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The surgical mortality of endarterectomy ranges from 1–2% to as much as 10%. Two large randomized clinical trials have demonstrated that carotid surgery done with a 30-day stroke and death risk of 3% or less will benefit asymptomatic people with ≥60% stenosis who are expected to live at least 5 years after surgery.
A decreased valvular area causes increased pressure gradient, and these parameters are used to classify and grade the aortic stenosis as mild, moderate or severe. The pressure gradient can be abnormally low in the presence of mitral stenosis , heart failure , co-existent aortic regurgitation and also ischaemic heart disease (disease related to ...
The most common cause of arterial stenosis is atherosclerosis, however other pathologies such as fibromuscular dysplasia, dissection, trauma or external compression may occur. [2] Atherosclerotic plaque can rupture, resulting in a source of emboli. These emboli can cause TIAs or strokes in the areas of the brain supplied by the affected artery.
The exact pathophysiology of Monckeberg's arteriosclerosis remains uncertain. However, it is thought that the condition arises from the fatty degeneration of smooth muscle cells within the arterial media, leading to the formation of a mass that undergoes hyaline degeneration and eventually calcification.
Coronary artery ectasia is characterized by an increased wall stress of the vessel, thinning of the arterial wall which causes progressive dilation and remodelling of the vessel. [2] The permanent dilation of the artery is thought to be mainly caused by inflammation, triggered by disease, chemicals, or physical stress of the vessel. [ 3 ]
Stenosis (from Ancient Greek στενός (stenós) ' narrow ') is the abnormal narrowing of a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture ).
Arterial stiffness may also affect the time at which pulse wave reflections return to the heart. As the pulse wave travels through the circulation it undergoes reflection at sites where the transmission properties of the arterial tree change (i.e. sites of impedance mismatch). These reflected waves propagate backward towards the heart.
The calculated aortic valve orifice area is currently one of the measures for evaluating the severity of aortic stenosis. A valve area of less than 1.0 cm 2 is considered to be severe aortic stenosis. [1] [2] There are many ways to calculate the valve area of aortic stenosis.
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