Aims and objectives
Carotid atherosclerotic disease is a well-known cause of transient ischemic attack (TIA) and stroke and its diagnosis and grading primarily relies on imaging,
including virtually every imaging modality from ultrasound (US) to cross-sectional imaging with computed tomography angiography (CTA) or magnetic resonance angiography (MRA).
The degree of internal carotid artery stenosis has been traditionally regarded as the primary determinant for the risk of neurovascular symptoms and the main criterion for defining optimal treatment of patients with carotid disease.
Nevertheless,
the recent literature has made it...
Methods and materials
Patient population
The present study was observational and the patients studied were recruited on a prospective and consecutive pattern from the Radiology and Neurology Department of the Hospital.
Institutional ethics review board approval and written informed consent from every patient were obtained.
Patients who were considered candidates for inclusion in the study were all those referred for carotid CTA after being diagnosed with carotid atherosclerotic disease on US,
either being symptomatic or asymptomatic based on clinical examination and brain imaging.
The cause of referral could...
Results
In total 54 patients (67.7% male,
32.3% female,
median age of patients: 61 years) and 65 internal carotid artery plaques were included in this study.
Diametric stenosis of the internal carotid artery (based on ECST criteria) was significantly higher in symptomatic plaques (median 74.8% vs 66.6%,
p<0.01).
Regarding plaque composition analysis,
symptomatic plaques were found to have significantly higher lipid volume (median mm3 124.3 vs 64.4,
p<0.01),
relative lipid volume (median 10.87 vs 7,
p=0.001),
lower relative calcification volume (median 4.9 vs 8.2,
p<0.05) and...
Conclusion
Based on the findings of this study it can be concluded that CTA quantification of carotid atherosclerotic plaque components is feasible using existing commercially available specialized software.
Features quantified include lipid,
fibrous matrix and calcification.
The volume of lipid tissue both in absolute and relative value,
the relative calcification volume and the ratio of lipid and calcification volume have been found to be associated with the occurrence of stroke,
with the symptomatic carotid plaques exhibiting higher absolute lipid volume,
higher relative lipid volume,
lower relative...
Personal information
Vasileios Rafailidis MD MSc PhD EDiR1
Ioannis Chryssogonidis Asst Prof1
Chrysostomos Xerras MD2
Thomas Tegos Assoc Prof2
Irini Nikolaou MD1
Afroditi Charitanti-Kouridou Prof1
Evangelos Destanis MD PhD1
Anna Kalogera-Fountzila Assoc Prof1
1Department of Radiology,
AHEPA University General Hospital,
Aristotle University of Thessaloniki,
Thessaloniki,
Greece.
2 1st Neurological Department,
AHEPA University General Hospital,
Aristotle University of Thessaloniki,
Thessaloniki,
Greece.
References
Aboyans V,
Ricco JB,
Bartelink MEL,
et al.
2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases,
in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral,
mesenteric,
renal,
upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS).
Eur Heart J.
2018;39(9):763-816.
MRC European...