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Myeong Chan Cho - One of the best experts on this subject based on the ideXlab platform.
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Perivascular Delivery of Rapamycin in Pluronic Gel Inhibits Neointimal Hyperplasia in a Rat Carotid Artery Injury Model, and the Complementary Role of Carotid Arteriography
2016Co-Authors: Jangwhan Bae, Kyungkuk Hwang, Dong Woon Kim, Myeong Chan ChoAbstract:Background and Objectives: Rapamycin has been shown to inhibit the vascular smooth muscle cell migration and proliferation that contributes to neointimal formation. We investigated whether the perivascular delivery of rapa-mycin in Pluronic gel could inhibit neointimal hyperplasia in a rat Carotid artery model, and we tested the usefulness of Carotid Arteriography. Materials and Methods: To assess the kinetics of rapamycin’s release from Pluronic gel, a [3H] thymidine incorporation assay was performed with using the media exposed to rapamycin in Pluronic gel for 10, 20, 60 and 120 min. We applied 100 μg of rapamycin in Pluronic gel to the perivascular space of the Carotid artery after the balloon injury (n=9), whereas only gel was applied in a control group (n=9). We performed the Carotid arteriogra-phy and the morphometric analysis 14 days after injury. Results: The [3H] thymidine incorporation assay showed a reduction of uptake in a time-dependent manner (86%, 48%, 45 % and 40 % of the control, respectively, at 10, 20, 60 and 120 minutes). The inhibiting effect of rapamycin on neointimal hyperplasia was identified on the Carotid arte-riography (mean luminal diameter; 0.75±0.11 vs. 0.60±0.12 arbitrary units, respectively, p<0.05) and on the morphometric analysis (neointima area: 0.09±0.03 vs. 0.17±0.06 mm2, respectively, p<0.05). Conclusion: This study demonstrated that perivascular delivery of rapamycin in Pluronic gel inhibits neointimal hyperplasia in a rat Carotid injury model. This animal model combined with Arteriography can be used for developing new drugs to trea
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perivascular delivery of rapamycin in pluronic gel inhibits neointimal hyperplasia in a rat Carotid artery injury model and the complementary role of Carotid Arteriography
Korean Circulation Journal, 2008Co-Authors: Mijin Jung, Jinsook Kwon, Nokwan Park, Yukyung Kim, Tae Jin Shim, Il Ha Jeong, Jangwhan Bae, Kyungkuk Hwang, Dong Woon Kim, Myeong Chan ChoAbstract:Background and Objectives: Rapamycin has been shown to inhibit the vascular smooth muscle cell migration and proliferation that contributes to neointimal formation. We investigated whether the perivascular delivery of rapamycin in Pluronic gel could inhibit neointimal hyperplasia in a rat Carotid artery model, and we tested the usefulness of Carotid Arteriography. Materials and Methods: To assess the kinetics of rapamycin’s release from Pluronic gel, a [H] thymidine incorporation assay was performed with using the media exposed to rapamycin in Pluronic gel for 10, 20, 60 and 120 min. We applied 100 μg of rapamycin in Pluronic gel to the perivascular space of the Carotid artery after the balloon injury (n=9), whereas only gel was applied in a control group (n=9). We performed the Carotid Arteriography and the morphometric analysis 14 days after injury. Results: The [H] thymidine incorporation assay showed a reduction of uptake in a time-dependent manner (86%, 48%, 45% and 40% of the control, respectively, at 10, 20, 60 and 120 minutes). The inhibiting effect of rapamycin on neointimal hyperplasia was identified on the Carotid Arteriography (mean luminal diameter; 0.75±0.11 vs. 0.60±0.12 arbitrary units, respectively, p<0.05) and on the morphometric analysis (neointima area: 0.09±0.03 vs. 0.17±0.06 mm, respectively, p<0.05). Conclusion: This study demonstrated that perivascular delivery of rapamycin in Pluronic gel inhibits neointimal hyperplasia in a rat Carotid injury model. This animal model combined with Arteriography can be used for developing new drugs to treat restenosis. In addition, this technique might be useful for vascular surgery such as coronary artery bypass grafting, arteriovenous fistula formation and peripheral vascular bypass graft insertion. (Korean Circ J 2008;38:80-86)
Curtis G Tribble - One of the best experts on this subject based on the ideXlab platform.
