#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Diagnosis, classification and principles of management of cerebrovascular atherosclerotic disease from perspective of angiology


Authors: P. Gavorník  1 3;  A. Dukát  1 3;  Ľ. Gašpar  1 3;  L. Slezáková 1,3;  N. Hučková 1,3;  K. Kusendová  1 3;  G. Gubo 1,2;  X. Faktorová 1,2;  E. Cikatricisová 1,2;  P. Sabaka 1,3
Authors‘ workplace: II. interná klinika LF UK a UN Bratislava 1;  Prvé angiologické pracovisko II. internej kliniky LF UK a UN Bratislava 2;  Angiologická sekcia Slovenskej lekárskej komory 3
Published in: Kardiol Rev Int Med 2015, 17(4): 354-361
Category: Cardiology Review

Overview

Aim:
The aim of this review is to look at internal and angiological studies of cerebrovascular arterial disease in order to assess their contribution to our expanding knowledge of organovascular arterial diseases and of atherosclerosis.

Discussion:
The National Institute of Neurological Disorders and Stroke (NINDS) is a part of the U.S. National Institute of Health (NIH). It conducts and funds research on disorders of the brain and nervous system. NINDS defines cerebral arteriosclerosis as the result of thickening and hardening of the walls of brain arteries, which can cause serious health problems. If an arterial wall becomes critically thick, or a blood clot is caught in a stenosis, blood flow to the brain can be reduced or blocked as a result of this stenosing‑ obliterating vascular process, leading to ischaemic stroke. When the thickening and hardening is uneven, arterial walls can develop aneurysms. If a bulge ruptures, bleeding in the brain can cause haemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom‑free strokes cause cumulative damage and death to neurons (nerve cells) in the brain, potentially manifested by apathy, depression, disorientation, aggressiveness, etc. Computer tomography (CT) and magnetic resonance imaging (MRI) of the brain can help reveal the presence of cerebral arteriosclerosis before ischaemic strokes, haemorrhagic strokes, or vascular dementia develop.

Conclusion:
Organovascular arterial ischaemic diseases are important manifestations of systemic atherosclerosis and other arterial diseases of the vascular system. Key clinical‑ etiology‑ anatomy‑ pathophysiology (CEAP) dia­gnostic aspects and management principles of cerebrovascular arterial ischaemic diseases are discussed in this review (project Vessels).

Keywords:
angiology/vascular medicine –  arteriology –  organovascular arterial ischaemic diseases –  cerebrovascular diseases –  CEAP diagnosis –  management


Sources

1. Gavorník P. Ateroskleróza a iné choroby tepien. 1. vyd. Bratislava: Univerzita Komenského – Vydavateľstvo UK 1999: 216.

2. Gavorník P, Dukát A, Gašpar Ľ et al. Choroby aorty –  dia­gnostika, klasifikácia a princípy manažmentu. Kardiol Rev Int Med 2014; 16: 493– 500.

3. Tanriover MD, Rigby S, van Hulstejin LH et al. On behalf of the Working Group on Professional Issues, European Federation of Internal Medicine (EFIM). What is the role of general internists in the tertiary or academic setting? Eur J Intern Med 2015; 26: 9– 11. doi: http:/ / dx.doi.org/ 10.1016/ j.ejim.2014.11.004. 

4. Sorita A, Ahmed A, Starr SR et al. Off‑ hour presentation and outcomes in patients with acute ischemic stroke: A systematic review and meta‑analysis. Eur J Intern Med 2014; 25: 394– 400. doi: 10.1016/ j.ejim.2014.03.012.

5. Porfidia A, Morretti T, Pola R et al. Thromboprophylaxis in patients with stroke: A delicate decision. Eur J Intern Med 2014; 25: e93– e94. doi: 10.1016/ j.ejim.2014.07.001.

6. Birns J, Qureshi S, Chen R et al. Endovascular stroke therapy. Eur J Intern Med 2014; 25: 584– 591. doi: 10.1016/ j.ejim.2014.06.025.

