The role of carotid stenosis ultrasound scale in the prediction of ischemic stroke

Tang, Yi; Wang, Mingyu; Wu, Taotao; Zhang, Jianyu; Yang, Ronghua; Zhang, Bo; Shi, Ying; Meng, Pin; Ji, Ningfei; Sun, Ying; Xu, Yingda; Xu, Bing-Chao; Zhou, Xinyu; He, Xiao Ying; Zhang, Guanghui; Niu, Xiaoqin; Li, Zai-Po; Wang, Bei; Xu, Bei; Cai, Zenglin; Zhang, Yong-Jin; He, Minqiang

doi:10.1007/s10072-019-04204-8

Cited by 14 publications

(12 citation statements)

References 22 publications

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“…the previous studies (14,24). Many studies demonstrated that the CBF decreased with the increase of the carotid stenosis degree (14,24).…”

Section: Discussionmentioning

confidence: 83%

Associations Between Carotid Plaque Characteristics and Perioperative Cerebral Blood Flow Determined by Arterial Spin Labeling Imaging in Patients With Moderate-to-Severe Stenosis Undergoing Carotid Endarterectomy

Liu¹,

Huo²,

Xu³

et al. 2022

Front. Neurol.

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PurposeTo examine the associations between carotid plaque characteristics and perioperative cerebral blood flow (CBF) by arterial spin labeling (ASL) imaging.Materials and MethodsPatients with unilateral moderate-to-severe carotid stenosis referred for carotid endarterectomy (CEA) were recruited and underwent carotid vessel wall and brain ASL magnetic resonance imaging. The following imaging features were measured: relative CBF (rCBF = CBFindex−hemisphere/CBFcontralateral−hemisphere) in the middle cerebral artery territory; plaque burden and the presence of lipid-rich necrotic core; intraplaque hemorrhage (IPH); calcification; ulcer and fibrous-cap rupture; and the volume and maximum plaque components' area percentages. The associations between plaque characteristics and perioperative CBF were analyzed.ResultsSixty-one patients (mean age, 66.6 ± 7.8 years; 55 males) were included. Univariate linear regression showed that rCBFpre−CEA was associated with stenosis [β, −0.462; 95% confidence interval (CI), from −0.797 to −0.126; p = 0.008], calcification (β, 0.103; 95% CI, 0.005–0.201; p = 0.040), maximum IPH area percentage (β, −0.127; 95% CI, from −0.223 to −0.030; p = 0.012), and ulcer (β, 0.069; 95% CI, 0.025–0.113; p = 0.005); rCBFpost−CEA was associated with the IPH volume (β, −0.060; 95% CI, from −0.107 to −0.014; p = 0.013). After adjusting for the confounding factors, the associations of calcification with rCBFpre−CEA (β, 0.099; 95% CI, from 0.004 to −0.194; p = 0.042) and IPH volume with rCBFpost−CEA (β, −0.060; 95% CI, from −0.109 to −0.011; p = 0.020) remained statistically significant, while those of rCBFpre−CEA with maximum IPH area percentage (β, −0.089; 95% CI, from −0.188 to 0.011; p = 0.080) and ulcer (β, 0.050; 95% CI, from −0.012 to 0.112; p = 0.100) did not remain statistically significant.ConclusionThe compositional characteristics of carotid atherosclerotic plaques, particularly IPH, were associated with perioperative CBF in patients with unilateral moderate-to-severe carotid stenosis undergoing CEA. Our findings indicated that the patients with larger carotid IPH could expect smaller improvement in CBF following CEA.

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“…the previous studies (14,24). Many studies demonstrated that the CBF decreased with the increase of the carotid stenosis degree (14,24).…”

Section: Discussionmentioning

confidence: 83%

Associations Between Carotid Plaque Characteristics and Perioperative Cerebral Blood Flow Determined by Arterial Spin Labeling Imaging in Patients With Moderate-to-Severe Stenosis Undergoing Carotid Endarterectomy

Liu¹,

Huo²,

Xu³

et al. 2022

Front. Neurol.

