Imaging the Vulnerable Carotid Plaque with CT: Caveats to Consider. Comment on Wang et al. Identification Markers of Carotid Vulnerable Plaques: An Update. Biomolecules 2022, 12, 1192

Rotzinger, David C.; Qanadli, Salah D.; Fahrni, Guillaume

doi:10.3390/biom13020397

Cited by 1 publication

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“…Identifying carotid plaque instability is important because it indicates an increased risk of stroke or other cardiovascular events. Imaging techniques such as ultrasound, MRA or CTA can help assess plaque stability by evaluating plaque composition, size, and characteristics 8 . Management of carotid plaque instability typically involves aggressive risk factor modification, including lifestyle changes (such as diet, exercise, and smoking cessation) and medications such as statins, single (or double antiplatelet agents), and/or anticoagulants to stabilize the plaque and reduce the risk of thrombosis and/or embolism.…”

Section: Discussionmentioning

confidence: 99%

Bubbles help in troubles: contrast-enhanced ultrasound (CEUS) as predictor of recurrence for TIA/stroke in low-grade internal carotid artery stenosis

D’Auria,

Santo

2024

Preprint

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Introduction Contrast-enhanced ultrasound (CEUS) allows to visualize atherosclerotic plaque neo-vessels which are the hallmark of carotid plaque instability. Aim Aim of our prospective study was to check the correlation between carotid CEUS analysis and the recurrence of TIA/stroke in patients with a previous recent TIA/stroke and neurological impairment congruent with the vascular stenosis. Materials and Methods From November 2021 to May 2023, 62 consecutive patients (mean age 73.8 +/- 12.2, female 51) with a TIA/stroke in the previous 30 days, underwent carotid ultrasound and carotid CEUS in outpatients setting after 10 days from the acute event. Inclusion criteria was one atherosclerotic plaque inside the internal carotid artery, congruent with symptoms, which was causing a stenosis less than 50% (low-grade stenosis). Carotid plaque neovascularization scoring method was: score 0: no visible microbubbles within the plaque (A); score 1: minimal microbubbles confined to periadventitial (B); and score 2: microbubbles present throughout the plaque core (C). During the six-month follow-up, we checked TIA/stroke recurrences. A multivariable logistic regression analysis was performed. Results In our series, 22% of patients have CEUS score 0, 35% CEUS score 1, and 43% CEUS score 2. At six-month follow-up we found 21% TIA/stroke recurrences in CEUS score 2, despite of the ongoing best medical therapy as per guidelines. In Cox regression analysis, CEUS-detected neovascularization was independently associated with TIA/stroke recurrence (hazard ratio, 5.37; 95% confidence interval, 1.36?2.31). Conclusions Plaque neovascularization, detected by CEUS, is an independent predictor of TIA/stroke recurrence at six-month follow-up in patients with carotid atherosclerosis despite of low-grade stenosis.

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Section: Discussionmentioning

confidence: 99%

Bubbles help in troubles: contrast-enhanced ultrasound (CEUS) as predictor of recurrence for TIA/stroke in low-grade internal carotid artery stenosis

D’Auria,

Santo

2024

Preprint

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Imaging the Vulnerable Carotid Plaque with CT: Caveats to Consider. Comment on Wang et al. Identification Markers of Carotid Vulnerable Plaques: An Update. Biomolecules 2022, 12, 1192

Abstract: We read with great interest the review by Wang et al. entitled “Identification Markers of Carotid Vulnerable Plaques: An Update”, recently published in Biomolecules [...]

Cited by 1 publication

References 34 publications

Bubbles help in troubles: contrast-enhanced ultrasound (CEUS) as predictor of recurrence for TIA/stroke in low-grade internal carotid artery stenosis

Bubbles help in troubles: contrast-enhanced ultrasound (CEUS) as predictor of recurrence for TIA/stroke in low-grade internal carotid artery stenosis

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