OBJECTIVE: To analyze the resolution of ONP after surgical or endovascular treatment in comparison with its spontaneous course.

METHODS: Between June 1999 and April 2008, 5 of 914 consecutive patients with ruptured and 10 of

344 with unruptured intracranial aneurysms causing ONP were treated at our institution. ONP was recorded at admission and at follow-up. The electronic database MEDLINE was searched for published studies of PcomA aneurysm-caused ONP. Two reviewers independently extracted data.

RESULTS: Overall, 26 studies and 15 patients of the current series totaling 201 PComA aneurysms met the inclusion criteria. A total of 132 patients underwent surgical clipping, 54 patients were treated endovascularly, and 15 patients remained untreated. Surgical treatment was associated Wnt inhibitor with a significantly higher rate

of complete ONP resolution (55% vs 32%; P = .006; odds ratio [OR], 2.6; 95% confidence interval [CI], 1.3-5.1) NVP-BSK805 ic50 and ONP resolution of any degree (92% vs 74%; P = .001; OR, 4.3; 95% CI, 1.8-10.4) compared with endovascularly treated patients. In the multivariate analyses, surgical clipping was significantly associated with ONP resolution of any degree (P < .0001; OR, 12.2; 95% CI, 3-49) and of complete resolution (P = .006; OR, 7.1; 95% CI, 1.8-28).

CONCLUSION: The present data indicate that ONP caused by PComA aneurysms resolves in a significantly higher portion of patients after surgical treatment compared with endovascular coiling and the spontaneous course.”
“Background: Endothelial gene silencing via small interfering RNA (siRNA) transfection represents a promising strategy for

the control of vascular disease. Here, we demonstrate endothelial gene silencing in human saphenous vein using three rapid siRNA transfection techniques amenable for use in the operating room.

Methods: Control siRNA, Cy5 siRNA, or siRNA targeting glyceraldehyde-3-phosphate dehydrogenase (GAPDH) or endothelial specific nitric oxide synthase (eNOS) were applied to surplus human saphenous vein for 10 minutes by (i) soaking, (ii) applying 300 mm Hg hyperbaric pressure, or (iii) 120 mm Hg luminal distending pressure. Transfected learn more vein segments were maintained in organ culture. siRNA delivery and gene silencing were assessed by tissue layer using confocal microscopy and immunohistochemistry.

Results: Distending pressure transfection yielded the highest levels of endothelial siRNA delivery (22% pixels fluorescing) and gene silencing (60% GAPDH knockdown, 55% eNOS knockdown) as compared with hyperbaric (12% pixels fluorescing, 36% GAPDH knockdown, 30% eNOS knockdown) or non-pressurized transfections (10% pixels fluorescing, 30% GAPDH knockdown, 25% eNOS knockdown).

Adjuvant intravesical therapy was based on risk. Followup cystoscopy at 3, 6 and 9 months was conducted with white light.

Results: Detection was performed as a within patient comparison in the fluorescence group. In this group 286 patients had at least 1 Ta or T1 tumor (intent to treat). In 47 patients (16%) at least 1 of the tumors was seen

only with fluorescence this website (p = 0.001). During the 9-month followup (intent to treat) there was tumor recurrence in 128 of 271 patients (47%) in the fluorescence group and 157 of 280 (56%) in the white light group (p = 0.026). The relative reduction in recurrence rate was 16%.

Conclusions: Hexaminolevulinate fluorescence cystoscopy significantly improves the detection of Ta and T1 lesions and significantly reduces the rate of tumor recurrence at 9 months.”
“BACKGROUND: The incidence of headache in patients with pituitary adenomas is high, and the underlying pathological mechanisms are not completely understood.

OBJECTIVE: We tested the efficacy of percutaneous ganglion block and trigeminal rhizotomy in the treatment of severe trigeminal/autonomic

headache associated with pituitary tumors.

METHODS: Eleven patients treated surgically for pituitary adenomas in whom intractable trigeminal headaches developed were enrolled in the study and underwent ictal cerebral single-photon emission computed tomography before starting treatment. Initially, all patients underwent a 6-month medical treatment trial. Patients who did not experience improvement in headache severity, VE 822 addressed by the Headache Impact Test-6 scale, underwent trigeminal percutaneous Dipeptidase ganglion blockade. Two patients subsequently underwent trigeminal balloon rhizotomy.

