The Comparison between Digital Subtraction Angiography, CT Angiography, and Doppler Ultrasonography in Evaluation and Assessment of Carotid Artery Stenosis

Banaei, Amin

doi:10.5812/amh.61661

Cited by 3 publications

(3 citation statements)

References 15 publications

(37 reference statements)

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“…Polarised light microscopy identi ied two different types of plaques, a soft one with a transparent structure and without the presence of bone tissue, called soft plaques, and hard plaques with woven bone structures. These indings are probably identical with echolucent (predominant lipid core) und echo-opaque plaques (predominantly ibrous tissue/ calcium) as identi ied by sonography and magnetic resonance tomography [27][28][29][30][31]. The major inding of our study is the presence of woven bone tissue in hard carotid plaques.…”

Section: Discussionsupporting

confidence: 82%

Evidence of woven bone formation in carotid artery plaques

Mirzaie¹,

Guliyev²,

Schultz³

et al. 2021

J Cardiol Cardiovasc Med

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Objective: Plaque morphology plays an important prognostic role in the occurrence of cerebrovascular events. Echolucent and heterogeneous plaques, in particular, carry an increased risk of subsequent stroke. Depending on the quality of the plaque echogenicity based on B-mode ultrasound examination, carotid plaques divide into a soft lipid-rich plaque and a hard plaque with calcification. The aim of this study was to investigate structural changes in the basement membrane of different carotid artery plaque types. Patients and methods: Biopsies were taken from 10 male patients (average age; 75 + 1 years) and 7 females (68 + 3 years). The study population included patients suffering from a filiform stenosis of the carotid artery, 8 patients with acute cerebrovascular events and 9 with asymptomatic stenosis. Scanning electron and polarised light microscopic investigations were carried out on explanted plaques to determine the morphology of calcified areas in vascular lesions. Results: By means of scanning electron microscopy, multiple foci of local calcification were identified. The endothelial layer was partially desquamated from the basement membrane and showed island-like formations. Polarised light microscopy allows us to distinguish between soft plaques with transparent structure and hard plaques with woven bone formation. Conclusion: The major finding of our study is the presence of woven bone tissue in hard plaques of carotid arteries, which may result from pathological strains or mechanical overloading of the collagen fibers. These data suggest a certain parallel with sclerosis of human aortic valves due to their similar morphological characteristics.

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Section: Discussionsupporting

confidence: 82%

Evidence of woven bone formation in carotid artery plaques

Mirzaie¹,

Guliyev²,

Schultz³

et al. 2021

J Cardiol Cardiovasc Med

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“…Based on these results, it can be concluded that the PSV ICA/ICA ratio should be included among the commonly used parameters for the evaluation of carotid stenosis. These results are in concordance with a recently published study (28).…”

Section: Discussionsupporting

confidence: 94%

Peak systolic velocity ratio for evaluation of internal carotid artery stenosis correlated with plaque morphology: substudy results of the ANTIQUE study

Pakizer,

Vybíralová,

Jonszta

et al. 2023

Front. Neurol.

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BackgroundAccurate assessment of carotid stenosis severity is important for proper patient management. The present study aimed to compare the evaluation of carotid stenosis severity using four duplex sonography (DUS) measurements, including peak systolic velocity (PSV), PSV ratio in stenosis and distal to stenosis (PSVICA/ICA ratio), end-diastolic velocity (EDV), and B-mode, with computed tomography angiography (CTA), and to evaluate the impact of plaque morphology on correlation between DUS and CTA.MethodsConsecutive patients with carotid stenosis of ≥40% examined using DUS and CTA were included. Plaque morphology was also determined using magnetic resonance imaging. Spearman’s correlation and Kendall’s rank correlation were used to evaluate the results.ResultsA total of 143 cases of internal carotid artery stenosis of ≥40% based on DUS were analyzed. The PSVICA/ICA ratio showed the highest correlation [Spearman’s correlation r = 0.576) with CTA, followed by PSV (r = 0.526), B-mode measurement (r = 0.482), and EDV (r = 0.441; p < 0.001 in all cases]. The worst correlation was found for PSV when the plaque was calcified (r = 0.238), whereas EDV showed a higher correlation (r = 0.523). Correlations of B-mode measurement were superior for plaques with smooth surface (r = 0.677), while the PSVICA/ICA ratio showed the highest correlation in stenoses with irregular (r = 0.373) or ulcerated (r = 0.382) surfaces, as well as lipid (r = 0.406), fibrous (r = 0.461), and mixed (r = 0.403; p < 0.01 in all cases) plaques. Nevertheless, differences between the mentioned correlations were not statistically significant (p > 0.05 in all cases).ConclusionPSV, PSVICA/ICA ratio, EDV, and B-mode measurements showed comparable correlations with CTA in evaluation of carotid artery stenosis based on their correlation with CTA results. Heavy calcifications and plaque surface irregularity or ulceration negatively influenced the measurement accuracy.

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“…Digital subtraction angiography (DSA) was the diagnostic modality of choice in the past; however, unless the results of non-invasive investigations are inconclusive and angiography is part of a therapeutic intervention, clinical guidelines advise against performing diagnostic angiography with selective carotid artery catheterisation due to the increased risk of stroke and distal embolisation from wire and catheter manipulation in the arch and its branches in addition to access site complications [ 16 ].…”

Section: Patient Preparationmentioning

confidence: 99%

CIRSE Standards of Practice on Carotid Artery Stenting

Spiliopoulos,

Blanc,

Gandini

et al. 2024

Cardiovasc Intervent Radiol

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Background Carotid artery stenting has been used effectively to treat internal carotid artery stenosis since 1989 (Mathias et al. in World J Surg. 25(3):328-34, 2001), with refined and expanded techniques and tools presently delivering outstanding results in percutaneous endoluminal treatment of carotid artery stenosis. Purpose This CIRSE Standards of Practice document is directed at interventional radiologists and details the guidelines for carotid artery stenting, as well as the different implementation techniques. In addition to updating all previously published material on the different clinical indications, it will provide all technical details reflective of European practice for carotid artery stenting. CIRSE Standards of Practice documents do not aim to implement a standard of clinical patient care, but rather to provide a realistic strategy and best practices for the execution of this procedure. Methods The writing group, which was established by the CIRSE Standards of Practice Committee, consisted of five clinicians with internationally recognised expertise in carotid artery stenting procedures. The writing group reviewed existing literature on carotid artery stenting procedures, performing a pragmatic evidence search using PubMed to select relevant publications in the English language from 2006 to 2022. Results Carotid artery stenting has an established role in the management of internal carotid artery stenosis; this Standards of Practice document provides up-to-date recommendations for its safe performance.

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The Comparison between Digital Subtraction Angiography, CT Angiography, and Doppler Ultrasonography in Evaluation and Assessment of Carotid Artery Stenosis

Cited by 3 publications

References 15 publications

Evidence of woven bone formation in carotid artery plaques

Evidence of woven bone formation in carotid artery plaques

Peak systolic velocity ratio for evaluation of internal carotid artery stenosis correlated with plaque morphology: substudy results of the ANTIQUE study

CIRSE Standards of Practice on Carotid Artery Stenting

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