Consensus Concerning the Morphology and the Risk of Carotid Plaques

Bray, J. M. De; Baud, J. M.; Dauzat, M.

doi:10.1159/000108415

Cited by 127 publications

(90 citation statements)

References 21 publications

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“…In brief, the following ultrasound color-Doppler characteristics were examined: echogenicity of the lesion with respect to the vessel wall; presence of acoustic shadows inside the lesion; homogeneity of the lesion wall; profile of the endoluminal surface; and the presence or absence of a cleavage plain. Characterization of lesions was consistent with methods describing echogenicity and plaque surface appearance previously established by an International Consensus Conference concerning plaque morphology and risk (19).…”

Section: Methodssupporting

confidence: 67%

Effects of Therapy with Maraviroc on the Carotid Intima Media Thickness in HIV-1/HCV Co-infected Patients

Maggi

Bruno

Perilli

et al. 2017

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Section: Methodssupporting

confidence: 67%

Effects of Therapy with Maraviroc on the Carotid Intima Media Thickness in HIV-1/HCV Co-infected Patients

Maggi

Bruno

Perilli

et al. 2017

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“…44 For plaque morphology assessment, we used the Gray-Weale classification, 17 which is slightly different from the classification recommended in this consensus (4 grades instead of 5). We have paid particular attention to standardize echogenicity classification against defined and wellrecognized reference structures located adjacent to the …”

Section: Discussionmentioning

confidence: 99%

Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis

et al. 2003

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Abstract-A better understanding of the interrelationships between the structure and function of the large arteries would lead to optimize cardiovascular disease prevention strategies. In this study, we investigated the relationships of aortic arterial stiffness assessed by carotid-femoral pulse-wave velocity (PWV), with carotid plaque echogenicity assessed by B-mode ultrasound. We analyzed 561 subjects (without coronary heart disease or stroke) who were volunteers for free health examinations (age, 58.3Ϯ10.8 years; 32.6% women). Extracranial carotid plaque echogenicity was graded from 1 (plaque appearing black or almost black) to 4 (plaque appearing white or almost white) according to the Gray-Weale classification. Plaques of grades 1 and 2 were defined as echolucent plaques, and plaques of grades 3 and 4 were defined as echogenic plaques. Key Words: atherosclerosis Ⅲ carotid arteries Ⅲ epidemiology Ⅲ hypertension, arterial Ⅲ ultrasonography S tudying the possible interrelationships between the structure and function of the large arteries would lead to a better understanding of the pathophysiology of vascular diseases, to a better evaluation of stroke and cardiovascular risks, and thus to the development of more adequate disease prevention strategies. In a recent study, we reported that the presence of carotid atherosclerotic plaques detected by B-mode ultrasound but not diffuse intima-media thickening was determinant of aortic arterial stiffness assessed by carotid-femoral pulse-wave velocity (PWV), independent of major known cardiovascular risk factors. 1 These findings obtained from a large study of hypertensive and normotensive subjects corroborate the recent results of the Rotterdam Study, showing that arterial stiffness was related to abdominal aortic and carotid atherosclerotic plaques. 2 The mechanisms linking arterial stiffness to atherosclerosis are not known at present. Atherosclerotic changes in the arterial wall could include smooth muscle cell proliferation, deposition of lipid and accumulation of collagen, elastin, and/or proteoglycans. 3,4 However, it is not known whether plaques with different contents are differentially related to arterial stiffness. Plaque echogenicity as assessed by B-mode ultrasound has been found to reliably predict the content of soft tissue and the amount of calcification. [5][6][7][8] Plaques that appear echolucent on B-mode ultrasound are lipid-rich, whereas echogenic plaques have a higher content of fibrous tissue and calcification. 9 -11 In our above-mentioned study, 1 plaque echogenicity was assessed; in the current article, we report the cross-sectional associations of aortic PWV with carotid echolucent and echogenic plaques in 561 hypertensive and nonhypertensive subjects.