RESULTS: Among the 11 patients, 6 did not have improved

Headache Impact Test-6 scale scores after 6 months of treatment with medications and underwent trigeminal ganglion blockade. Significant improvement in headache severity was noted in 3 of them. Long-term response was obtained in 1 patient, and the other 2, in whom the response was transient, were then successfully treated with trigeminal rhizotomy. Cerebral single-photon emission computed tomography showed increased uptake in the thalamus/hypothalamus region in patients who responded well to manipulation of the trigeminal-hypothalamic system.

CONCLUSION: Percutaneous ganglion blockade and trigeminal rhizotomy may be promising alternative options for the treatment of severe headache in selected patients with pituitary adenomas.”
“Purpose: In a multicenter, prospectively randomized study we evaluated bacillus Calmette-Guerin alone vs bacillus Calmette-Guerin plus interferon alpha-2b and megadose vitamins vs recommended daily allowance vitamins during induction and maintenance intravesical therapy in the treatment of nonmuscle invasive bladder cancer.

In addition, social approach and avoidance behavior towards a novel social target were measured 7 weeks after stress. Social defeat stress chronically reduced

social behavior, whereas depletion of VTA BDNF chronically increased social behavior. Our results reveal that depletion of VTA BDNF alleviates some consequences of intermittent social defeat stress, enhances social behavior, and may contribute to weight gain. These data implicate VTA BDNF in protracted behavioral responses to stress, social stimuli, and weight regulation. (C) 2011 Elsevier Ireland Ltd. All rights reserved.”
“INI1/hSNF5 is an HIV-1 integrase (IN) binding https://www.selleckchem.com/products/lcl161.html protein specifically incorporated into virions. A truncated mutant of INI1 (S6, amino acids 183 to 294) harboring the minimal IN binding Rpt1 domain potently inhibits HIV-1 particle production in a transdominant manner. The inhibition requires interaction of S6 with IN within Gag-Pol. While INI1 is a nuclear protein and harbors a masked nuclear export signal (NES), the transdominant

negative mutant S6 is cytoplasmic, due to the unmasking of NES. Here, we examined the effects of subcellular localization of S6 on HIV-1 inhibition and further investigated the stages of assembly that are affected. We found that targeting a nuclear localization signal-containing S6 variant [NLS-S6(Rpt1)] to the nucleoplasm (but not to the nucleolus) resulted in complete reversal of inhibition of particle production. Electron microscopy indicated that although no

electron-dense particles at any stage Selleck BI-D1870 of assembly were seen in cells expressing S6, virions were produced in cells expressing the rescue mutant NLS-S6(Rpt1) to wild-type levels. Immunofluorescence analysis revealed that p24 exhibited a diffuse pattern of localization within the cytoplasm in cells expressing S6 in contrast to accumulation along the membrane in controls. Pulse-chase analysis indicated that in S6-expressing cells, although Gag(Pr55(gag)) protein translation was unaffected, processing and release of p24 were defective. Together, these results indicate that expression of S6 in the cytoplasm interferes with trafficking of Gag-Pol/Gag D-malate dehydrogenase to the membrane and causes a defective processing leading to inhibition of assembly at an early stage prior to particle formation and budding.”
“Different lines of evidence support BDNF as a candidate gene in mood and anxiety modulation. More recently, the Met allele of the BDNF Val66Met polymorphism has been implicated in anxiety in animal models and anxiety-traits in humans. The aim of this study is to evaluate the a priori hypothesis that the association between anxiety disorders and Val66Met polymorphism at the BDNF gene would be replicated in a community sample of children and adolescents.

Results: CHF patients with Type D personality had lower levels of Hsp70 than non-Type D patients (6.48 ng/mL versus

7.85 ng/mL, p = .04, d = 0.26), and in case of an ischemic etiology, higher levels of XO (13.57 ng/mL versus 9.84 ng/mL, p = .01, d = 0.98). There were no significant univariate differences for depression. When adding depression as an additional independent variable in the Type D analysis, the effect of Type D personality remained significant (F = 5.460, p = .02) and was independent of depression (F = 0.942, p = .33). The ratio of XO to Hsp70 was significantly higher in Type D patients with CHF as compared with non-Type D patients (6.14 versus 2.83, p = .03, d = 0.39), independent of etiology class. Conclusion:

