An Atlas of Contrast-Enhanced Angiography by Nicholas Bunce

By Nicholas Bunce

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J Hypertens 1994; 2(suppl):s5–14 2. Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH. Blood pressure, stroke, and coronary heart disease, part 2: short-term reductions in blood pressure. Overview of randomised drug trials in their epidemiological context. Lancet 1990; 335:827–38 3. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP).

MRA demonstrates mild narrowings at the origins of the right and left internal carotid arteries. There are severe stenoses near the origins of the left and right external carotid arteries. She was referred for a neurological opinion prior to coronary intervention SURGICAL INTERVENTION FOR CAROTID ARTERY STENOSIS Asymptomatic patients Several trials have investigated the role of surgical intervention in patients with carotid Carotid artery disease 43 artery stenosis. The Asymptomatic Carotid Atherosclerosis Study (ACAS) assessed whether the addition of carotid endarterectomy to aggressive medical management reduced the incidence of stroke in patients with asymptomatic carotid artery stenosis26.

AORTIC COARCTATION Aortic coarctation is a congenital abnormality of the aorta that usually presents in childhood with cardiac failure or in young adults with resistant hypertension18. Many patients have an additional bicuspid aortic valve19,20, and some have aneurysm of the circle of Willis21. Clinical signs may include radio-femoral delay or upper limb hypertension, and a continuous interscapular or anterior chest murmur20. Three subgroups can be identified with MRA: a localized juxtaductal stenosis occurs opposite the site of the ductus arteriosus; hypoplastic arch produces a tubular narrowing of the arch aorta; and aortic arch interruption is usually fatal.

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