Aims and objectives
Carotid atherosclerosis represents an important cause of stroke,
with thromboembolism from a moderately or severely stenotic internal carotid artery plaque accounting for up to 15% of all cases .
Although the degree of stenosis has traditionally been regarded as the primary factor defining the risk for stroke,
a great number of studies have highlighted the importance of other factors as well.
Such features include plaque composition and surface morphology and the term “vulnerable plaque” has been introduced to describe those plaques associated with increased risk...
Methods and materials
This was an observational study where patients were recruited on a prospective and consecutive pattern from the Radiology and Neurology Department.
Institutional ethics review board approval and written informed consent from every patient were obtained.
Patients candidates for inclusion in the study were those referred for carotid conventional US,
either being symptomatic or asymptomatic based on clinical examination and brain imaging.
The cause of referral could either be occurrence of transient ischemic attack or stroke (symptomatic patients) or other unrelated conditions (such as...
54 patients (72.2% male,
median age of patients: 61 years) with 62 internal carotid artery plaques (mean stenosis 68.9%) were included in the present study.
Median (IQR) of SII-CDU for plaques without and with an ulceration detected on MDCTA were 10.6 (7.3) and 11.9 (16.5) respectively.
Mean (SD) of SII-CEUS for plaques without and with an ulceration were 11.7 (5.6) and 24.3 (13.9).
The respective boxplots can be found in Fig. 2.The SII-CDU did not significantly differ between non-ulcerated and ulcerated plaques based...
Based on the findings of this study,
the SII proved to be a feasible way to quantify carotid plaque surface irregularities and a valuable indicator of superficial ulceration,
a crucial feature of carotid plaque vulnerability,
with the SII-CEUS being significantly different in plaques with and without ulceration while SII-CDU was not.
As far as diagnostic accuracy is concerned,
the SII-CEUS outperformed SII-CDU in terms of AUC for the detection of ulceration.
CEUS was thus found superior to CDU for the quantitative detection of superficial ulceration,...
Vasileios Rafailidis MD MSc PhD EDiR1
Ioannis Chryssogonidis Asst Prof1
Enrico Grisan PhD2
Thomas Tegos Assoc Prof3
Dimitrios Rafailidis MD PhD4
Paul S Sidhu Prof5
Afroditi Charitanti-Kouridou Prof1
Panagiotis Prassopoulos Prof1
Vasileios Rafailidis has received a scholarship for his PhD studies from the Alexander S.
Onassis Public Benefit Foundation.
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,
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.