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Vulnerable carotid plaque

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https://www.readbyqxmd.com/read/28529262/investigations-of-carotid-stenosis-to-identify-vulnerable-atherosclerotic-plaque-and-determine-individual-stroke-risk
#1
Madieke I Liem, Fiona Kennedy, Leo H Bonati, Aad van der Lugt, Bram F Coolen, Aart J Nederveen, Hans R Jager, Martin M Brown, Paul J Nederkoorn
Selection of patients with atherosclerotic carotid stenosis for revascularization is mainly based on the degree of luminal narrowing of the carotid artery. However, identification of other features of plaque apart from the degree of stenosis could enable better selection for intervention if they are also associated with the occurrence of stroke. Before these risk factors can possibly play a role in treatment decisions, their prognostic value needs to be proven. The purpose of this narrative review is to summarize current knowledge regarding the risk factors for stroke in patients with carotid stenosis, how they can be determined, and to what extent they predict stroke, based on recent literature...
May 20, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28487806/synchronous-carotid-bifurcation-endarterectomy-and-retrograde-kissing-stenting-of-the-innominate-and-left-common-carotid-artery-in-a-patient-with-a-bovine-aortic-arch
#2
Alessandro Robaldo, Guido Carignano, Alberto Balderi, Claudio Novali
Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a "bovine" aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28487317/head-to-head-comparison-of-inflammation-and-neovascularization-in-human-carotid-plaques-implications-for-the-imaging-of-vulnerable-plaques
#3
Fabian Demeure, Caroline Bouzin, Véronique Roelants, Anne Bol, Robert Verhelst, Parla Astarci, Bernhard L Gerber, Anne-Catherine Pouleur, Agnès Pasquet, Christophe de Meester, Jean-Louis J Vanoverschelde, David Vancraeynest
BACKGROUND: Inflammation and intraplaque neovascularization are acknowledged to be 2 features of plaque vulnerability, although their temporal expression and their respective value in predicting clinical events are poorly understood. To determine their respective temporal associations, we conducted a comprehensive assessment of inflammation and intraplaque neovascularization in the carotid plaque of symptomatic and asymptomatic patients. METHODS AND RESULTS: Thirty patients with severe carotid stenosis underwent (18)F-fluorodeoxyglucose-positron emission tomography/computed tomographic imaging...
May 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28482222/noninvasive-detection-of-increased-carotid-artery-temperature-in-patients-with-coronary-artery-disease-predicts-major-cardiovascular-events-at-one-year-results-from-a-prospective-multicenter-study
#4
Konstantinos Toutouzas, Georgios Benetos, Iosif Koutagiar, Nikolaos Barampoutis, Fotini Mitropoulou, Periklis Davlouros, Petros P Sfikakis, Dimitrios Alexopoulos, Christodoulos Stefanadis, Elias Siores, Dimitris Tousoulis
BACKGROUND AND AIMS: Limited prospective data have been reported regarding the impact of carotid inflammation on cardiovascular events in patients with coronary artery disease (CAD). Microwave radiometry (MWR) is a noninvasive, simple method that has been used for evaluation of carotid artery temperature which, when increased, predicts 'inflamed' plaques with vulnerable characteristics. We prospectively tested the hypothesis that increased carotid artery temperature predicts future cerebro- and cardiovascular events in patients with CAD...
April 23, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28479433/relationship-between-calcification-and-vulnerability-of-the-carotid-plaques
#5
Rodolfo Pini, Gianluca Faggioli, Silvia Fittipaldi, Francesco Vasuri, Matteo Longhi, Enrico Gallitto, Gianandrea Pasquinelli, Mauro Gargiulo, Andrea Stella
INTRODUCTION: Carotid plaques with a high degree of calcification are usually considered at low embolic risk. However, since a precise evaluation of the extent of calcification is not possible preoperatively through duplex ultrasound and postoperatively by conventional histological examination due to the de-calcification process, the relationship between the amount of calcium involvement and plaque vulnerability has not been evaluated yet. This study aims to correlate the extent of carotid plaque calcification with clinical, radiological and histological complications...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28436693/expression-of-circulating-mir-17-92-cluster-and-hdac9-gene-in-atherosclerotic-patients-with-unstable-and-stable-carotid-plaques
#6
Silvia Ferronato, Aldo Mombello, Ilaria Posenato, Paola Candiani, Alberto Scuro, Carlo Setacci, Macarena Gomez-Lira
AIMS: The miR-17-92 cluster and HDAC9 gene are involved in inflammatory, apoptotic, and angiogenic processes that are activated in the vulnerable carotid plaque. The aim of this research was to determine whether expression of one or more of the miRs of the cluster and/or HDAC9 expression could represent biomarkers for patients with unstable atherosclerotic carotid plaques. MATERIALS AND METHODS: Plasma levels of miRs and HDAC9 expression in peripheral blood were analyzed by real-time PCR in patients with histologically classified stable or unstable plaques...
