Ursachen und Risikofaktoren der Arteriosklerose

Debus, Eike Sebastian; Torsello, Giovanni; Schmitz‐Rixen, Thomas; Flessenkämper, I.; Storck, M.; Wenk, H.; Grundmann, Reinhart T.

doi:10.1007/s00772-013-1233-6

Cited by 6 publications

(4 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The cause of ischemic stroke is an arterial vascular disease, which in its most common form, atherosclerosis, is an inflammatory response of the vessel wall to lipid metabolism disturbances and endothelial stress. This leads to the formation of multi-focal plaques and thus to the narrowing and hardening of the arteries and consequently to an insufficient supply of oxygen to the brain [8]. A special role in atherosclerosis development plays the carotid artery, which is responsible for an estimated 18 -25 % of thromboembolic strokes [17].…”

Section: Introductionmentioning

confidence: 99%

Proper tangential vector field for the wall shear stress evaluation in numerical blood flow simulations in human carotis tree

Richter¹,

Probst²,

Hundertmark³

et al. 2022

Preprint

View full text Add to dashboard Cite

In numerical simulations of the cardiovascular system the realistic depiction of the blood vessel is essential. The vessel morphology plays a critical role in the underlying hemodynamical computation, for which 3D geometries are obtained via imaging techniques from patients' CTA or MRI scans. To evaluate the patients' current risks suffering vessel wall damage or an ischemic stroke, areas of interest are closely observed. A main indicator for these defects is the stress the blood is exerting on the surrounding vessel tissue. The wall shear stress (WSS) and its cyclic evaluation as the oscillatory shear index (OSI) can be used as an indicator for future medical procedures. As a result of low resolution imaging and craggy stenotic surface areas, the geometry model's mesh is often non smooth on the surface areas. The automatically generated tangential vector fields of such a surface topology are sometimes strongly non unidirectional. Making an interpretation of the orientation-based WSS difficult and partially unreliable. To smooth out the erratic surface tangential field, we apply a projection of the vessel's center-line tangents to the surface. We validate our approach by comparing the orientation focused evaluation of the WSS to the generic method with automatically generated tangential vectors. The results of this work focus on the carotid bifurcation and a distal stenosis area in the internal carotid artery.

show abstract

Section: Introductionmentioning

confidence: 99%

Proper tangential vector field for the wall shear stress evaluation in numerical blood flow simulations in human carotis tree

Richter¹,

Probst²,

Hundertmark³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Carotid stenosis is essentially an expression of generalized arteriosclerosis and, thus, also of systemic disease requiring adjunctive drug treatment/prevention with acetylsalicylic acid (ASA) and statins [1]. …”

Section: Introductionmentioning

confidence: 99%

“…Asymptomatic stenosis of the extracranial internal carotid artery (ICA) is a frequent incidental finding requiring further diagnostic investigation and treatment. Carotid stenosis is essentially an expression of generalized arteriosclerosis and, thus, also of systemic disease requiring adjunctive drug treatment/prevention with acetylsalicylic acid (ASA) and statins [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of long-term results of carotid endarterectomy for asymptomatic carotid artery stenosis

2018

Self Cite

View full text Add to dashboard Cite

This article summarizes the current study situation on treatment of asymptomatic carotid artery stenosis and discusses the evidence situation in the literature. The 10-year results of the ACST study have shown that in comparison to conservative treatment, carotid endarterectomy (CEA) has retained a positive long-term effect on the reduction of all forms of stroke. All multicenter randomized controlled trials comparing CEA with carotid artery stenting (CAS) and, in particular the SAPHIRE and CAVATAS studies, have in common that despite a basic evidence level of Ib, the case numbers of asymptomatic patients are too small for a conclusive therapy recommendation. In the overall assessment of the CREST study the resulting difference in the questionable endpoint of “perioperative myocardial infarction” in favor of the CAS methods, could not be confirmed for exclusively asymptomatic patients. In the long-term course of the CREST study, both methods were classified as equivalent, even when the 4‑year results of periprocedural and postprocedural stroke rates in the separate assessment of the asymptomatic study participants clearly favored the CEA. The results of the ACST-1 study showed an equivalent effect of both treatment methods with respect to all investigated endpoints; however, the unequal sizes of the groups in addition to the statistically insufficient case numbers put a question mark on the validity of the study results. The results of the ASCT-2 and CREST-2 studies are to be awaited, which also investigate the significance of “CEA versus CAS” (ASCT-2) and “CEA/CAS + best medical treatment (BMT) versus BMT alone” in only asymptomatic stenoses. The current S3 guidelines allow operative therapy to be considered in patients with a 60–99% asymptomatic carotid artery stenosis, because the risk of stroke is statistically significantly reduced.

show abstract

“…Jede Manifestationsform und -lokalisation stellt jedoch ein Indiz für eine generalisierte Erkrankung des Organismus dar, das wissen wir inzwischen aus einer Vielzahl groß angelegter internationaler Studien. Da die betroffenen Patienten schon im Anfangsstadium eine erhöhte kardiovaskuläre Morbidität und Mortalität aufweisen, muss es neben der Verhinderung des Fortschreitens einer immobilisierenden peripheren Gefäßerkrankung und der Verhinderung einer Amputation ("Beininfarkt") im Management der Patienten ebenso intensiv darum gehen, die übrigen kardiovaskulä-ren Risiken im Sinne der sekundären und tertiären Prävention bestmöglich zu therapieren [1]. Wir wissen heute, dass das 10-Jahres-Risiko für das Auftreten eines tödlichen kardiovaskulären Ereignisses geschlechtsspezifisch ist und direkt vom systolischen Blutdruck, dem Cholesterin und einer Nikotinanamnese abhängt: Das Risiko ist bei 60-jährigen Frauen ohne Risikofaktoren mit 2% am geringsten, dagegen bei 60-jährigen Männern mit systolischen RR Werten von 180 mmHg und Raucheranamnese mit 21% mit Abstand am höchsten [3].…”

unclassified

Arteriosklerose – Circulation und Training InformatiOns Netzwerk

Debus

2013

Gefässchirurgie

Self Cite

View full text Add to dashboard Cite

Ursachen und Risikofaktoren der Arteriosklerose

Cited by 6 publications

References 39 publications

Proper tangential vector field for the wall shear stress evaluation in numerical blood flow simulations in human carotis tree

Proper tangential vector field for the wall shear stress evaluation in numerical blood flow simulations in human carotis tree

Comparison of long-term results of carotid endarterectomy for asymptomatic carotid artery stenosis

Arteriosklerose – Circulation und Training InformatiOns Netzwerk

Contact Info

Product

Resources

About