Current status and future developments of contrast-enhanced ultrasound of carotid atherosclerosis

Kate, Gerrit L. ten; Oord, Stijn C.H. van den; Sijbrands, Eric J.G.; Lugt, Aad van der; Jong, Nico de; Bosch, Johan G.; Steen, Antonius F.W. van der; Schinkel, Arend F. L.

doi:10.1016/j.jvs.2012.07.028

Cited by 83 publications

(80 citation statements)

References 36 publications

(66 reference statements)

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“…Therefore, we compared neuropsychological RAVLT score before CAS and at 1-month follow-up. We found a direct association between plaque enhancement and postprocedural microembolization, which is consistent with our previous findings on plaque vulnerability and with published data [5,6]. In detail, patients with a SI max value of more than 26 have a significantly higher risk of developing cerebral microembolization with CAS.…”

Section: Discussionsupporting

confidence: 92%

“…There is a growing body of evidence that CEUS evaluation of carotid artery lesions can be a cost-effective and reliable method to define plaque vulnerability and predict the risk of embolization [5,6,11]. Because of the significantly higher risk of periprocedural embolization during primary CAS as compared with carotid endoarterectomy, CEUS can be advantageously applied as a useful imaging system for Table 2 Results of the study between patients who developed post procedural cerebral ischemic injury (Microembolization+) and those without post-procedural ischemic injury (Microembolization−) * p value <0.05.…”

Section: Discussionmentioning

confidence: 99%

“…A valuable technique to define plaque enhancement and potential risk of embolization is contrast-enhanced ultrasound (CEUS) [5][6][7][8], while diffusion-weighted magnetic resonance imaging (DW-MRI) is a highly reliable imaging method for detecting recent ischemic brain lesions [9]. The aim of this study is to compare plaque enhancement as evaluated by CEUS with new cerebral ischemic lesions after CAS and to define the clinical impact of the neurological injury.…”

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confidence: 99%

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Contrast-enhanced ultrasound to predict the risk of microembolization during carotid artery stenting

et al. 2015

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to assess neurocognitive function was administered before and 1 month after the procedure. Results Nineteen patients (54 %) developed new cerebral ischemic lesions after carotid artery stenting. Contrast enhancement of the plaque was greater in the patients with post-procedural microembolization than in those without it [maximum signal intensity 26 ± 7.7 vs. 21 ± 5.2, respectively, (p = 0.039), mean signal intensity, 20.7 ± 6.1 vs. 16.5 ± 5.3, respectively (p = 0.048)]. No correlation was found between neurocognitive test scores and microembolization or plaque enhancement. Conclusion Contrast enhancement of the carotid plaque is strongly associated with post-procedural microembolization and for this reason it can be considered a reliable tool for an accurate selection of patients undergoing this endovascular treatment. However, the neurocognitive test scores performed in this study are not enough sensible to appreciate the impact of the neurological injury on the day life activities.Keywords Contrast-enhanced ultrasound · Diffusionweighted magnetic resonance imaging · Carotid artery stenting · CEUS · CAS · Microembolization Background and purpose

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Contrast-enhanced ultrasound to predict the risk of microembolization during carotid artery stenting

et al. 2015

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“…Vasa vasorum-derived plaque neovascularization and inflammation are considered the main causes of atherosclerotic plaque vulnerability and rupture (11,15,26). Previous studies have shown that the amount of intraplaque contrast enhancement correlated with the presence and the extent of intraplaque neovascularization and with the degree of inflammation on histologic examination of the plaque after endarterectomy (13,26). Therefore, CEUS permitting direct visualization of parietal vasa vasorum and quantifying carotid wall vascularization may represent a valuable tool for detecting inflammation in carotid arteries of patients with LVV and may also provide a nonivasive technique to monitor therapeutic interventions.…”

Section: Discussionmentioning

confidence: 99%

Contrast‐Enhanced Ultrasound of the Carotid Artery in Patients With Large Vessel Vasculitis: Correlation With Positron Emission Tomography Findings

Germanò

Macchioni

Possemato

et al. 2016

Arthritis Care & Research

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Objective. To assess the findings of contrast-enhanced ultrasound (CEUS) of carotid arteries in patients with large vessel vasculitis (LVV) and to compare them with those observed using F-FDG uptake (P < 0.001) and maximum standardized uptake value (SUV) in the right carotid artery/mean SUV in the superior vena cava (P 5 0.001). When active vascular 18 F-FDG uptake ( ‡2) was considered the gold standard for defining vascular inflammation, carotid CEUS had a sensitivity of 100% (95% confidence interval [95% CI] 65-100) and a specificity of 92% (95% CI 72-99). The positive likelihood ratio was 12.5 (95% CI 3.3-47.2). Severe vascularization at CEUS and active vascular 18 F-FDG uptake were significantly more frequent in active disease according to Kerr's criteria compared to inactive (P 5 0.001 and P 5 0.002, respectively). Conclusion. Carotid CEUS vascularization grade and the grade of vascular inflammation on 18 F-FDG-PET were correlated in patients with LVV.

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“…Carotid contrast-enhanced ultrasonography (CEUS) can offer some information about the presence of neovascularization [73] in particular when microbubbles are used [74,75]. However, the reproducibility and utility of this modality for clinical care are not well established [76].…”

Section: The Plaque Neovascularizationmentioning

confidence: 99%

Imaging of the Carotid Artery Vulnerable Plaque

Saba¹,

Anzidei

Marincola

et al. 2013

Cardiovasc Intervent Radiol

111

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Atherosclerosis involving the carotid arteries has a high prevalence in the population worldwide. This condition is significant because accidents of the carotid artery plaque are associated with the development of cerebrovascular events. For this reason, carotid atherosclerotic disease needs to be diagnosed and those determinants that are associated to an increased risk of stroke need to be identified. The degree of stenosis typically has been considered the parameter of choice to determine the therapeutical approach, but several recently published investigations have demonstrated that the degree of luminal stenosis is only an indirect indicator of the atherosclerotic process and that direct assessment of the plaque structure and composition may be key to predict the development of future cerebrovascular ischemic events. The concept of ''vulnerable plaque'' was born, referring to those plaque's parameters that concur to the instability of the plaque making it more prone to the rupture and distal embolization. The purpose of this review is to describe the imaging characteristics of ''vulnerable carotid plaques.''

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Current status and future developments of contrast-enhanced ultrasound of carotid atherosclerosis

Cited by 83 publications

References 36 publications

Contrast-enhanced ultrasound to predict the risk of microembolization during carotid artery stenting

Contrast-enhanced ultrasound to predict the risk of microembolization during carotid artery stenting

Contrast‐Enhanced Ultrasound of the Carotid Artery in Patients With Large Vessel Vasculitis: Correlation With Positron Emission Tomography Findings

Imaging of the Carotid Artery Vulnerable Plaque

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