BACKGROUND AND PURPOSE Activation of plasma protein C (PC) zymogen by thrombin-thrombomodulin at the endothelial surface is an important endogenous antithrombotic mechanism. It is unknown whether activated protein C (APC) is generated in vivo in the cerebrovasculature, because there is only limited thrombomodulin expression in human brain vascular endothelium. Therefore, we tested the hypothesi...

In eight patients undergoing carotid endarterectomy, the mean velocity and an index of pulse amplitude in the middle cerebral artery were monitored continuously by transcranial doppler ultrasound. rCBF was measured by intracarotid injection of 133 Xenon shortly before and at the time of the carotid artery occlusion, and again a few minutes after carotid flow was reestablished. Comparison of the...

Venous stasis retinopathy and ischemic oculopathy are ocular manifestations of ischemia in the distribution of the carotid artery. While not as common as transient monocular blindness or retinal arterial emboli, they are readily recognizable and indicate the presence of severe, often bilateral, carotid occlusive disease. Patterns of occlusion vary but usually include complete occlusion of at le...

Animal models are essential for understanding the pathology of stroke and investigating potential treatments. However, in vivo stroke models are associated, particularly in mice, with high variability in lesion volume. We investigated whether a surgical refinement where reperfusion is not reliant on the Circle of Willis reduced outcome variability. Mice underwent 60 min of transient middle cere...

A retrospective review was performed of the National Cardiovascular Data Registry Carotid Artery Revascularization and Endarterectomy Peripheral Vascular Intervention registries from January 2007 to July 2019. Of 58,423 patients who had undergone carotid revascularization, 8% contralateral occlusion (CCO). with CCO, 69% underwent transfemoral artery stenting (TF-CAS) 31%, endarterectomy (CEA). ...

A 2-year-old child fell on a toothbrush, sustaining a pharyngeal injury. Eighteen hours later, localizing symptoms of a cerebrovascular accident became evident. Magnetic resonance angiography showed occlusion of the internal carotid artery and a cerebral infarction. She was treated with anticoagulation and made a complete recovery. Pharyngeal injuries may be complicated by internal carotid arte...

We described 9 consecutive patients who underwent operative carotid artery exploration with attempted carotid endarterectomy (CEA) for symptomatic internal carotid artery (ICA) occlusion. Indications for this surgery based on vascular imaging included segmental occlusion of the proximal ICA and also extensive occlusion of the distal ICA in selected patients in whom color-flow duplex ultrasound ...

Pathogenesis of Cerebral Infarction Secondary to Mechanical Carotid Artery Occlusion • The immediate postoperative cerebral complications of 65 carotid occlusions were evaluated. The occlusions were done in all but one case for intracranial saccular aneurysms and were performed by either direct ligation (quick type) or slow turning down of a Silverstone clamp or similar device (slow occlusion)....

Basilar artery territory stroke may result from embolism arising from the site of vertebral artery occlusion. This stroke mechanism (local embolism) has been well documented in the middle cerebral artery territory from extracranial internal carotid artery disease but not fully appreciated in the vertebral basilar circulation. We report two patients whose clinical presentation indicated major ba...