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“…In addition, Doppler ultrasound is currently the preferred noninvasive CAS detection method, which is simple, safe, and low-cost. However, it cannot detect intracranial CAS lesions, and the results are easily affected by the skill level of the operator [ 29 ]. Therefore, dynamic circulating blood and serum biomarkers have attracted extensive attention [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Dysregulation of miR-637 serves as a diagnostic biomarker in patients with carotid artery stenosis and predicts the occurrence of the cerebral ischemic event

Zhang

Liu

2021

Bioengineered

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“…A large number of studies have demonstrated that carotid stenosis plays an important role in the reduction in the preoperative CBF. 10,16,17 Jongen et al 17 reported that, in patients with unilateral symptomatic carotid stenosis of ≥50%, rCBF declined with carotid stenosis increased. A clinical study including 750 patients with ischemic stroke also reported the decreased blood flow accompanied by the increased degree of carotid stenosis 16 …”

Section: Discussionmentioning

confidence: 99%

Associations Between Carotid Plaque Characteristics and Improvement of Cerebral Blood Perfusion in Patients With Moderate to Severe Carotid Stenosis Undergoing Carotid Endarterectomy

Huo

Yang

et al. 2020

Magnetic Resonance Imaging

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BackgroundThe relationship between plaque characteristics and their predictive value for perioperative cerebral blood flow (CBF) are unknown.PurposeTo investigate the relationship between carotid plaque characteristics and perioperative CBF utilizing MRI.Study TypeProspective.PopulationIn all, 131 patients with carotid moderate‐to‐severe stenosis referred for carotid endarterectomy (CEA).Field Strength/Sequence3T, black‐blood T1‐ and T2‐weighted, 3D time‐of‐flight, and simultaneous noncontrast angiography intraplaque hemorrhage.AssessmentThe relative CBF (rCBF = CBFindex‐hemisphere/CBFcontralateral‐hemisphere) and the CBF difference ratio (DRCBF = [CBFpost‐CEA – CBFpre‐CEA]/CBFpre‐CEA) in the middle cerebral artery territory were measured. The pre‐ and post‐CEA CTP data were used as the assessment standard for CBF change. Carotid lipid‐rich necrotic core (LRNC), intraplaque hemorrhage, calcification, fibrous cap rupture, maximum wall thickness, normalized wall index (NWI), and stenosis were determined.Statistical TestsPearson or Spearman correlation, Mann–Whitney U‐test, and linear regression.ResultsPatients with LRNC had higher rCBFpre‐CEA than those without (1.0 ± 0.1 vs. 0.9 ± 0.1, P < 0.05). NWI was weakly correlated with rCBFpre‐CEA (r = −0.213, P < 0.05) and DRCBF (r = 0.185, P < 0.05) and marginally correlated with rCBFpost‐CEA (r = 0.166, P = 0.057). LRNC was weakly correlated with rCBFpre‐CEA (r = 0.179, P < 0.05). NWI was associated with rCBFpre‐CEA (β = −0.035; 95% confidence interval [CI] [−0.064, −0.006]; P < 0.05), rCBFpost‐CEA (β = 0.042; 95% CI [0.002, 0.081]; P < 0.05) and DRCBF (β = 0.105; 95% CI [0.026, 0.185]; P < 0.05). After adjusting for confounding factors, associations of NWI with rCBFpost‐CEA (β = 0.059; 95% CI [0.016, 0.103]; P < 0.05) and DRCBF (β = 0.110; 95% CI [0.021, 0.199]; P < 0.05) remained statistically significant, while the association between NWI and rCBFpre‐CEA was no longer significant (β = −0.026; 95% CI [−0.058, 0.006]; P = 0.112).The associations of LRNC with rCBFpre‐CEA (β = 0.057; 95% CI [−0.0006, 0.114]; P = 0.052) and DRCBF (β = −0.157; 95% CI [−0.314, 0.001]; P = 0.051) were close to statistical significance. After adjusting for confounding factors, these associations were statistically significant (of LRNC vs. rCBFpre‐CEA: β = 0.060; 95% CI [0.003, 0.118]; P < 0.05; LRNC vs. DRCBF: β = −0.205; 95% CI [−0.375, −0.036]; P < 0.05).Data ConclusionCarotid plaque burden and components, particularly LRNC, might be effective indicators for CBF change following CEA.Level of Evidence 1Technical Efficacy Stage 5

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The role of carotid stenosis ultrasound scale in the prediction of ischemic stroke

Cited by 14 publications

References 22 publications

Associations Between Carotid Plaque Characteristics and Perioperative Cerebral Blood Flow Determined by Arterial Spin Labeling Imaging in Patients With Moderate-to-Severe Stenosis Undergoing Carotid Endarterectomy

Associations Between Carotid Plaque Characteristics and Perioperative Cerebral Blood Flow Determined by Arterial Spin Labeling Imaging in Patients With Moderate-to-Severe Stenosis Undergoing Carotid Endarterectomy

Dysregulation of miR-637 serves as a diagnostic biomarker in patients with carotid artery stenosis and predicts the occurrence of the cerebral ischemic event

Associations Between Carotid Plaque Characteristics and Improvement of Cerebral Blood Perfusion in Patients With Moderate to Severe Carotid Stenosis Undergoing Carotid Endarterectomy

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