7. Gavorník P. Etiopatogenéza neurovaskulárnych ischemických chorôb (syndrómov). Neurológia 2010; 5: 61– 68.

8. Park JH, Ovbiagele B. Optimal combination secondary prevention drug treatment and stroke outcomes. Neurology 2015; 84: 50– 56. doi: 10.1212/ WNL.0000000000001099.

9. Jauch EC, Saver JL, Adams HP et al. The American heart association stroke council, council on cardiovascular nursing, council on peripheral vascular disease, and council on clinical cardiology. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American heart association/American stroke association. Stroke 2013; 44: 870–947. doi: 10.1161/STR.0b013e318284056a.

10. Bushnell C, McCullough LD, Awad IA et al. The American heart association stroke council, council on cardiovascular and stroke nursing, council on clinical cardiology, council on epidemiology and prevention, and council for high blood pressure research. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American heart association/American stroke association. Stroke 2014; 45: 1545–1588. doi: 10.1161/01.str.0000442009.06663.48.

11. Kernan WN, Ovbiagele B, Black HR et al. The American heart association stroke council, council on cardiovascular and stroke nursing, council on clinical cardiology, and council on peripheral vascular disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American heart association/American stroke association. Stroke 2014; 45: 2160–2236. doi: 10.1161/STR.0000000000000024.

12. Meschia JF, Bushnell C, Boden-Albala B et al. The American heart association stroke council, council on cardiovascular and stroke nursing, council on clinical cardiology, council on functional genomics and translational biology, and council on hypertension. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American heart association/American stroke association. Stroke 2014; 45: 3754–3832. doi: 10.1161/STR.0000000000000046.

13. Catapano AL, Reiner Z, De Backer G et al. ESC/ EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2011; 217: 3– 46. doi: 10.1016/ j.atherosclerosis.2011.06.012.

14. Alis R, Sanchis‑ Gomar F, Risso‑ Ballester J et al. Inhibition of xanthine oxidase to prevent statin‑induced myalgia and rhabdomiolysis. Atherosclerosis 2015; 239: 38– 42. doi: 10.1016/ j.atherosclerosis.2014.12.055.

15. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (Version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Devel­oped with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis 2012; 223: 1– 68. doi: 10.1016/ j.atherosclerosis.2012.05.007.

16. Grundy SM, Arai H, Barter P et al. An International Atherosclerosis Society Position Paper: Global recommendations for the management of dyslipidemia‑ Full report. Expert Dyslipidemia Panel of the International Atherosclerosis Society. J Clin Lipidol 2014; 8: 29– 60. doi: 10.1016/ j.jacl.2013.12.005.

17. Guyatt GH, Akl EA, Crowther M et al. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians (ACCP) evidence‑based clinical practice guidelines. Chest 2012; 141 (Suppl 2): 1S–801S.

18. James PA, Oparil S, Carter BL et al. 2014 Evidence‑based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507– 520. doi: 10.1001/ jama.2013.284427.

19. Jensen MD, Ryan DH, Apovian CM et al. 2013 AHA/ ACC/ TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014; 129 (Suppl 2): S102– S138. doi: 10.1161/ 01.cir.0000437739.71477.ee.

20. American Diabetes Association: Standards of Medical Care in Diabetes. Diabetes Care 2015; 38 (Suppl): S1– S93.

21. Staekenborg SS, van Straaten ECW, van der Flier WM et al. Small vessel versus large vessel vascular dementia. J Neurol 2008; 255: 1644– 1651. doi: 10.1007/ s00415- 008- 0944- 1.

22. Inzucchi SE, Bergenstal RM, Buse JB et al. Man­agement of hyperglycemia in type 2 diabetes, 2015: a patient‑ centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes Diabetes Care 2015; 38: 140– 149. doi: 10.2337/ dc14- 2441.

23. Gavorník P. Angiológia 1 pre všeobecných praktických lekárov‑ Flebológia. 1. vyd. Bratislava: Vydavateľstvo Dr. Josef Raabe 2013: 125.

