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Printable Handouts
Navigable Slide Index
- Introduction
- Conflicts of interest
- Some facts - USA
- Some facts - EU
- Some facts - costs
- Some facts – stroke types
- Some facts - carotid endarterectomy
- Some facts - best medical treatment
- Which is the optimal?
- Microemboli detection on transcranial Doppler
- Microemboli as a predictor
- BMT reduced microemboli
- Asymptomatic carotid emboli study (ACES)
- Doppler embolic signals predict stroke risk
- Carotid plaque echolucency on duplex ultrasound
- Is plaque echolucency associated with stroke?
- Plaque echolucency and increased stroke risk
- Plaque echolucency and ipsilateral stroke risk
- Plaque echolucency and transcranial Doppler
- Progression of carotid artery stenosis severity
- ACSRS study group
- BMT did not prevent progression of stenosis
- Increased risk for cardiovascular events
- Carotid plaque volume predicts cardiac events
- Silent embolic infarcts on brain CT or MRI
- Silent embolic infarcts and stroke - ACSRS
- Silent embolic infarcts and stroke
- Reduced cerebrovascular reserve
- Impaired cerebrovascular reserve and stroke
- Size of juxtaluminal hypoechoic area
- Juxtaluminal hypoechoic area predicts stroke
- Identification of intraplaque haemorrhage using MRI
- Carotid plaques and ischaemic stroke
- Carotid plaque MRI to select high risk groups
- Carotid ulceration
- Carotid ulcers are associated with stroke
- Carotid ‘vulnerable plaque’ and embolic potential
- Summary
- Thank you
Topics Covered
- Some facts about strokes
- Microemboli detection on transcranial Doppler
- Carotid plaque echolucency on duplex ultrasound
- Progression of the severity of carotid artery stenosis
- Silent embolic infarcts on brain CT or MRI
- Reduced cerebrovascular reserve
- Size of juxtaluminal hypoechoic area
- Identification of intraplaque haemorrhage using MRI
- Carotid ulceration
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Talk Citation
Paraskevas, K. (2018, June 27). How to identify which patients with asymptomatic carotid stenosis could benefit from endarterectomy or stenting [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 12, 2024, from https://doi.org/10.69645/JXRU6980.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Kosmas Paraskevas has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
How to identify which patients with asymptomatic carotid stenosis could benefit from endarterectomy or stenting
Published on June 27, 2018
20 min
Other Talks in the Series: Stroke Prevention
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Kosmas Paraskevas.
I am a vascular specialist at
the Department of Vascular Surgery of the Royal Free Hospital in London, UK.
The title of my talk is "How to Identify Which Patients with
Asymptomatic Carotid Stenosis Could Benefit from Endarterectomy or Stenting."
0:19
I have no conflicts of interest.
0:22
First, some facts.
Stroke is the fifth leading cause of death in the US,
killing about 140,000 Americans each year.
Someone in the United States has a stroke every 40 seconds.
Every four minutes somebody dies of stroke.
Every year about 795,000 people in the United States have a stroke.
About 610,000 of these are first and new strokes while 185,000 are recurrent strokes.
0:52
In Europe, stroke causes about 1,100,000 deaths per year.
This makes it the second commonest cause of death.
More than half of all stroke survivors
remain dependent on others for everyday activities.
1:08
Stroke cost United States about $34 billion annually,
including the cost of health care services,
medications and lost productivity.
By 2030, stroke is predicted to increase to $300 billion.
1:26
About 85% of all strokes are ischemic,
whereas 15% are hemorrhagic.
Thromboemboli originating from ipsilateral carotid stenosis
are the cause of approximately 50% of ischemic strokes.
Only one in five of these patients has had
a warning in the form of a transit ischemic attack.
The other four out of five patients had previously asymptomatic carotid stenosis.
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