Current status of carotid ultrasound in atherosclerosis

Ho, Sai-Yin

doi:10.21037/qims.2016.05.03

Cited by 43 publications

(28 citation statements)

References 83 publications

(111 reference statements)

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“…It has been demonstrated that low and/or oscillatory arterial shear stress promotes early plaque formation . In the carotid artery, shear wall stress is lower at the posterior wall and the location where the majority of plaques occur . We hypothesize that given the different branching geometry of the VA from the subclavian, the lower wall shear stress may occur at the medial wall, promoting plaque formation.…”

Section: Discussionmentioning

confidence: 87%

Topography of Vertebral Artery Origin Plaques: Characteristics and Determinants

Simonetto

DeSousa

Campo

et al. 2018

J of Ultrasound Medicine

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Section: Discussionmentioning

confidence: 87%

Topography of Vertebral Artery Origin Plaques: Characteristics and Determinants

Simonetto

DeSousa

Campo

et al. 2018

J of Ultrasound Medicine

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“…Due to the inter-patient variation in terms of defensive mechanisms, this is an additional factor preventing an assessment of stenotic degree based on the comparison between patent vessel diameter and the total width of the vessel (and even more so surface area measurements). On the other hand, comparing the diameter of a patent vessel at the site of stenosis with the segment located above may produce an error of underestimation in the case of significant stenosis of more than 70–80% (2,8) . In such cases, a decrease in the flow volume (in accordance with the Spencer’s Curve) occurs, leading to decreased blood pressure and, consequently, reduced vascular diameter.…”

Section: Discussionmentioning

confidence: 99%

The importance of blood flow volume in the brainsupplying arteries for the clinical management – the impact of collateral circulation

et al. 2018

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Aim: An assessment of increased compensatory blood flow in the brain-supplying arteries in patients with significant carotid artery stenosis. Materials and methods: Doppler ultrasound was performed in 218 patients over 60 years of age to evaluate both the degree of brain-supplying artery stenosis as well as the blood flow volume balance in all vessels supplying the brain: the internal carotid artery, the external carotid artery and the vertebral artery. The control group included 94 patients with no stenosis in the extracranial segments and no neurological manifestations, in whom blood flow values were calculated (the internal carotid artery – 290 mL/min, the external carotid artery – 125 mL/min, the vertebral artery – 80 mL/min); the total mean blood flow in the brain-supplying arteries was 985 mL/min. A 33% increase in blood flow was considered compensatory. In addition to the control group, 30 patients with asymptomatic stenosis of less than 50% and 12 patients after endarterectomy with mean blood flow of 920 mL/min and 960 mL/min, as well as two groups of particular interest to us, i.e. 38 patients with no compensatory blood flow increase despite significant stenosis (>50%) with mean blood flow of 844 mL/min and 44 patients with similar stenosis and with compensatory blood flow increase up to 1174 mL/min were included in the analysis. Results: Comparison of the two groups showed several significant differences: increased blood flow (118% vs. 86% of the norm) in patients with compensated stenosis, an increased number of asymptomatic patients (70% vs. 37%) and a threefold increase in the number of patients with occlusions (15 : 5) in the group of patients with increased blood supply to the brain. Conclusions: All potential blood-supplying vessels, including the external carotid artery, are involved in brain tissue perfusion in some of the patients with significant stenosis. Determining the degree of compensation may have an important impact on the indications for surgical treatment, which will make a valuable contribution to the current criteria (asymptomatic/symptomatic patients).

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“…[4][5][6] Carotid plaques also progress circumferentially, thus quantification of plaque volume instead of plaque area can reflect the actual plaque burden more sensitively. 3,4,7,8 Recent study 8 17.39%, p=0.241). 42 Retrospective high resolution MR study including non-significant stenosis in the intracranial vessel demonstrated that eccentricity was more higher in the symptomatic plaque than in the asymptomatic plaque (p=0.028).…”

Section: Assessment Of Carotid Plaque Burden Using Ultrasonographymentioning

confidence: 91%

“…Since then, unfortunately IMT did accurately reflect neither atherosclerosis nor prediction of clinical events. 2,3 To improve the predictive power of plaque screening for cardio-cerebrovascular events beyond IMT, quantifying the carotid plaque burden has been developed as a good alternative to IMT measurement. Carotid plaques grow along the artery 2.4 times faster than they thicken, thus we can easily deduce that two-dimensional measurement of total plaque area reflects the actual plaque burden more accurately.…”

Section: Assessment Of Carotid Plaque Burden Using Ultrasonographymentioning

confidence: 99%

Diagnostic and Therapeutic Approach of Carotid and Cerebrovascular Plaque on the Basis of Vessel Imaging

Lee

Park

2017

J Lipid Atheroscler

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Atherosclerosis, characterized by chronic systemic inflammation with plaque formation, is one of the major causes of cerebrovascular disease. Recent advances in imaging technologies can help further understand the overall process and biology of plaque formation and rupture. Thus, these imaging techniques could aid clinicians to make better decision for risk stratification, therapeutic planning, and prediction of future cerebrovascular event. Ultrasonography, magnetic resonance imaging, and positron emission tomography are the rapidly-evolving imaging modalities dealing with assessment of atherosclerotic plaque. By advances in imaging technology for evaluating plaque, we can characterize the vulnerability of plaque in-vivo, understand the composition and activity of plaque, assess therapeutic response to treatment, and ultimately predict the overall risk of future cerebrovascular episodes. In this review, we will introduce current understanding of various advanced imaging modalities and clinical application of these imaging technologies. (J Lipid Atheroscler 2017 June;6(1):15-21)

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Current status of carotid ultrasound in atherosclerosis

Cited by 43 publications

References 83 publications

Topography of Vertebral Artery Origin Plaques: Characteristics and Determinants

Topography of Vertebral Artery Origin Plaques: Characteristics and Determinants

The importance of blood flow volume in the brainsupplying arteries for the clinical management – the impact of collateral circulation

Diagnostic and Therapeutic Approach of Carotid and Cerebrovascular Plaque on the Basis of Vessel Imaging

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