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Carotid Arteriography impacts Carotid stenosis management
Vascular Surgery, 2001Co-Authors: Stewart M Long, John A Kern, Steven M Fiser, Aditya K Kaza, David C Cassada, Brian T Miller, Jeffrey A Claridge, Irving L Kron, Curtis G TribbleAbstract:Recent literature advocates Carotid endarterectomy on duplex alone. The authors hypothesized that Carotid angiography adds information that alters clinical management in a substantial number of patients compared to the use of Carotid duplex examination alone. The records of 182 consecutive patients who underwent Carotid artery duplex and subsequent Carotid/cerebral angiography for suspected Carotid artery stenosis between January 1998 and April 1999 were reviewed retrospectively. Carotid artery duplex examinations were stratified based on stenosis: < or =39%, 40% to 59%, 60% to 79% (moderate), 80% to 99% (severe), 100%. Carotid stenosis on angiograms was determined by NASCET criteria. New information found at angiography included vertebral, subclavian, or arch atherosclerosis, intracranial pathosis, or a change in duplex stenosis category to a degree of stenosis not requiring surgery. Clinical importance was attributed to angiograms that altered the patients' management plan. Angiography provided additional information in 53% (97/182) of patients. Vertebral disease was found in 25.1%, subclavian disease in 16.4%, intracranial disease in 15.3%, aortic arch disease in 3.3%. Patient treatment was altered in 30% (55/182). Angiographic findings downgraded the stenosis to medical therapy in 20.9% (38/182). The surgical plan was influenced in 5.5% (10/182). Nine intracranial aneurysms were discovered. Carotid angiography was essential for vascular bypass surgery planning in 3.3% (6/182). Angioplasty was performed in 2.2% (4/182). The accurate determination of stenosis is critical in determining optimal treatment of patients with Carotid artery stenosis. Routine Carotid angiography remains valuable in the clinical treatment of these patients.
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Carotid Arteriography impacts Carotid stenosis management discussion
Scientific Session of the American Heart Association, 2001Co-Authors: Stewart M Long, John A Kern, Steven M Fiser, Aditya K Kaza, David C Cassada, Brian T Miller, Jeffrey A Claridge, Irving L Kron, Curtis G Tribble, Eugene R ZierlerAbstract:Recent literature advocates Carotid endarterectomy on duplex alone. The authors hypothesized that Carotid angiography adds information that alters clinical management in a substantial number of patients compared to the use of Carotid duplex examination alone. The records of 182 consecutive patients who underwent Carotid artery duplex and subsequent Carotid/cerebral angiography for suspected Carotid artery stenosis between January 1998 and April 1999 were reviewed retrospectively. Carotid artery duplex examinations were stratified based on stenosis: ≤39%, 40% to 59%, 60% to 79% (moderate), 80% to 99% (severe), 100%. Carotid stenosis on angiograms was determined by NASCET criteria. New information found at angiography included vertebral, subclavian, or arch atherosclerosis, intracranial pathosis, or a change in duplex stenosis category to a degree of stenosis not requiring surgery. Clinical importance was attributed to angiograms that altered the patients' management plan. Angiography provided additional information in 53% (97/182) of patients. Vertebral disease was found in 25.1%, subclavian disease in 16.4%, intracranial disease in 15.3%, aortic arch disease in 3.3%. Patient treatment was altered in 30% (55/182). Angiographic findings downgraded the stenosis to medical therapy in 20.9% (38/182). The surgical plan was influenced in 5.5% (10/182). Nine intracranial aneurysms were discovered. Carotid angiography was essential for vascular bypass surgery planning in 3.3% (6/182). Angioplasty was performed in 2.2% (4/182). The accurate determination of stenosis is critical in determining optimal treatment of patients with Carotid artery stenosis. Routine Carotid angiography remains valuable in the clinical treatment of these patients.
Anthony J. Comerota - One of the best experts on this subject based on the ideXlab platform.
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NOTESGender Differences in Carotid Stenosis: Are We Overdiagnosing Disease in Women?