24. Gavorník P. Angiológia 2 pre všeobecných praktických lekárov‑ Arteriológia. 1. vyd. Bratislava: Vydavateľstvo Dr. Josef Raabe 2014: 174.

25. Gavorník P. Rehabilitácia a interná medicína. Interná med 2013; 13: 498– 501.

26. Wang YL, Ma H, Yang J et al. Association between estimated glomerular filtration rate, ankle‑ brachial index, and recurrent ischemic stroke in a Chinese population of ischemic stroke patients. Vasa 2013; 42: 177– 183. doi: 10.1024/ 0301- 1526/ a000266.

27. Remková A, Bátorová A, Mistrík M et al. Reverzia antikoagulačného účinku nových perorálnych antikoagulancií pri krvácaní a v urgentných situáciách s rizikom krvácania –  spoločné odporúčania odborných spoločností. Interná med 2014; 14: 105– 114.

28. Šteňo J. Princípy chirurgického liečenia cievnych ochorení mozgu. In: Princípy chirurgie II. Bratislava: SAP 2010: 165– 166.

29. Vulev I, Klepanec A, Bazik R et al. Endovascular treatment of internal carotid and vertebral artery aneurysms using a novel pericardium covered stent. Interv Neuroradiol 2012; 18: 164– 171.

30. Tomka J, Slyško R, Mondek P. K životnému jubileu prof. MU Dr. V. Šefránka, CSc. Monitor medicíny SLS 2014; 4: 40– 41.

31. Taskinen M‑ R, Borén J. New insights into the pathophysiology of dyslipidemia in type 2 diabetes. Atherosclerosis 2015; 239: 483– 495. doi: 10.1016/ j.atherosclerosis.2015.01.039.

32. Joshi PH, Nasir K. The highs and lows of cardiovascular risk prediction: Time for paradigm shift? Atherosclerosis 2015; 239: 436– 438. doi: 10.1016/ j.atherosclerosis.2015.02.001.

33. Yeh SJ, Jeng JS, Tang SC et al. Taiwan Stroke Registry Investigators. Low estimated glomerular filtration rate is associated with poor outcomes in patients who suffered a large artery atherosclerosis stroke. Atherosclerosis 2015; 239: 328– 334. doi: 10.1016/ j.atherosclerosis.2015.01.038.

34. Ashor AW, Lara J, Mathers JC et al. Effect of vitamin C on endothelial function in health and disease: A systematic review and meta‑analysis of randomised controlled trials. Atherosclerosis 2014; 235: 9– 20. doi: 10.1016/ j.atherosclerosis.2014.04.004.

35. Arcidiacono MV, Traveset A, Rubinat E et al. Microangiopathy of large artery wall: neglected complication of diabetes mellitus. Atherosclerosis 2013; 228: 142– 147. doi: 10.1016/ j.atherosclerosis.2013.02.011.

36. Bays H. Adiposopathy, “Sick Fat,” Ockham’s Razor, and Resolution of the Obesity Paradox. Curr Atheroscler Rep 2014; 16: 409. doi: 10.1007/ s11883- 014- 0409- 1.

37. Bergqvist D, Björck M, Lees T et al. Validation of the VASCUNET registry –  pilot study. Vasa 2014; 43: 141– 144. doi: 10.1024/ 0301– 1526/ a000340.

38. Bonaiuti D. Drugs in stroke rehabilitation. Eur J Phys Rehab Med 2013; 49: 227– 231.

39. Boyd CM, Kent DM. Evidence‑based medicine and the hard problem of multimorbidity. J Gen Intern Med 2014; 29: 552– 553. doi: 10.1007/ s11606- 013- 2658- z.

40. Carpentier PH. The birth of the European Society for Vascular Medicine (ESVM) –  a new step forward in the development of vascular medicine. Vasa 2013; 42: 315– 316. doi: 10.1024/ 0301- 1526/ a000295.