April 24, 2017: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/28412421/change-in-carotid-plaque-components-a-4-year-follow-up-study-with-serial-mr-imaging
#7
Laura Pletsch-Borba, Mariana Selwaness, Aad van der Lugt, Albert Hofman, Oscar H Franco, Meike W Vernooij
OBJECTIVES: The goal of this study was to determine how carotid plaque components (e.g., intraplaque hemorrhage [IPH], calcification, lipid core) change over time and which cardiovascular risk factors are associated with the development of each component. BACKGROUND: Carotid atherosclerotic plaque components are important markers of plaque vulnerability. How these components change and which factors lead to the development and changes in the components remain unclear...
April 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28411037/carotid-plaque-evaluation-using-gemstone-spectral-imaging-comparison-with-magnetic-resonance-angiography
#8
Yuki Shinohara, Makoto Sakamoto, Keita Kuya, Junichi Kishimoto, Eijiro Yamashita, Shinya Fujii, Masamichi Kurosaki, Toshihide Ogawa
BACKGROUND: The present study compared the applicability of computed tomography carotid plaque imaging using effective Z maps with gemstone spectral imaging (GSI) to that of magnetic resonance plaque imaging using 3-dimensional time-of-flight magnetic resonance angiography. METHODS: Stenosis was assessed in 18 carotid arteries of 14 patients, and the effective Z values of noncalcified carotid plaques were compared with the signal intensities of magnetic resonance angiography...
April 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28402079/inverse-association-between-size-of-the-lipid-rich-necrotic-core-and-vascularization-in-human-carotid-plaques
#9
Ola Hjelmgren, Lars Johansson, Ulrica Prahl, Caroline Schmidt, Göran M L Bergström
PURPOSE: To study the relationship between the size of the lipid-rich necrotic core measured by MRI (magnetic resonance imaging) and the level of plaque vascularization measured by contrast-enhanced ultrasound, in human carotid plaques. Further, to compare the size of lipid-rich necrotic core from MRI to plaque echogenicity. METHODS: Thirty-one subjects with carotid plaques underwent standard B-mode ultrasound, contrast-enhanced ultrasound and MRI. The lipid-rich necrotic core was quantified using MRI...
April 12, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28397443/an-evaluation-of-dual-source-computed-tomography-used-with-the-de-weert-classification-to-detect-vulnerable-plaque-using-ivus-virtual-histology-as-a-standard-of-reference
#10
Bartosz Dołęga-Kozierowski, Piotr Klimeczek, Michał Lis, Róża Krycińska, Anna Chrapusta, Urszula Zaleska-Dorobisz, Jerzy Garcarek, Wojciech Witkiewicz
BACKGROUND: One of the main risk factors for cerebral ischemic events is atherosclerotic disease of the internal carotid artery (ICA). Nowadays, increasing attention is being paid to the relationship between the morphological features of atherosclerotic plaque and the occurrence of stroke. Several studies have demonstrated that the presence of specific vulnerable plaque types, with a large lipid core and thin fibrous cap, can be used as an independent risk predictor of cerebral ischemic events...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28390769/vascular-applications-of-contrast-enhanced-ultrasound-imaging
#11
REVIEW
Kunal S Mehta, Jake J Lee, Ashraf A Taha, Efthymios Avgerinos, Rabih A Chaer
OBJECTIVE: Contrast-enhanced ultrasound (CEUS) imaging is a powerful noninvasive modality offering numerous potential diagnostic and therapeutic applications in vascular medicine. CEUS imaging uses microbubble contrast agents composed of an encapsulating shell surrounding a gaseous core. These microbubbles act as nearly perfect intravascular reflectors of ultrasound energy and may be used to enhance the overall contrast and quality of ultrasound images. The purpose of this narrative review is to survey the current literature regarding CEUS imaging and discuss its diagnostic and therapeutic roles in current vascular and selected nonvascular applications...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28388659/identification-of-neovascularization-by-contrast-enhanced-ultrasound-to-detect-unstable-carotid-stenosis
#12
Charlotte Schmidt, Thomas Fischer, Ralph-Ingo Rückert, Timm Oberwahrenbrock, Lutz Harms, Golo Kronenberg, Hagen Kunte
BACKGROUND: Plaque neovascularization accompanies local inflammation and critically contributes to plaque instability. Correct identification of intraplaque neovascularization by contrast-enhanced ultrasound (CEUS) may provide an additional risk marker in carotid stenosis. This pilot study investigates the correlation between histological evaluation of carotid plaque specimens and pre-surgery CEUS to identify neovascularization. METHODS: 17 patients with high-grade internal carotid artery (ICA) stenosis were studied...