CHF patients with Type D personality are characterized by an increased oxidative stress burden, apparent in check details the decreased antioxidant levels and an increased oxidative stress ratio.”
“Perceptual learning is a special type of non-declarative learning that involves experience-dependent plasticity in sensory cortices. The cholinergic system is known to modulate declarative learning. In particular, reduced levels or efficacy of the neurotransmitter acetylcholine were found to facilitate declarative memory consolidation. However, little is known about the role of the cholinergic system in memory consolidation of non-declarative learning. Here we compared two groups BMS-777607 of non-smoking men who learned a visual texture discrimination task (TDT). One group received chewing tobacco Bupivacaine containing nicotine for 1 h directly following the TDT training. The other group received a similar tasting control substance without nicotine. Electroencephalographic recordings during substance consumption showed reduced

alpha activity and P300 latencies in the nicotine group compared to the control group. When re-tested on the TDT the following day, both groups responded more accurately and more rapidly than during training. These improvements were specific to the retinal location and orientation of the texture elements of the TDT suggesting that learning involved early visual cortex. A group comparison showed that learning effects were more pronounced in the nicotine group than in the control group. These findings suggest that oral consumption of nicotine enhances the efficacy of nicotinic acetylcholine receptors. Our findings further suggest that enhanced efficacy of the cholinergic system facilitates memory consolidation in perceptual learning (and possibly other types of non-declarative learning). In that regard acetylcholine seems to affect consolidation processes in perceptual learning in a different manner than in declarative learning. Alternatively, our findings might reflect dose-dependent cholinergic modulation of memory consolidation.

This article is part of a Special Issue entitled ‘Cognitive Enhancers’. (C) 2012 Elsevier Ltd. All rights reserved.

59 +/- 1.35, P=0.02). Tumor-to-organ ratios were generally higher in mice treated with Acipimox. This was supported by PET imaging data, both semi-quantitatively (mean tumor FDG uptake) and visually (tumor-to-background ratios). In mice with CWR22Rv1 xenografts there was no effect of Acipimox on FDG uptake, either in biodistribution or PET imaging. C-14-acetate uptake was unaffected in PO and CWR22Rv1 xenografts.

Conclusions: In mice with PO PCa xenografts, acute administration of Acipimox increases tumor uptake of (18) F-FDG with general improvements in tumor-to-background ratios. Data indicate that administration of Acipimox prior

to (18) F-FDG PET scans has potential to improve sensitivity and specificity in patients with Geneticin in vitro castration-resistant advanced PCa. (C) 2013 Elsevier Inc. All rights reserved.”
“This study investigated differences in HPA axis function, measured as salivary cortisol concentrations, between 18 women with chronic trapezius myalgia (MYA) and 30 healthy female controls (CON). In addition, the interactions between HPA axis reactions to psychosocial stress and aspects of pain, health and psychological symptoms were analyzed. Salivary cortisol PKC412 cost was measured both in daily life, to assess the circadian profile, and in the laboratory during light repetitive work and standardized psychosocial stress (Trier Social Stress Test, TSST). MYA and CON exhibited similar circadian

rhythms and comparable salivary cortisol response magnitudes after TSST. In subjects defined as responders to the TSST, the mean peak time point of the cortisol response after TSST differed significantly between MYA and CON. Furthermore, negative psychological states and higher pain intensity were related to a slower HPA axis response to TSST. Low circadian variations in cortisol and smaller cortisol responses to TSST were found among subjects scoring

high on anxiety sensitivity. Thus, a relatively favorable sample of female chronic trapezius myalgia patients exhibited normal circadian rhythm and normal salivary cortisol response magnitudes after a psychosocial stress test. In the subgroup of responders, the MYA group showed indications of a slower salivary cortisol response to psychosocial stress. Further studies are needed to elucidate the possibility of altered Vinorelbine Tartrate HPA axis activity in terms of a slower salivary cortisol response. (c) 2009 Elsevier Ltd. All rights reserved.”
“Cognitive deficits occur in over half of multiple sclerosis patients, with hippocampal-dependent learning and memory commonly impaired. Data from in vivo MRI and post-mortem studies in MS indicate that the hippocampus is targeted. However, the relationship between structural pathology and dysfunction of the hippocampus in MS remains unclear. Hippocampal neuropathology also occurs in experimental autoimmune encephalomyelitis (EAE), the most commonly used animal model of MS.