41. Hafner F, Hackl G, Haas E et al. Idiopathic carotidynia. Vasa 2014; 43: 287– 292. doi: 10.1024/ 0301- 1526/ a000365.

42. Howangyin KY, Silvestre JS. Diabetes mellitus and ischemic diseases. molecular mechanisms of vascular repair dysfunction. Arterioscler Thromb Vasc Biol 2014; 34: 1126– 1135. doi: 10.1161/ ATVBAHA.114.303090.

43. Kerk N, Goerge T. Livedoid vasculopathy –  a thrombotic disease. Vasa 2013; 42: 317– 322. doi: 10.1024/ 0301- 1526/ a000296.

44. Kramer MH, Bauer W, Dicker D et al. The Working Group on Professional Issues, European Federation of Internal medicine (EFIM). The changing face of internal medicine: Patient centred care. Eur J Intern Med 2014; 25: 125– 127. doi: 10.1016/ j.ejim.2013.11.013.

45. Messner B, Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis. Arterioscler Thromb Vasc Biol 2014; 34: 509– 515. doi: 10.1161/ ATVBAHA.113.300156.

46. Mitchell GF. Arterial stiffness and hypertension: chicken or egg? Hypertension 2014; 64: 210– 214. doi: 10.1161/ HYPERTENSIONAHA.114.03449.

47. Moazzam AM, Savas SN, Amar AP et al. Dif­fuse aneurysmal disease –  a review. Reviews in Vascular Medicine 2014; 2: 48– 57. doi:10.1016/ j.rvm.2013.11.003

48. Mueller S, Pfannkuche M, Breithardt G et al. The quality of oral anticoagulation in general practice in patients with atrial fibrillation. Eur J Intern Med 2014; 25: 247– 254. doi: 10.1016/ j.ejim.2013.12.013.

49. Ruff CT, Giugliano RP, Braunwald E et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta‑analysis of randomised trials. Lancet 2014; 383: 955– 962. doi: 10.1016/ S0140- 6736(13)62343– 0.

50. Selvin E, Rawlings AM, Grams M et al. Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol 2014; 2: 279– 288. doi: 10.1016/ S2213- 8587(13)70199- 2.

51. Menaa F. Stroke in sickle cell anemia patients: A need for multidisciplinary approaches. Atherosclerosis 2013; 229: 496– 503. doi: 10.1016/ j.atherosclerosis.2013.05.006.

52. Auer J. Coronary evaluation in patients with stroke: recognizing the risk. Atherosclerosis 2015; 238: 427– 429. doi: 10.1016/ j.atherosclerosis.2014.11.010.

53. McEvoy JW, Nasir K. ABI and stroke: action at a dis­tance and a call to action. Atherosclerosis 2014; 234: 73– 74. doi: 10.1016/ j.atherosclerosis.2014.02.012.

54. Willeit K, Kiechl S. Atherosclerosis and atrial fibrillation –  Two closely intertwined diseases. Atherosclerosis 2014; 233: 679– 681. doi: 10.1016/ j.atherosclerosis.2013.11.082.

55. Li M, Hou W, Zhang X et al. Hyperuricemia and risk of stroke: a systematic review and meta‑analysis of prospective studies. Atherosclerosis 2014; 232: 265– 270. doi: 10.1016/ j.atherosclerosis.2013.11.051.

56. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281– 1357. doi: 10.1097/ 01.hjh.0000431740.32696.cc.

57. Ay H, Benner T, Arsava EM, Furie KL et al. A computerized algorithm for etiologic classification of ischemic stroke: the Causative Classification of Stroke System. Stroke 2007; 38: 2979– 2984.

58. Zanchetti A, Liu L, Mancia G et al. Blood pressure and low‑ density lipoprotein‑cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence. J Hypertens 2014; 32: 1741– 1750. doi: 10.1097/ HJH.0000000000000253.

59. Moran AE, Odden MC, Thanataveerat A et al. Cost‑effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med 2015; 372: 447– 455. Correction: N Engl J Med 2015; 372: 1677. doi: 10.1056/ NEJMsa1406751.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#