2017: PloS One
https://www.readbyqxmd.com/read/28386172/angiotensin-ii-accelerated-vulnerability-of-carotid-plaque-in-a-cholesterol-fed-rabbit-model-assessed-with-magnetic-resonance-imaging-comparing-to-histopathology
#13
Beibei Sun, Huilin Zhao, Xiao Li, Hong Yao, Xiaosheng Liu, Qing Lu, Jieqing Wan, Jianrong Xu
This study sought to reveal the effect of angiotensin II (Ang II)-induced atherosclerotic vulnerability in rabbits and to determine whether in vivo magnetic resonance imaging (MRI) can determine the effect of Ang II on atherosclerotic development over time. In total, 24 elderly male New Zealand white rabbits underwent an intravascular balloon injury in the left common carotid artery (LCCA) and were subsequently fed a high cholesterol diet for 12 weeks. At 8 weeks, rabbits were randomly assigned to receive either Ang II (1...
March 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28360913/lectin-pathway-of-complement-activation-is-associated-with-vulnerability-of-atherosclerotic-plaques
#14
Stefano Fumagalli, Carlo Perego, Rosalia Zangari, Daiana De Blasio, Marco Oggioni, Francesca De Nigris, Francesco Snider, Peter Garred, Angela M R Ferrante, Maria-Grazia De Simoni
Inflammatory mechanisms may be involved in atherosclerotic plaque rupture. By using a novel histology-based method to quantify plaque instability here, we assess whether lectin pathway (LP) of complement activation, a major inflammation arm, could represent an index of plaque instability. Plaques from 42 consecutive patients undergoing carotid endarterectomy were stained with hematoxylin-eosin and the lipid core, cholesterol clefts, hemorrhagic content, thickness of tunica media, and intima, including or not infiltration of cellular debris and cholesterol, were determined...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28359716/pretreatment-with-and-ongoing-use-of-omega-3-fatty-acid-ethyl-esters-reduce-the-slow-flow-phenomenon-and-prevent-in-stent-restenosis-in-patients-undergoing-carotid-artery-stenting
#15
Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Syuichi Yamada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
OBJECTIVE: Carotid artery stenting (CAS) is a less invasive alternative to carotid endarterectomy, but it is essential to prevent thromboembolic complications during CAS and to suppress in-stent restenosis (ISR) after CAS because of the relatively high risk of periprocedural and follow-up stroke events. Clinical trials have demonstrated the strong relationship of carotid plaque vulnerability with the subsequent risk of ipsilateral ischemic stroke and thromboembolic complications during CAS...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28319050/extracellular-matrix-proteomics-identifies-molecular-signature-of-symptomatic-carotid-plaques
#16
Sarah R Langley, Karin Willeit, Athanasios Didangelos, Ljubica Perisic Matic, Philipp Skroblin, Javier Barallobre-Barreiro, Mariette Lengquist, Gregor Rungger, Alexander Kapustin, Ludmilla Kedenko, Chris Molenaar, Ruifang Lu, Temo Barwari, Gonca Suna, Xiaoke Yin, Bernhard Iglseder, Bernhard Paulweber, Peter Willeit, Joseph Shalhoub, Gerard Pasterkamp, Alun H Davies, Claudia Monaco, Ulf Hedin, Catherine M Shanahan, Johann Willeit, Stefan Kiechl, Manuel Mayr
BACKGROUND: The identification of patients with high-risk atherosclerotic plaques prior to the manifestation of clinical events remains challenging. Recent findings question histology- and imaging-based definitions of the "vulnerable plaque," necessitating an improved approach for predicting onset of symptoms. METHODS: We performed a proteomics comparison of the vascular extracellular matrix and associated molecules in human carotid endarterectomy specimens from 6 symptomatic versus 6 asymptomatic patients to identify a protein signature for high-risk atherosclerotic plaques...
