Contrast-Enhanced Ultrasound Imaging of Intraplaque Neovascularization in Carotid Arteries

Coli, Stefano; Magnoni, Marco; Sangiorgi, Giuseppe; Marrocco-Trischitta, Massimiliano M.; Melisurgo, Giulio; Mauriello, Alessandro; Spagnoli, Luigi Giusto; Chiesa, Roberto; Cianflone, Domenico; Maseri, Attilio

doi:10.1016/j.jacc.2008.02.082

Cited by 305 publications

(263 citation statements)

References 39 publications

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“…Many efforts have been recently made using non-invasive techniques [8][9][10][11][12] for identifying plaques at high risk of disruption leading to thrombosis, generally defined as "vulnerable plaques" [13,14]. These latter lesions are characterized by a large necrotic core with an overlying thin cap rich in inflammatory cells.…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic carotid plaque rupture with unexpected thrombosis over a non-canonical vulnerable lesion

et al. 2011

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a b s t r a c tObjective: Several studies have demonstrated that carotid plaque rupture and thrombosis represent the most important factors correlated with the onset of acute cerebrovascular symptoms. Nevertheless, ruptured thrombotic plaques have been described also in asymptomatic patients. What still needs to be clarified is why a plaque rupture leads either to an acute ischemic syndrome or, in a minor group of patients, remains asymptomatic. The purpose of this study was to systematically compare the histologic features of thrombotic plaques both in asymptomatic and symptomatic patients in order to identify specific findings that could explain the peculiar clinical behavior that characterizes each of the clinical settings. Methods: A total of 157 thrombotic plaques from 60 asymptomatic patients and 97 with major stroke who consecutively underwent CEA were serially sectioned and studied by histology. Results: A minute cap disruption very frequently characterizes thrombotic plaques of asymptomatic patients and it was always smaller than large ulcers observed in thrombotic symptomatic plaques (651 ± 687 m vs. 4150 ± 3526, p = 0.001). In asymptomatics this typical feature was associated with fewer inflammatory cells (20.1 ± 8.8 vs. 33.9 ± 26.1 cells × hpf, p = 0.001), smaller lipidic-necrotic core (33.9% ± 2.9% vs. 42.0% ± 2.4%; p = 0.04) and larger calcification (16.2 ± 12.8% vs. 8.1 ± 12.2%, p = 0.02). Symptomatic patients with thrombotic plaques showed higher incidence of metabolic syndrome (p = 0.002) and moderate-high Framingham risk scores (p = 0.001) comparing to asymptomatic individuals. Conclusion: The transformation from a stable to a vulnerable plaque is a gradual process in the natural history of the disease and plaque rupture is an event not necessarily occurring at a late phase but also at earlier one. In this case, the rupture will be most likely smaller and clinically asymptomatic.

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Section: Introductionmentioning

confidence: 99%

Asymptomatic carotid plaque rupture with unexpected thrombosis over a non-canonical vulnerable lesion

et al. 2011

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“…Shah et al (35) identified a strong correlation between CEUS analysis of plaque neovascularization in carotid arteries and histological scores on surgical specimens. Coli et al (39) demonstrated that CEUS measurements of contrast enhancement correlated well with histologically determined neovessel density in plaques.…”

Section: Discussionmentioning

confidence: 96%

Improved plaque neovascularization following 2-year atorvastatin therapy based on contrast-enhanced ultrasonography: A pilot study

Jin

et al. 2018

Exp Ther Med

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Abstract. The present study assessed changes in carotid plaque neovascularization following long-term atorvastatin therapy (20 mg/day) using contrast-enhanced ultrasonography (CEUS). In this prospective case series, seven males (mean age, 68±9 years) and three females (mean age, 67±10 years) with a total of 13 carotid plaques underwent standard ultrasonography and CEUS at baseline, as well as after 1 and 2 years of atorvastatin treatment. The same plaques were then examined using real-time CEUS. The results of the enhanced intensity of plaque neovascularization at baseline were compared with results obtained during follow-up to examine the effects of long-term atorvastatin therapy. Standard ultrasonography revealed that 7 of the 13 carotid plaques were uniformly echolucent, whereas 6 carotid plaques were predominantly echolucent. CEUS revealed an enhanced intensity of 10.5±2.1 decibels (dB) prior to treatment, which decreased significantly to 7.3±2.6 dB following 2 years atorvastatin therapy (P<0.001). The ratio of enhanced intensity in the carotid artery lumen to that in the plaque was 3.10±1.10 at baseline and this value significantly increased to 4.96±2.98 following treatment for 2 years (P<0.001). The current pilot study therefore indicates that two-year atorvastatin therapy (20 mg/day) may reduce plaque neovascularization in the Chinese population.

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“…This finding is interesting because carotid plaque neovascularization has also been evaluated by contrast-enhanced sonography and has recently been regarded as a surrogate marker of atherosclerosis due to associations with plaque echolucency and ischemic symptoms. [20][21][22] Comparing findings of neovascularization between contrast-enhanced ultrasonography and OCT would be important in future examinations.…”

Section: Discussionmentioning

confidence: 99%

Visualization of Internal Carotid Artery Atherosclerotic Plaques in Symptomatic and Asymptomatic Patients: A Comparison of Optical Coherence Tomography and Intravascular Ultrasound

Yoshimura¹,

Kawasaki²,

Yamada³

et al. 2011

AJNR Am J Neuroradiol

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Contrast-Enhanced Ultrasound Imaging of Intraplaque Neovascularization in Carotid Arteries

Cited by 305 publications

References 39 publications

Asymptomatic carotid plaque rupture with unexpected thrombosis over a non-canonical vulnerable lesion

Asymptomatic carotid plaque rupture with unexpected thrombosis over a non-canonical vulnerable lesion

Improved plaque neovascularization following 2-year atorvastatin therapy based on contrast-enhanced ultrasonography: A pilot study

Visualization of Internal Carotid Artery Atherosclerotic Plaques in Symptomatic and Asymptomatic Patients: A Comparison of Optical Coherence Tomography and Intravascular Ultrasound

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