Role of CT Angiographic Plaque Morphologic Characteristics in Addition to Stenosis in Predicting the Symptomatic Side in Carotid Artery Disease

Eesa, Muneer; Hill, Michael D.; Al-Khathaami, Ali M.; Alzawahmah, Mohamed; Sharma, Pooja; Menon, Bijoy K; Tymchuk, Sarah; Demchuk, Andrew M.; Goyal, Mayank

doi:10.3174/ajnr.a2078

Cited by 44 publications

(28 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A more interesting approach would be to use the calcified plaque volume as a marker for ischemic symptoms. 15 A recent study 17 suggested that extensive calcification is more commonly associated with the asymptomatic side. However, Nandalur et al 18 have shown that the ratio of calcified plaque volume and total plaque volume is significantly inversely associated with the occurrence of symptoms.…”

Section: Discussionmentioning

confidence: 99%

The Relation of Carotid Calcium Volume with Carotid Artery Stenosis in Symptomatic Patients

Marquering¹,

Majoie²,

Smagge³

et al. 2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

The Relation of Carotid Calcium Volume with Carotid Artery Stenosis in Symptomatic Patients

Marquering¹,

Majoie²,

Smagge³

et al. 2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…6 Similarly, our work supports data from previous CTA studies of carotid plaque, suggesting that extensive calcification may afford a protective effect, possibly by preventing adhesion and subsequent aggregation of platelet-rich thrombi, although this claim requires further histopathologic confirmation. 24 An additional strength of maximum soft plaque thickness measurements is that such data are readily acquired from standard axial source images in CTA, with a highly reproducible simple linear measurement. Wintermark et al, 25 for example, demonstrated in a cross-sectional analysis from CTA data that certain carotid wall characteristics were significantly associated with stroke, including wall volume, fibrous cap thickness, and number and location of lipid clusters on source images.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Computed Tomography Angiography Plaque Thickness Measurements in High-Grade Carotid Artery Stenosis

Gupta

Baradaran

Kamel

et al. 2014

Stroke

View full text Add to dashboard Cite

Background and Purpose— Increasing evidence suggests that carotid artery imaging can identify vulnerable plaque elements that increase stroke risk. We correlated recently proposed markers, soft and hard plaque thickness measurements on axial computed tomography angiography source images, with symptomatic disease status (ipsilateral stroke or transient ischemic attack) in high-grade carotid disease. Methods— Soft plaque and hard plaque thickness were measured with a recently validated technique using computed tomography angiography source images in subjects with ≥70% extracranial carotid artery stenosis. Logistic regression analyses were used to assess the strength of association between soft and hard plaque thickness measurements and previous stroke or transient ischemic attack. Receiver operating characteristic analysis was also performed. Results— Compared with asymptomatic subjects, those with symptomatic carotid disease had significantly larger soft plaque and total plaque thickness measurements and smaller hard plaque thickness measurements. Each 1-mm increase in soft plaque resulted in a 2.7 times greater odds of previous stroke or transient ischemic attack. Soft plaque thickness measurements provided excellent discrimination between symptomatic and asymptomatic disease, with receiver operating characteristic analysis showing an area under the curve of 0.90. A cutoff of 3.5-mm maximum soft plaque thickness provided a sensitivity of 81%, specificity of 83%, positive predictive value of 85%, and a negative predictive value of 78%. Conclusions— Increasing maximum soft plaque thickness measurements are strongly associated with symptomatic disease status in carotid artery stenosis. Prospective validation of these results may translate into a widely accessible stroke risk stratification tool in high-grade carotid artery atherosclerotic disease.

show abstract

“…From the axial source images, image post-processing can be performed to produce an angiographic display, identifying plaque calcium, luminal surface ulceration (Saba et al, 2007; U-King-Im et al, 2010) and intraluminal thrombus (Eesa et al, 2010). However, limitations of CT and CT angiography (CTA) include exposure to ionizing radiation in addition to artefacts induced by calcification and implanted metallic devices.…”

Section: Imaging Modalities For Assessing Focal Carotid Plaque Hemorrmentioning

confidence: 99%

Plaque hemorrhage in carotid artery disease: Pathogenesis, clinical and biomechanical considerations

Zhang

Sadat

Brown

et al. 2014

Journal of Biomechanics

View full text Add to dashboard Cite

Stroke remains the most prevalent disabling illness today, with internal carotid artery luminal stenosis due to atheroma formation responsible for the majority of ischemic cerebrovascular events. Severity of luminal stenosis continues to dictate both patient risk stratification and the likelihood of surgical intervention. But there is growing evidence to suggest that plaque morphology may help improve pre-existing risk stratification criteria. Plaque components such a fibrous tissue, lipid rich necrotic core and calcium have been well investigated but plaque hemorrhage (PH) has been somewhat overlooked. In this review we discuss the pathogenesis of PH, its role in dictating plaque vulnerability, PH imaging techniques, marterial properties of atherosclerotic tissues, in particular, those obtained based on in vivo measurements and effect of PH in modulating local biomechanics.

show abstract

Role of CT Angiographic Plaque Morphologic Characteristics in Addition to Stenosis in Predicting the Symptomatic Side in Carotid Artery Disease

Cited by 44 publications

References 31 publications

The Relation of Carotid Calcium Volume with Carotid Artery Stenosis in Symptomatic Patients

The Relation of Carotid Calcium Volume with Carotid Artery Stenosis in Symptomatic Patients

Evaluation of Computed Tomography Angiography Plaque Thickness Measurements in High-Grade Carotid Artery Stenosis

Plaque hemorrhage in carotid artery disease: Pathogenesis, clinical and biomechanical considerations

Contact Info

Product

Resources

About