April 3, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28314627/n-%C3%AE%C2%B5-carboxymethyl-lysine-concentration-in-debris-from-carotid-artery-stenting-correlates-independently-with-signal-intensity-on-t1-weighted-black-blood-magnetic-resonance-images
#17
Ayumu Eto, Noriyuki Sakata, Ryoji Nagai, Jun-Ichi Shirakawa, Ritsurou Inoue, Fumiaki Kiyomi, Kouhei Nii, Hiroshi Aikawa, Minoru Iko, Masanori Tsutsumi, Kimiya Sakamoto, Fumihiro Hiraoka, Takahumi Mitsutake, Hayatsura Hanada, Kiyoshi Kazekawa
BACKGROUND AND PURPOSE: Because magnetic resonance imaging (MRI) focuses on the morphological characteristics of carotid artery plaques, its diagnostic value with respect to plaque vulnerability is limited. We examined the correlation between N(ε)-(carboxymethyl)lysine (CML), a main chemical structure of advanced glycation end-products, and the vulnerability of plaques visualized on MRI scans. MATERIALS AND METHODS: We enrolled 43 patients who had undergone carotid artery stenting (CAS) for carotid artery stenosis; all underwent MRI studies, including black-blood MRI and diffusion-weighted imaging (DWI)...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28304220/high-resolution-magnetic-resonance-imaging-of-carotid-atherosclerotic-plaques-a-correlation-study-with-histopathology
#18
Zhangyong Xia, Hua Yang, Xiaochun Yuan, Jiyue Wang, Shigang Zhang, Liyong Zhang, Yang Qu, Jun Chen, Liqun Jiao, Le-Xin Wang, Yifeng Du
BACKGROUND: This study aimed to utilize high-resolution magnetic resonance imaging (MRI) to investigate the characteristics of stable and vulnerable carotid arteriosclerotic plaques, with correlations to histopathological findings. PATIENTS AND METHODS: High-resolution MRI was performed in 817 patients, using three-dimensional magnetic resonance angiography. Plaque composition was evaluated by measuring the areas occupied by calcification, a lipid-rich necrotic core, intra-plaque haemorrhage, and fibrous cap rupture...
March 17, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28303857/research-progress-on-the-risk-factors-and-outcomes-of-human-carotid-atherosclerotic-plaques
#19
REVIEW
Xiang-Dong Xiong, Wei-Dong Xiong, Shang-Shen Xiong, Gui-Hai Chen
OBJECTIVE: Atherosclerosis is an inflammatory process that results in complex lesions or plaques that protrude into the arterial lumen. Carotid atherosclerotic plaque rupture, with distal atheromatous debris embolization, causes cerebrovascular events. This review aimed to explore research progress on the risk factors and outcomes of human carotid atherosclerotic plaques, and the molecular and cellular mechanisms of human carotid atherosclerotic plaque vulnerability for therapeutic intervention...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28283423/echolucency-of-the-carotid-artery-is-associated-with-short-term-plaque-progression-and-positive-remodeling-in-the-culprit-coronary-artery-in-ami-survivors
#20
Mika Futamata, Satoshi Matsuoka, Takuya Shimizu, Toru Yoshizaki, Jun-Ei Obata, Takamitsu Nakamura, Daisuke Fujioka, Yosuke Watanabe, Kazuto Nakamura, Kazuhiro Watanabe, Kiyotaka Kugiyama
BACKGROUND: Rapid plaque progression and positive remodeling are recognized as vulnerable coronary plaque characteristics. This study examined whether serial carotid ultrasonography might be of value for assessment of coronary plaque progression and positive remodeling, measured by serial intravascular ultrasound (IVUS), in survivors of acute myocardial infarction (AMI). METHODS: Thirty-nine patients with AMI had repeated examinations by IVUS of culprit coronary arteries and echolucency of the coronary artery on admission (1st test) and 6 months later (2nd test)...
March 7, 2017: Journal of Cardiology
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