Thoracic Aortic 18F-Sodium Fluoride Activity and Ischemic Stroke in Patients With Established Cardiovascular Disease

Fletcher, Alexander; Tew, Yong Yong; Tzolos, Evangelos; Joshi, Shruti; Kaczynski, Jakub; Nash, Jennifer; Debono, Samuel; Lembo, Maria; Kwieciński, Jacek; Bing, Rong; Syed, Maaz; Doris, Mhairi; Beek, Edwin Jacques Rudolph van; Moss, Andrew; Jenkins, William; Walker, Niki L.; Joshi, Nikhil; Pawade, Tania; Adamson, Philip D; Whiteley, William; Wardlaw, Joanna M.; Slomka, Piotr J.; Williams, Michelle; Newby, David E.; Dweck, Marc R

doi:10.1016/j.jcmg.2021.12.013

Cited by 33 publications

(64 citation statements)

References 32 publications

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“…Forty-five articles were included in this review [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ] ( Figure 1 ), to which were added selected articles on methodological and other aspects. Findings in the articles are summarized in the following sections and in Tables S1–S6 in the Supplementary Material .…”

Section: Resultsmentioning

confidence: 99%

“…Anti-atherosclerotic intervention evaluated by NaF-PET/CT [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

“…Several studies dealt with one arterial bed only, i.e., coronary arteries [ 16 , 17 , 18 , 20 , 29 , 30 , 31 , 38 , 39 , 44 ], global heart [ 22 , 23 , 24 , 25 , 27 , 34 ], pulmonary arteries [ 11 ], left carotid artery [ 28 ], aorta [ 26 , 32 , 41 , 42 , 48 , 49 ], abdominal aorta [ 13 , 33 , 45 ], or several arterial beds [ 5 , 6 , 7 , 8 , 9 , 10 , 12 , 14 , 15 , 21 , 35 , 36 , 37 , 40 , 41 , 43 , 46 , 47 ]. Eight reports were experimental animal studies [ 5 , 6 , 32 , 42 , 43 , 45 , 48 , 49 ], and one was an image case report [ 44 <...…”

Section: Resultsmentioning

confidence: 99%

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NaF-PET Imaging of Atherosclerosis Burden

et al. 2023

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The method of 18F-sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT) of atherosclerosis was introduced 12 years ago. This approach is particularly interesting because it demonstrates microcalcification as an incipient sign of atherosclerosis before the development of arterial wall macrocalcification detectable by CT. However, this method has not yet found its place in the clinical routine. The more exact association between NaF uptake and future arterial calcification is not fully understood, and it remains unclear to what extent NaF-PET may replace or significantly improve clinical cardiovascular risk scoring. The first 10 years of publications in the field were characterized by heterogeneity at multiple levels, and it is not clear how the method may contribute to triage and management of patients with atherosclerosis, including monitoring effects of anti-atherosclerosis intervention. The present review summarizes findings from the recent 2¾ years including the ability of NaF-PET imaging to assess disease progress and evaluate response to treatment. Despite valuable new information, pertinent questions remain unanswered, not least due to a pronounced lack of standardization within the field and of well-designed long-term studies illuminating the natural history of atherosclerosis and effects of intervention.

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Section: Resultsmentioning

confidence: 99%

“…Anti-atherosclerotic intervention evaluated by NaF-PET/CT [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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NaF-PET Imaging of Atherosclerosis Burden

et al. 2023

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“…16) If the infarction site is also in other vascular territory and the retrieved thrombus contains a large amount of cholesterol crystals with poor hemocytes, AES should be suspected more aggressively than cardiogenic or paradoxical embolism. Recent study has shown that 18 F-sodium fluoride activity in the thoracic aorta on positron emission tomography is strongly associated with progressive atherosclerosis and ischemic stroke, 17) which will be deemed useful for diagnosis of AES in the future. Of note, cerebral emboli can occur due to retrograde flow from the descending aorta, which is seen even in patients with normal aortic valves.…”

Section: Discussionmentioning

confidence: 99%

Cholesterol Crystals in the Retrieved Thrombus by Mechanical Thrombectomy for Cerebral Embolism: A Case Report and Literature Review

Sugiyama

Hasegawa

KUDO

et al. 2022

NMC Case Report Journal

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There are only a few case reports in which cholesterol crystals were found in the thrombus retrieved by mechanical thrombectomy for cryptogenic stroke, leading to a definitive diagnosis. We herein report a case of aortogenic embolic stroke diagnosed by the presence of rich cholesterol crystals in the retrieved thrombus and review the previously reported cases. A woman in her 80s was transferred as an emergency due to consciousness disturbance, right conjugate deviation, and severe left hemiparesis. Magnetic resonance imaging showed occlusion of the right middle cerebral artery (MCA) and acute infarction in the territory. The MCA was recanalized by thrombectomy using an aspiration catheter and stent retriever, and the symptoms improved. Although the physiological examination did not detect the embolic source during hospitalization, pathological examination of the thrombus revealed atheroma with numerous cholesterol crystal clefts and intermixing of fibrin. Contrast-enhanced computed tomography performed based on the pathological results showed atheromatous lesions in the aortic arch as the embolic source. As a subsequent treatment, medications of a strong statin and an antiplatelet agent were continued, and the patient had no recurrence. The finding that the retrieved thrombus is a simple atheroma containing cholesterol crystals with poor hemocytes suggests embolism due to plaque rupture. Pathological examination of the thrombus obtained by thrombectomy is one of the useful diagnostic approaches for stroke etiology and the determination of its treatment.

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“…The pathogenesis of atherosclerosis includes a cascade of molecular events (15), and imaging can be used to assess each step. Imaging atherosclerosis with new and novel PET radiotracers and evaluating its association with stroke and multi-vessel coronary artery disease can help elucidate the basic mechanisms of atherosclerosis (16)(17)(18)(19)(20). In addition, the reproducibility and in vivo imaging can be useful in the longitudinal follow-up of disease status (21).…”

Section: Editorial On the Research Topic Atherosclerosis And Function...mentioning

confidence: 99%