The low values of coefficient of variation in the intra- (1.74%) and inter-assay (2.41%) analysis suggested that the assay was a highly reproducible. The Plexor real-time PCR was compared with three other real-time PCR systems (SYBR Green, TaqMan, LUX) with conclusion that it can be used as a method of choice for the detection and quantitation of PCV2. (C) 2011 Elsevier B.V. All rights reserved.”
“Objectives: To compare the risk for cardiovascular mortality between bipolar I and bipolar II subtypes and determine correlates of cardiovascular mortality. Bipolar disorder conveys an increased risk of cardiovascular mortality. Methods: Participants with major affective

disorders were recruited for the National Institute of Mental Health Collaborative Depression Study and followed prospectively for up to 25 years. A total of 435 participants met the diagnostic criteria for bipolar I (n = 288) or bipolar II (n = 147) disorder based on Research see more Diagnostic Criteria at intake and measures of psychiatric symptoms during

follow-up. Diagnostic subtypes were contrasted by cardiovascular mortality risk using Cox proportional hazards regression. Affective symptom burden (the proportion of time with clinically significant manic/hypomanic or depressive symptoms) and treatment exposure were additionally included in the models. Results: Thirty-three participants died from cardiovascular causes. Participants with bipolar I disorder Hepatic fructokinase had more than double the cardiovascular mortality risk of those with bipolar It disorder, after controlling for age and gender (hazard ratio = 2.35, 95% Confidence Interval = 1.04-5.33; 4SC-202 p = .04). The observed difference in cardiovascular mortality between these subtypes was at least partially confounded by the burden of clinically significant manic/hypomanic symptoms

which predicted cardiovascular mortality independent of diagnosis, treatment exposure, age, gender, and cardiovascular risk factors at intake. Selective serotonin uptake inhibitors seemed protective although they were introduced late in follow-up. Depressive symptom burden was not related to cardiovascular mortality. Conclusions: Participants with bipolar I disorder may face a greater risk of cardiovascular mortality than those with bipolar II disorder. This difference in cardiovascular mortality risk may reflect manic/hypomanic symptom burden.”
“Previously, a novel macula-like virus was identified from Bombyx mori cultured cell line BmN and termed B. mori macula-like virus (BmMLV). BmMLV encodes a 6.5-kb-long positive, single-strand RNA genome, which contains putative RNA-dependent RNA polymerase (RdRp), coat protein (cp) and p15 genes. In this study, CP expression in several B. mori-derived cell lines was examined by using the CP antibody. Surprisingly, Western blot analysis revealed that all of the cell lines tested have already been infected with BmMLV.

Smooth muscle cells in the intestines, urinary bladder, and arteries have been shown to express NGF. To address whether this website enhanced NGF production among these different organ systems stimulates comparable patterns of sympathetic collateral growth, we generated transgenic mice that express NGF under the control of the smooth muscle a-actin promoter. In response to elevated levels of NGF protein in the colon, bladder, and arteries/arterioles, sympathetic axons displayed robust sprouting only in the colon and bladder. These data reveal that, unlike most other peripheral tissues, sympathetic efferents; in adult mammalian arteries/arterioles do not undergo collateral growth in response

to increased levels of smooth muscle-derived NGF. NeuroReport 20:223-227 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.”
“Background/Aims:

Dual blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) has higher antiproteinuric effects than single blockade in adults. In children, little is known on dual blockade of the renin-angiotensin system. The study investigates whether adding an ARB to proteinuric children already on ACEI reduces proteinuria. Methods: A total of 10 children (median age 13.3 years) with chronic kidney disease and persistent proteinuria despite maximal dose of ACEI were included. Losartan APR-246 concentration was given at an initial dose 0.8 mg/kg/day. Proteinuria, blood pressure (BP) and renal function (glomerular filtration rate) were measured. Results: Mean proteinuria decreased from 484 +/- 290 mg/mmol creatinine to 223 +/- 197 after 1-3 months of losartan treatment and remained stable at 234 +/- 153, 224 +/- 177 and 195 +/- 133

after 3-6, 6-12 months and at the last follow-up check (median 1.9 years, p < 0.05 for all visits vs. before treatment). The median percentage decrease in proteinuria was 66, 56, 44 and 66% during the study periods. No significant change in BP, glomerular filtration rate or serum potassium was observed. One child complained of rash, which led to discontinuation of losartan. Conclusion: Adding an ARB to current ACEI treatment can further reduce proteinuria in children with chronic kidney disease without affecting BP. Copyright (C) 2009 S. Karger AG, Basel”
“This study PIK-5 examined the possibility that hemispheric differences in stress-induced brain activation vary as a function of sex. Using in-vivo voltammetry, increases in extracellular dopamine release in response to predator odour and tail pinch stress were recorded bilaterally and simultaneously in either the infralimbic cortex or basolateral amygdala. In both stress-sensitive brain regions, significant sex x hemisphere interactions were observed, with males and females showing greater dopamine activation in right-brain and left-brain structures, respectively.