2015Co-Authors: Anthony J. ComerotaAbstract:arotid endarterectomy (CEA) reduces the risk for stroke in selected patients with symptomatic and asymptomatic Carotid atherosclerosis.1–5 Because of its observed benefit and the prevalence of Carotid bifur-cation atherosclerosis, CEA is the most commonly performed vascular reconstructive procedure. In gen-eral, the benefit of CEA is related to the degree of stenosis, although in two national trials of patients with asymptomatic disease, observations of the stenosis-spe-cific benefit did not persist.4,5 Carotid Arteriography is commonly considered the most reliable method for evaluating Carotid atheroscle-rosis, and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) investigators stan-dardized the method of quantifying the degree of Carotid stenosis.1 Carotid duplex ultrasound scanning compares favorably with Arteriography in quantifying Carotid ath-erosclerosis.6–10 In an effort to reduce the risk for ischemic complications from Carotid Arteriography, many physi-cians are using Carotid duplex scanning as the definitive diagnostic procedure before CEA.11–13 Diagnostic criteria for Carotid duplex scanning have been established and accepted as reliable from labora-tories accredited by the Intersocietal Commission for the Accreditation of Vascular Laboratories with ongo-ing quality-assurance programs. However, despite efforts to maintain accurate diagnostic criteria that reflect arte-riographically demonstrable disease, personal observations were made at a worrisome frequency that Carotid duplex scanning resulted in overestimation of disease severity in women, yet false-positive studies were infrequently observed in men. This raised the con-cern that women may have higher velocities in their Carotid arteries than men do for similar amounts of dis-ease, and led to this retrospective analysis of Carotid duplex ultrasound scanning versus Arteriography strat-ified by gender. The purpose of this study was to examine whether there were velocity differences based on gender in patients with Carotid artery disease and whether different velocity criteria should be used in women than men, especially at clinically relevant thresh-olds of disease
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Carotid artery velocity characteristics after Carotid artery angioplasty and stenting
Journal of Vascular Surgery, 2007Co-Authors: Santiago Chahwan, Todd M Miller, John P Pigott, Ralph C Whalen, Linda Jones, Anthony J. ComerotaAbstract:Objective Correlation of Carotid duplex ultrasound (DUS) flow velocities with Carotid artery stenosis before and after Carotid endarterectomy is well established. With the evolution of catheter-based techniques, Carotid stenosis increasingly is being treated with angioplasty and stenting (CAS). CAS changes the physical properties of the arterial wall, which may alter blood flow velocities compared with the nonstented Carotid. Opinions differ about whether DUS is a reliable tool to assess technical outcome and recurrent stenosis after CAS. This study correlated Carotid DUS flow velocity findings with Carotid Arteriography after CAS. Methods Data from 77 pairs of Carotid arteriograms with corresponding DUS after CAS in 68 patients were reviewed. Preintervention and postintervention DUS and Carotid arteriogram data were evaluated for each patient. Peak systolic velocities (PSV), end-diastolic velocities (EDV), and internal Carotid artery/common Carotid artery ratios (ICA/CCA) were correlated with the post-CAS arteriogram. Results The mean preintervention PSV was 390 ± 110 cm/s (range, 216 to 691 cm/s), and the average EDV was 134 ± 51 cm/s (range, 35 to 314 cm/s). Postintervention DUS was obtained a mean of 5 days after CAS (range, 1 to 30 days). Sixty (81%) post-CAS arteriograms were normal, and each corresponded to a normal postintervention DUS (PSV range, 30 to 118 cm/s; EDV range, 18 to 60 cm/s). In 14 arteries (19%), completion arteriograms revealed residual stenoses of 20% to 40% in 13, and 50% in one. The mean PSV was 175 cm/s (range, 137 to 195 cm/s), and the mean EDV was 44 cm/s (range, 20 to 62 cm/s). All velocities exceeded the threshold of a 50% stenosis by DUS criteria for a nonstented Carotid artery. In three arteries (2 patients), high-grade recurrent stenoses detected by DUS developed that required reintervention during follow-up. This high-grade restenosis was confirmed by Arteriography in each patient, providing an additional three correlations. Conclusions Normal DUS imaging reliably identifies arteriographically normal Carotid arteries after CAS. Carotid velocities are disproportionately elevated with mild and moderate degrees of stenoses, and velocity criteria for quantitating stenoses in these patients require modification. However, DUS appropriately identifies severe recurrent stenoses after CAS.
