in the lower hsCRP group. Plaque echolucency did not differ between groups. High-sensitivity CRP levels ≥2.0 mg/L were accompanied by elevated IMT in the carotid bulbs independently of other cardiovascular risk factors. Total plaque area was larger among women with plaques in the high hsCRP group versus the lower hsCRP group. [ABSTRACT FROM PUBLISHER]

The objective was to investigate which screening variables in a population study predicted carotid endarterectomy. Among 793 carotid endarterectomies performed at Malmö University Hospital between 1991 and 1998, 85 patients (14 females) were identified that had participated in a population screening between 1974 and 1991. Median time from screening to operation was 16 years (range 6–26 years). Screening variables were compared with corresponding values from the background screening population (n =33261). As operated patients were older than the background population at screening (49 [37–60] vs. 46 [26–61] years; p _ 0.0001), comparisons were age-adjusted. Operated patients had higher systolic blood pressure (SBP; 130 [126–133] vs. 125 [125–125] mmHg; p _ 0.01), serum total cholesterol (6.1 [5.9–6.3] vs. 5.7 [5.7–5.7] mmol/l; p _ 0.0001), serum triglyceride (1.4 [1.3–1.6] vs. 1.1 [1.1–1.1] mmol/l; p _ 0.0001), serum glutamic acid transferase (0.46 [0.40–0.53] vs. 0.40 [0.40–0.41] _kat/l; p _ 0.05), and plasma fibrinogen (3.77 [3.42–4.16] vs. 3.35 [3.30–3.41] mmol/l; p _ 0.05) levels, a lower 120-min insulin/glucose ratio at an oral glucose tolerance test (OGTT; 0.48 [0.38–0.58] vs. 0.60 [0.59–0.61]; p _ 0.05) and forced vital lung capacity (3.7 [3.6–3.9] vs. 3.9 [3.9–4.0] l/min; p _ 0.05), and a higher prevalence of smoking at screening (68% vs. 45%; p _ 0.0001). Smoking, SBP, serum total cholesterol, and the 120-min insulin/glucose ratio remained independent predictors for carotid surgery in multivariate analysis. No differences existed among patients operated on because of symptomatic and asymptomatic stenosis. In conclusion, increased SBP and total cholesterol, lower 2-h insulin/glucose ratio at an OGTT, and smoking predict carotid surgery at long-term follow-up. [ABSTRACT FROM AUTHOR]

Investigates the hypothesis that clinical criteria alone can be used for deciding when preoperative carotid artery screening is needed. Link between carotid and coronary artery disease; Symptoms; Risk factors including history of ischemic attack or stroke.

Examines the effect of the North American Symptomatic Carotid Endarterectomy Trial's recommendations for carotid endarterectomy at 50% stenosis on magnetic resonance angiography and Doppler ultrasonography. Accuracy of peak systolic velocity; Performance over a wide range of stenosis thresholds; Attractiveness of noninvasive imaging.