Literature Review On Atherosclerosis

Coronary artery disease remains number one killer of the western civilization despite 40 years of aggressive drug and surgical interventions (Esselstyn). Usually, pharmaceutical drugs, such as statin, are given to try to slow the progression, but may provide uncomfortable side effects. In fact, the majority of patients discontinue statins within 1 year of treatment initiation (Maningat). Furthermore, surgery is performed to circumvent clogged arteries and literally bypass the symptoms. In the last year, 500,000 coronary bypass procedures were performed (Swaminathan et al). However, these surgeries can have significant risks, including the potential to cause further heart damage, stroke, and brain dysfunction. Thus, it is evident that these way of treatments may not be enough on its own, and that getting to the

In blocked or obstructed arteries, blocked coronary artery blood flow may be resulted by the deposition of cholesterol, calcium and some fatty substances referred to as plaque. The deposition process begins at early ages and when growing at a different rate in every individual regarding the presence of the risk factors. These deposits accumulate gradually eventually reducing the diameter of the coronary artery to the extent that blood vessels can no longer pass blood to the need of muscles of the heart. Apart from the clogging plaque, there exist other mechanisms that may also contribute to the reduction of blood flow to the heart. These include spasm of the coronary artery and also

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

1). Chest X-ray was normal. Initial laboratory studies were remarkable for white blood cells count of 12.1K, a creatine kinase MB fraction of < 3 mm was associated with significant reductions in restenosis and the rate of target vessel revascularization19. In SES-SMART trial patients were randomly assigned to receive a Sirolimus-eluting or bare-metal stent in small coronary artery. Sirolimus stent was associated with significant reductions in the rates of angiographic restenosis (primary outcome), target lesion revascularization and MI at 8 months20. The composite clinical endpoint ( death, non-fatal MI, ischemia- driven target lesion revascularization, and cerebrovascular accidents) was significantly lower with the sirolimus-eluting stent21. In the TAXUS V trial, in the subset of patients with small coronary arteries, the paclitaxel stent was associated with significant reductions in angiographic restenosis and target lesion revascularization at nine months compared to bare metal stents22. Although DES improves target lesion revascularization rates compared to bare-metal stents in small vessels, the absolute rates are still higher in small vessels than large

Atherosclerosis can be a serious condition; it is when the arteries become clogged by fatty substances such as plaques or atheroma. This causes arteries to become narrow and harden which can restrict blood flow preventing organs from functioning properly (Williams 2000).

Atherosclerosis is the hardening and narrowing of arteries, which quietly and gradually blocks arteries, putting blood flow at risk, according to WebMD. Plaque gathers up in the arteries and is composed of fatty substances, calcium, fibrin, cholesterol, and waste products from cells. It can completely or partly cut off the blood in the artery. One of two things can happen in the area where the plaque is building up in the artery: a piece of the plaque may break off or a blood clot may form on the plaque's surface, according to the American Heart Association. Atherosclerosis is a kind of arteriosclerosis, which is simply the thickening and hardening of arteries. It is typically the agent of strokes, peripheral vascular disease, and heart attacks,

Atherosclerosis is a reduction of the arteries triggered by a buildup of plaque. It is also called arteriosclerosis or hardening of the arteries. Arteries are the blood vessels that transport oxygen and nutrients from the heart to the rest of the body. As the body gets older, fat and cholesterol can collect in the arteries and form plaque. The buildup of plaque makes it difficult for blood to flow through the arteries. This buildup may transpire in any artery in the body and can result in a shortage of blood and oxygen in various tissues of the body. Pieces of plaque can also break off, causing a blood clot. If left untreated, atherosclerosis can lead to heart attack, stroke, and heart failure. Atherosclerosis is a fairly common problem associated with aging. According to the University of Maryland

A stent is a small mesh tube that's used to treat narrow or weak arteries, for example, the coronary arteries which supply oxygen-rich blood to your heart. Doctors place stents in arteries as part of a procedure called percutaneous coronary intervention, or PCI, sometimes called angioplasty. In coronary arteries narrowed by the buildup of plaque the procedure opens the blockage and restores blood flow to the heart muscle. Doctors also may place a stent in weak arteries to improve blood flow and help prevent the arteries from bursting. To place a stent in one of your coronary arteries your doctor will make a small opening in a blood vessel in your upper thigh, arm or neck. Through this opening your doctor will thread a thin flexible tube call a catheter.

Presently, the treatment strategies used are risk factor modification, conventional pharmacology and surgical revascularization. These strategies have hitherto not been of enormous solution as the disease progression still result in recurrent symptoms. This has now led to the exploitation of advances in comprehending the vascular biology of atherogenesis to introduce novel cell and molecular-based therapies. The application of immunomodulation, lipid-lowering agents like statins, gene transfer, antisense technology and so on has resulted in new therapeutic strategies to interrupt cell proliferation and disorder of the vessel wall. In this essay, immunomudulation and lipid-lowering agent shall be discussed.

I rejected my null hypothesis that the aneurysm recurrence rate from stent assisted coiling is equal to that of unassisted coiling in favor of the alternative hypothesis that the aneurysm recurrence rate from stent assisted coiling is not equal to that of unassisted coiling. A two proportion Z-test with a Z value of -4.858766 is less than the table Z value of 1.96 at an alpha level of 0.05 allowed me to make that claim. The results from this study would be able to help patients and doctors alike to determine which treatment would be the best to reduce the chance of aneurysms recurring.

However, a meta-analysis by Brown et al showed worse short-term outcomes for certain groups of symptomatic carotid stenosis patients after undergoing carotid stenting compared with carotid endarterectomy. The poor predictive factors of adverse events are elderly age more than 70 years and complex anatomy of the aortic arch (i.e. type 3 and bovine aortic arch)4. Moreover, type 3 arch was counted as a predictor of major adverse events and confirmed in Thai patients5. The normal and bovine variants of aortic arch types are shown in Figures 1 and 2,

- Patients within this age group with at least one vessel with 20% stenosis that is indicated on a coronary angiography

Atherosclerosis can be associate with atheromata’formation, which are raised, fibroadipose plaques that develop within the intimal layer of the artery or within the innermost layers of the tunica media. Some atheromata undergo calcification or ulceration, and mural thrombi can form over complicated and uncomplicated atheromata. As a result, can block or diminished the blood flow in the artery, turning tissue and organs oxygen deprived.

DAPT had to have long enough time after implanting the stent into arteries to prevent stent thrombosis.Premature discontinuation of anticoagulation therapy, also known as premature discontinuation of DAPT, means discontinuation of DAPT for less than three months for sirolimus-eluting stents (SES) and shorter than six months for paclitaxel-eluting stents (PES). The outcome of the premature discontinuation of DAPT can increase the risk of stent thrombosis, myocardial infarction, and death. Bare-metal stents (BMS) do not relate to blood clotting issues after stent implantation such as stent thrombosis. Therefore, it can be said that BMS do not need anti-clotting therapies. On the contrary, drug-eluting stents have been involved with late stent thrombosis. To prevent this issue, optimal conditions of several factors should be considered. Those factors can be stent position and expansion, the number of stents, stent size, stent design, patient and lesion, and premature discontinuation of antiplatelet medicines. Revascularization can be defined that produce the healthy blood circulation to a body part again under the situation carrying depletion of oxygen to an organ. The terminology, revascularization, is usually used by surgical

The stent will be placed where it can be expanded to hold the artery open. Some stents are designed to simply keep the artery held open. Other stents used are drug-eluting stents. These stents are coated with pharmacologic agents that work to prevent restenosis of the artery.