Jangwhan Bae - One of the best experts on this subject based on the ideXlab platform.
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Perivascular Delivery of Rapamycin in Pluronic Gel Inhibits Neointimal Hyperplasia in a Rat Carotid Artery Injury Model, and the Complementary Role of Carotid Arteriography
2016Co-Authors: Jangwhan Bae, Kyungkuk Hwang, Dong Woon Kim, Myeong Chan ChoAbstract:Background and Objectives: Rapamycin has been shown to inhibit the vascular smooth muscle cell migration and proliferation that contributes to neointimal formation. We investigated whether the perivascular delivery of rapa-mycin in Pluronic gel could inhibit neointimal hyperplasia in a rat Carotid artery model, and we tested the usefulness of Carotid Arteriography. Materials and Methods: To assess the kinetics of rapamycin’s release from Pluronic gel, a [3H] thymidine incorporation assay was performed with using the media exposed to rapamycin in Pluronic gel for 10, 20, 60 and 120 min. We applied 100 μg of rapamycin in Pluronic gel to the perivascular space of the Carotid artery after the balloon injury (n=9), whereas only gel was applied in a control group (n=9). We performed the Carotid arteriogra-phy and the morphometric analysis 14 days after injury. Results: The [3H] thymidine incorporation assay showed a reduction of uptake in a time-dependent manner (86%, 48%, 45 % and 40 % of the control, respectively, at 10, 20, 60 and 120 minutes). The inhibiting effect of rapamycin on neointimal hyperplasia was identified on the Carotid arte-riography (mean luminal diameter; 0.75±0.11 vs. 0.60±0.12 arbitrary units, respectively, p<0.05) and on the morphometric analysis (neointima area: 0.09±0.03 vs. 0.17±0.06 mm2, respectively, p<0.05). Conclusion: This study demonstrated that perivascular delivery of rapamycin in Pluronic gel inhibits neointimal hyperplasia in a rat Carotid injury model. This animal model combined with Arteriography can be used for developing new drugs to trea
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perivascular delivery of rapamycin in pluronic gel inhibits neointimal hyperplasia in a rat Carotid artery injury model and the complementary role of Carotid Arteriography
Korean Circulation Journal, 2008Co-Authors: Mijin Jung, Jinsook Kwon, Nokwan Park, Yukyung Kim, Tae Jin Shim, Il Ha Jeong, Jangwhan Bae, Kyungkuk Hwang, Dong Woon Kim, Myeong Chan ChoAbstract:Background and Objectives: Rapamycin has been shown to inhibit the vascular smooth muscle cell migration and proliferation that contributes to neointimal formation. We investigated whether the perivascular delivery of rapamycin in Pluronic gel could inhibit neointimal hyperplasia in a rat Carotid artery model, and we tested the usefulness of Carotid Arteriography. Materials and Methods: To assess the kinetics of rapamycin’s release from Pluronic gel, a [H] thymidine incorporation assay was performed with using the media exposed to rapamycin in Pluronic gel for 10, 20, 60 and 120 min. We applied 100 μg of rapamycin in Pluronic gel to the perivascular space of the Carotid artery after the balloon injury (n=9), whereas only gel was applied in a control group (n=9). We performed the Carotid Arteriography and the morphometric analysis 14 days after injury. Results: The [H] thymidine incorporation assay showed a reduction of uptake in a time-dependent manner (86%, 48%, 45% and 40% of the control, respectively, at 10, 20, 60 and 120 minutes). The inhibiting effect of rapamycin on neointimal hyperplasia was identified on the Carotid Arteriography (mean luminal diameter; 0.75±0.11 vs. 0.60±0.12 arbitrary units, respectively, p<0.05) and on the morphometric analysis (neointima area: 0.09±0.03 vs. 0.17±0.06 mm, respectively, p<0.05). Conclusion: This study demonstrated that perivascular delivery of rapamycin in Pluronic gel inhibits neointimal hyperplasia in a rat Carotid injury model. This animal model combined with Arteriography can be used for developing new drugs to treat restenosis. In addition, this technique might be useful for vascular surgery such as coronary artery bypass grafting, arteriovenous fistula formation and peripheral vascular bypass graft insertion. (Korean Circ J 2008;38:80-86)
Stewart M Long - One of the best experts on this subject based on the ideXlab platform.