Results: Although phenoxybenzamine eliminated adrenergic responses, the isoprostane 15-F-2t-IsoP and 2 closely related E-ring molecules (15-E-1t-IsoP and 15-E(2t)IsoP) still evoked powerful contractions; 15-E-2t-IsoP was approximately 10-fold more potent than the other 2 agents. Responses were mediated through thromboxane receptors because

they were sensitive to ICI-192605. Furthermore, they were sensitive to the Rho-kinase inhibitors Y-27632 or H-1152 (both 10(-5) mol/L) or to cyclopiazonic acid (which depletes the internal Ca2+ pool), but not to nifedipine. In single cells, 15-E-2t-IsoP elevated [Ca2+](i) and suppressed K+ current.

Conclusions: Isoprostanes accumulate after coronary artery bypass graft surgery, yet none of the currently MK-4827 available antispasm treatments for radial artery grafts is effective against isoprostane-induced vasoconstriction. It is imperative that more specific treatment strategies be developed. We found that isoprostane responses in radial arteries are mediated by prostanoid receptors selective for thromboxane A(2) with activation of

Rho-kinase and release of Ca2+. Pretreatment of radial artery grafts with Rho-associated kinase inhibitors may potentially reduce postoperative graft spasm. Clinical studies to test this are indicated.”
“With the aim of producing selective radiotracers for in vivo imaging of the vesicular Anlotinib acetylcholine transporter (VAChT) using positron mission tomography (PET), here, we report synthesis and analysis of a new class of conformationally constrained vesamicol analogues with moderate lipophilicity. The sequential ring opening on trans- 1,4-cyclohexadiene dioxide enabled an approach to synthesize 6-arylpiperidino-octahydrobenzo[1,4]oxazine-7-ols [morpholino vesamicols]. The radiosynthesis of the [F-18]fluoroacetyl-substituted derivative ([F-18]FAMV) was achieved starting from a corresponding bromo precursor [2-Bromo-1-[7-hydroxy-6-(4-phenyl-piperidin-1-yl)-octahydro-benzo[1,4] oxazin-4-yl]-ethanone] and using a modified commercial computer-controlled module system with a radiochemical yield

of 27 +/- 4%, a high radiochemical purity (99%) and a specific activity of 35 GBq/mu mol. In competitive binding assays using a PC12 cell line overexpressing VAChT and [H-3]-(-) vesamicol, 2-fluoro-1-[7-hydroxy-6-(4-phenyl-piperidin-1-yl)-octahydro-benzo[1,4]oxazin-4-yl]-ethanone Alanine-glyoxylate transaminase (FAMV) demonstrated a high selectivity for binding to VAChT (K-i: 39.9 +/- 5.9 nM) when compared to its binding to sigma(1/2) receptors (K-i>1500 nM). The compound showed a moderate lipophilicity (logD((pH 7))= 1.9) and a plasma protein binding of 49%. The brain uptake of [F-18]FAMV was about 0.1% injected dose per gram at 5 min after injection and decreased continuously with time. Notably, an increasing accumulation of radioactivity in the lateral brain ventricles was observed.

“
“5-HT1A receptors were studied via [H-3]WAY-100635 and [H-3]8-OH-DPAT binding to rat brain cortical membranes. We characterized the effect of zinc (Zn2+) on the binding properties of the 5-HT1A receptor. The allosteric ternary complex model was applied to determine the

dissociation constant (K-A) of Zn2+ and their cooperativity factors (alpha) affecting the dissociation constants (K-D, K-i) of [H-3]WAY-100635, [H-3]8-OH-DPAT, and serotonin (5-HT), the endogenous neurotransmitter. Zn2+ (5 mu M-1 mM) inhibited the binding of agonist/antagonist to 5-HT1A receptors, mostly by decreasing both the ligands’ affinity Defactinib and the maximal number of sites. In [S-35]GTP gamma S binding assays Zn2+ behaved as insourmountable antagonist of 5-HT1A receptors, in agreement with radioligand binding assays. The residues involved in the formation of the inhibitory binding site on the 5-HT1A receptor were assessed by using N-ethyl-maleimide (NEM) or diethylpyrocarbonate (DEPC) which modify preferentially cysteine and histidine residues, respectively. Exposure to both agents did not block the negative allosteric GDC-0994 molecular weight effects of Zn2+ on agonist and antagonist binding. Our findings represent the first quantitative analysis of allosteric binding interactions for 5-HT1A receptors. The physiological significance of Zn2+ modulation of 5-HT1A receptors is unclear, but the colocalization of 5-HT1A receptors

