Computerized plaque analysis has the potential to identify patients with histologically unstable carotid plaques. This model requires validation, but offers the potential to influence patient selection for emergency interventions and the monitoring of medical therapy.

The VIRTUE Registry of Type B Thoracic Dissections -Study Design and Early ResultsThe VIRTUE Registry Investigators. Eur J Vasc Endovasc Surg 2011;41:8-15. Introduction: Endovascular procedures for repair of Type B aortic dissection have become increasingly common and are often considered to be first line therapy for acute complicated dissections. The long term durability of these repairs is largely undefined.Methods: The Virtue Registry is a prospective, non-randomised, multi centre European Clinical Registry designed to inform on the clinical and morphological outcomes of 100 patients with Type B aortic dissection treated with the Medtronic Valiant thoracic stent graft. Patients with acute, sub-acute and chronic Type B dissections will be prospectively followed for three years. Clinical outcomes and aortic morphology will be defined.Results: Fifty patients had an acute dissection, 24 a sub-acute dissection and 26 a chronic lesion. The 30-day mortality for the acute, sub-acute and chronic lesions was 8%, 0% and 0%. The in hospital composite outcome (mortality, stroke or paraplegia) for the three groups was 16%, 0% and 3.8% respectively. The effect of left subclavian artery (LSCA) revascularisation was defined with the composite endpoint of patients with a covered, nonrevascularised LSCA being 20% as compared to 5.8% in the covered, revascularised group.Conclusion: The early outcomes for the treatment of Type B aortic dissection are reported in the Virtue Registry. Longer term follow-up is planned to report on clinical and morphological outcomes up to 36 months post-procedure. Objectives:To assess the accuracy of colour-Doppler ultrasound (CDUS), contrast-enhanced ultrasonography (CEUS), computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in detecting endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).Design: Prospective, observational study. consecutive patients who underwent EVAR were evaluated with CDUS, CEUS, CTA and MRA as well as angiography, if further treatment was necessary. Sensitivity, specificity, accuracy and negative predictive value of ultrasound examinations were compared with CTA and MRA as the reference standards, or with angiography when available.Results: Twenty-four endoleaks (22%, type II: 22 cases, type III: two cases) were documented. Sensitivity and specificity of CDUS, CEUS, CTA, and MRA were 58% and 93%, 96% and 100%, 83% and 100% and 96% and 100% respectively. CEUS allowed better classification of endoleaks in 10, two and one patients compared with CDUS, CTA and MRA, respectively.Conclusions: The accuracy of CEUS in detecting endoleaks after EVAR is markedly better than CDUS and is similar to CTA and MRA. CEUS seems to be a feasible tool in the long-term surveillance after EVAR, and it may better classify endoleaks missed by other imaging techniques.

In this study, a policy of regular surveillance for type 2 endoleaks was not associated with any adverse events. We therefore advocate the conservative approach for type 2 endoleaks.

Within a cohort of patients presenting with recent onset cerebral ischaemic events undergoing CEA, the plaques of patients with recurrent events following admission to hospital had evidence a large lipid core and a low GSM.