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Carotid Arteriography impacts Carotid stenosis management
Vascular Surgery, 2001Co-Authors: Stewart M Long, John A Kern, Steven M Fiser, Aditya K Kaza, David C Cassada, Brian T Miller, Jeffrey A Claridge, Irving L Kron, Curtis G TribbleAbstract:Recent literature advocates Carotid endarterectomy on duplex alone. The authors hypothesized that Carotid angiography adds information that alters clinical management in a substantial number of patients compared to the use of Carotid duplex examination alone. The records of 182 consecutive patients who underwent Carotid artery duplex and subsequent Carotid/cerebral angiography for suspected Carotid artery stenosis between January 1998 and April 1999 were reviewed retrospectively. Carotid artery duplex examinations were stratified based on stenosis: < or =39%, 40% to 59%, 60% to 79% (moderate), 80% to 99% (severe), 100%. Carotid stenosis on angiograms was determined by NASCET criteria. New information found at angiography included vertebral, subclavian, or arch atherosclerosis, intracranial pathosis, or a change in duplex stenosis category to a degree of stenosis not requiring surgery. Clinical importance was attributed to angiograms that altered the patients' management plan. Angiography provided additional information in 53% (97/182) of patients. Vertebral disease was found in 25.1%, subclavian disease in 16.4%, intracranial disease in 15.3%, aortic arch disease in 3.3%. Patient treatment was altered in 30% (55/182). Angiographic findings downgraded the stenosis to medical therapy in 20.9% (38/182). The surgical plan was influenced in 5.5% (10/182). Nine intracranial aneurysms were discovered. Carotid angiography was essential for vascular bypass surgery planning in 3.3% (6/182). Angioplasty was performed in 2.2% (4/182). The accurate determination of stenosis is critical in determining optimal treatment of patients with Carotid artery stenosis. Routine Carotid angiography remains valuable in the clinical treatment of these patients.
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Carotid Arteriography impacts Carotid stenosis management discussion
Scientific Session of the American Heart Association, 2001Co-Authors: Stewart M Long, John A Kern, Steven M Fiser, Aditya K Kaza, David C Cassada, Brian T Miller, Jeffrey A Claridge, Irving L Kron, Curtis G Tribble, Eugene R ZierlerAbstract:Recent literature advocates Carotid endarterectomy on duplex alone. The authors hypothesized that Carotid angiography adds information that alters clinical management in a substantial number of patients compared to the use of Carotid duplex examination alone. The records of 182 consecutive patients who underwent Carotid artery duplex and subsequent Carotid/cerebral angiography for suspected Carotid artery stenosis between January 1998 and April 1999 were reviewed retrospectively. Carotid artery duplex examinations were stratified based on stenosis: ≤39%, 40% to 59%, 60% to 79% (moderate), 80% to 99% (severe), 100%. Carotid stenosis on angiograms was determined by NASCET criteria. New information found at angiography included vertebral, subclavian, or arch atherosclerosis, intracranial pathosis, or a change in duplex stenosis category to a degree of stenosis not requiring surgery. Clinical importance was attributed to angiograms that altered the patients' management plan. Angiography provided additional information in 53% (97/182) of patients. Vertebral disease was found in 25.1%, subclavian disease in 16.4%, intracranial disease in 15.3%, aortic arch disease in 3.3%. Patient treatment was altered in 30% (55/182). Angiographic findings downgraded the stenosis to medical therapy in 20.9% (38/182). The surgical plan was influenced in 5.5% (10/182). Nine intracranial aneurysms were discovered. Carotid angiography was essential for vascular bypass surgery planning in 3.3% (6/182). Angioplasty was performed in 2.2% (4/182). The accurate determination of stenosis is critical in determining optimal treatment of patients with Carotid artery stenosis. Routine Carotid angiography remains valuable in the clinical treatment of these patients.