and Zn2+ in the nervous system (e.g. in the hippocampus and cerebral cortex) suggests that Zn2+ released at nerve terminals may modulate signals generated by the 5-HT1A receptors in vivo. Finally, these findings suggest that synaptic Zn2+ may be a factor influencing Galactosylceramidase the effectiveness of therapies that rely on 5-HT1A receptor activity (c) 2008 Elsevier Ltd. All rights reserved.”
“We

investigated the ability of western equine encephalitis virus envelope glycoproteins (WEEV GP) to pseudotype lentiviral vectors. The titers of WEEV GP-pseudotyped human immunodeficiency virus type 1 (HIV) ranged as high as 8.0 X 10(4) IU/ml on permissive cells. Sera from WEEV-infected mice specifically neutralized these pseudotypes; cell transduction was also sensitive to changes in pH. The host range of the pseudotyped particles in vitro was somewhat limited, which is atypical for most alphaviruses. HIV vectors pseudotyped by WEEV GP may be a useful tool for characterizing WEEV cell binding and entry and screening for small-molecule inhibitors.”
“Significant advances have been made in understanding the underlying defects of and developing potential treatments for Fragile X syndrome (FXS), the most common heritable mental retardation. It has been shown that neuronal metabotropic glutamate receptor 5 (mGluR5)-mediated signaling is affected in FX animal models, with consequent alterations in activity-dependent protein translation and synaptic spine functionality.

In the presence of inhibitors of GABA receptors, spontaneous excitatory post-synaptic currents (sEPSCs) and spontaneous spike rates were reduced in a concentration-dependent manner by both DM and PM. IC50 values were 0.037 and 0.70 mu M for inhibition of sEPSCs and 0.60 and 21.8 mu M for inhibition of spontaneous spike rate by DM and PM, respectively.

Both compounds altered burst activity by decreasing the number of spikes during spontaneous bursting, the number of sEPSCs within a bursting release event and the duration of sEPSC bursts while increasing both the interspike interval and the time between sEPSCs. Exposure of neurons to the VGSC-specific modulator veratridine had effects similar to both DM and PM, while

inhibition Selleck 4EGI-1 of voltage-gated calcium channels had no effect on spontaneous spike rates. In the absence of GABA receptor antagonists, both DM and PM increased SHP099 purchase spontaneous spike rates. Altogether, these data demonstrate that DM and PM disrupt network activity in vitro, largely via a VGSC-dependent mechanism. Published by Elsevier Inc.”
“Background: While medical high risk (MHR) has been proposed as an indication for carotid artery stenting (CAS), the impact of MHR on long-term survival and stroke after CAS has not been described.

Methods: A retrospective chart review of CAS procedures at our institution was performed. One hundred seventy-nine consecutive patients who underwent 196 CAS procedures were classified by MHR status based on cardiac, pulmonary, and renal criteria routinely used in high-risk clinical trials. Survival and stroke rates were compared after 90 CAS procedures in MHR patients vs 106 CAS PIK-5 procedures in normal risk patients. Survival results were also compared with 365 contemporaneous carotid endarterectomy (CEA) procedures in 346 patients.

Results: The mean age of CAS patients was 72 years, with 87% having a smoking history, 85% hypertension,

38% diabetes, 39% symptomatic, and 74% documented coronary artery disease. Mean follow-up was 23 months. Recurrent stenosis after CEA comprised 21% of all CAS procedures. During the 30-day post-procedure period, there were five minor strokes, one major stroke, and one death, for a combined stroke/death rate of 3.6%. Kaplan-Meier analysis demonstrated mortality of 5% at 1 year and 21% at 3 years for the entire cohort. Cox regression analysis found that MHR designation was not associated with increased mortality or an increase in a composite end point of death or stroke. MHR patients had mortality of 4% at 1 year and 22% at 3 years. Normal risk patients had mortality of 6% at 1 year and 20% at 3 years. Preoperative age over 80 years old, low density lipoprotein (LDL) >= 160 mg/dL, and serum creatinine >= 1.5 mg/dL conferred statistically significant risk for death (Hazard ratios: 2.9, 4.3, and 2.4, respectively).