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“…23 Ultrasonography is usually a technologist-dependent study, with variation also occurring from machine to machine. DeBray et al 24 suggested that echo-density measurement should be used to reflect the overall brightness of the plaque, with the term hyperechoic referring to echogenic plaque and the term hypoechoic referring to echolucent plaque. The terms homogeneous and heterogeneous should be used for plaque of uniform and nonuniform consistency, respectively, thus, expressing their ultrasonic texture.…”

Section: Aburahma Et Al Plaque Heterogeneity and Selection For Ceamentioning

confidence: 99%

Carotid Plaque Ultrasonic Heterogeneity and Severity of Stenosis

AbuRahma

Wulu

Crotty

2002

Stroke

128

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Background and Purpose-Several studies have reported on the correlation of ultrasonic carotid plaque morphology, cerebrovascular symptoms, and intraplaque hemorrhage. This study correlates ultrasonic carotid plaque morphology with the degree of carotid stenosis. Methods-Carotid arteries (nϭ2460) were examined by using color duplex ultrasound during a 1-year period. Carotid stenoses were classified into Ͻ50%, 50% to Ͻ60%, 60% to Ͻ70%, and Ͼ70% to 99%. Ultrasonic plaque morphology was characterized as either heterogeneous (mixed hyperechoic, hypoechoic, and isoechoic) or homogeneous. Results-Heterogeneous plaques were noted in 138 of 794 arteries with Ͻ50% stenosis, in 191 of 564 arteries with 50%to Ͻ60% stenosis, in 301 of 487 arteries with 60% to Ͻ70% stenosis, and in 496 of 615 arteries with 70% to 99% stenosis. The higher the degree of stenosis, the more likely it is to be associated with heterogeneous plaques.Heterogeneous plaques were present in 59% of the arteries with Ն50% stenoses versus 17% of the arteries with Ͻ50% stenoses, in 72% of the arteries with Ն60% stenoses versus 24% of the arteries with Ͻ60% stenosis, and in 80% of the arteries with Ն70% stenoses versus 34% of the arteries with Ͻ70% stenoses (PϽ0.0001 and odds ratios of 6.9, 8.1, and 8.0, respectively). Heterogeneous plaques were associated with an incidence of symptoms that was higher than that for homogeneous plaques for all grades of stenoses; percentages were, respectively, as follows: 68% versus 16% for Ͻ50% stenosis; 76% versus 21% for 50% to Ͻ60% stenosis; 79% versus 23% for 60% to Ͻ70% stenosis, and 86% versus 31% for Ն70% to 99% stenosis (PϽ0.0001 and odds ratios of 8.9, 11.9, 12.6, and 13.7, respectively). Heterogeneity of plaques was more positively correlated with symptoms than with any degree of stenosis (regardless of plaque structure). Eighty percent of all heterogeneous plaques were symptomatic versus 58% for all stenoses Ն50%, 68% for all stenoses Ն60%, and 75% for all stenoses Ն70% (PϽ0.0001, PϽ0.0001, and Pϭ0.02, respectively). Conclusions-The higher the degree of carotid stenosis, the more likely it is to be associated with ultrasonic heterogeneous plaque and cerebrovascular symptoms. Heterogeneity of the plaque was more positively correlated with symptoms than with any degree of stenosis. These findings suggest that plaque heterogeneity should be considered in selecting patients for carotid endarterectomy.

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Consensus Concerning the Morphology and the Risk of Carotid Plaques

Cited by 127 publications

References 21 publications

Effects of Therapy with Maraviroc on the Carotid Intima Media Thickness in HIV-1/HCV Co-infected Patients

Effects of Therapy with Maraviroc on the Carotid Intima Media Thickness in HIV-1/HCV Co-infected Patients

Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis

Carotid Plaque Ultrasonic Heterogeneity and Severity of Stenosis

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