Is Neovascularization a Leading Mechanism of Intra-plaque Hemorrhage and Carotid Plaque Destabilization?

Migdalski, Arkadiusz; Brazis, Paweł; Wierzchowski, Paweł; Woda, Łukasz; Jawień, Arkadiusz

doi:10.1016/j.ejvs.2019.06.1203

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most notably, investigators have identified that intraplaque neovascularization (IPN) and hemorrhage are histopathological features associated with a vulnerable plaque that in case of rupture could result in a CVA [37][38][39].…”

Section: Discussionmentioning

confidence: 99%

3D-Arterial analysis software and CEUS in the assessment of severity and vulnerability of carotid atherosclerotic plaque: a comparison with CTA and histopathology

et al. 2022

View full text Add to dashboard Cite

Purpose Our purpose is to assess Multiparametric Ultrasound (MPUS) efficacy for evaluation of carotid plaque vulnerability and carotid stenosis degree in comparison with Computed Tomography angiography (CTA) and histology. Material and methods 3D-Arterial Analysis is a 3D ultrasound software that automatically provides the degree of carotid stenosis and a colorimetric map of carotid plaque vulnerability. We enrolled 106 patients who were candidates for carotid endarterectomy. Prior to undergoing surgery, all carotid artery plaques were evaluated with Color-Doppler-US (CDUS), Contrast-Enhanced Ultrasound (CEUS), and 3D Arterial analysis (3DAA) US along with Computerized Tomographic Angiography (CTA) to assess the carotid artery stenosis degree. Post-surgery, the carotid specimens were fixed with 10% neutral buffered formalin solution, embedded in paraffin and used for light microscopic examination to assess plaque vulnerability morphological features. Results The results of the CTA examinations revealed 91 patients with severe carotid stenoses with a resultant diagnostic accuracy of 82.3% for CDUS, 94.5% for CEUS, 98.4% for 3DAA, respectively. The histopathological examination showed 71 vulnerable plaques with diagnostic accuracy values of 85.8% for CDUS, 93.4% for CEUS, 90.3% for 3DAA, 92% for CTA, respectively. Conclusions The combination of CEUS and 3D Arterial Analysis may provide a powerful new clinical tool to identify and stratify “at-risk” patients with atherosclerotic carotid artery disease, identifying vulnerable plaques. These applications may also help in the postoperative assessment of treatment options to manage cardiovascular risks.

show abstract

Section: Discussionmentioning

confidence: 99%

3D-Arterial analysis software and CEUS in the assessment of severity and vulnerability of carotid atherosclerotic plaque: a comparison with CTA and histopathology

et al. 2022

View full text Add to dashboard Cite

show abstract

“…1 The role of IPN in plaque destabilization and lesion progression has gained severe concern, and the IPN process might be the primary mechanism of intraplaque hemorrhage and carotid plaque destabilization. 2 Ultrasound imaging techniques, for example, contrast-enhanced carotid ultrasonography (CEUS), and Toshiba/Canon Aplio 500s superb microvascular imaging (SMI) (Toshiba/Canon, Tokyo, Japan), have enabled routine characterization of IPN features in patients with carotid stenosis. Correlations between the presence of IPN in CEUS and pathological verification have been extensively studied, suggested that CEUS is well suited to detect neovascularization of carotid plaque.…”

mentioning

confidence: 99%

Detection of Carotid Atherosclerotic Intraplaque Neovascularization Using Superb Microvascular Imaging: A Meta‐Analysis

Song

Xing

Zhang

et al. 2021

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives-Although superb microvascular imaging (SMI) (Toshiba/Canon, Tokyo, Japan) has enabled routine characterization of intraplaque neovascularization (IPN) features in patients with carotid stenosis, no reports have been published on the multicenter and large sample size research in this aspect. The efficacy of SMI in detecting carotid IPN has not been concluded. This study aimed to assess the efficacy of SMI comparing with contrastenhanced carotid ultrasonography (CEUS) in the detection of carotid IPN or pathologic evaluations of IPN correlated with a history of stroke or transient ischemic attack (TIA).Methods-Web of Science, Cochrane Library, PubMed, Embase, and Scopus were searched up to August 2020 to identify peer-reviewed human studies on the diagnostic accuracy of SMI in detecting IPN. For the selected study, the correlation coefficient R and Kappa index between SMI and CEUS in detecting IPN were calculated. The correlation coefficient R between SMI in identifying IPN and pathologic evaluations of IPN and the odds ratio of IPN detected by SMI and history of stroke or TIA were also extracted. The subgroup analysis was performed to indicate the source of heterogeneity.Results-Our search identified 11 reports enrolling a total of 605 carotid stenosis patients. Carotid IPN detected by SMI was significantly correlated with which detected by CEUS (R, 0.89; 95% CI, 0.80-0.94; P = .00, and Kappa index, 0.73; 95% CI, 0.67-0.80; P = .00). Notably, a significant correlation was observed in SMI in detecting IPN and pathologic evaluations of IPN (R, 0.52; 95% CI, 0.40-0.62; P = .00). The odds ratio of IPN detected by SMI and history of stroke or TIA was pooled summary with statistical significance (OR, 3.33; 95% CI, 1.78-6.23; P = .00). In subgroup analysis, lower heterogeneity was associated with the degree of carotid stenosis, patients from which country, and types of equipment.Conclusions-SMI and CEUS display an excellent agreement in detecting carotid IPN. IPN detected by SMI shows high consistency with pathologic evaluations of IPN. Individuals with carotid IPN are more likely to develop stroke or TIA than those without carotid IPN.

show abstract

Is Neovascularization a Leading Mechanism of Intra-plaque Hemorrhage and Carotid Plaque Destabilization?

Cited by 2 publications

References 0 publications

3D-Arterial analysis software and CEUS in the assessment of severity and vulnerability of carotid atherosclerotic plaque: a comparison with CTA and histopathology

3D-Arterial analysis software and CEUS in the assessment of severity and vulnerability of carotid atherosclerotic plaque: a comparison with CTA and histopathology

Detection of Carotid Atherosclerotic Intraplaque Neovascularization Using Superb Microvascular Imaging: A Meta‐Analysis

Contact Info

Product

Resources

About