There are mainly six points which are highlighted in this presentation:
Stroke and Carotid Atherosclerosis highly correlated; in fact carotid plaques are responsible for 25-30% of the strokes
Level of stenosis is not the only indicator of plaque vulnerability
Neovessels alleged to be associated with plaque vulnerability
There are mainly two ways to detect the level of noevascularisation non-invasively: Magnetic Resonance Imaging (MRI) and Ultrasound (US)
Vulnerable carotid plaques:
Stroke is the third cause of death (1).
Unstable carotid artery atherosclerotic plaques cause 25-30% of all strokes (2).
Atherosclerotic plaques tend to progress rapidly.
Those with a high tendency to cause thrombotic complications,
such as myocardial infarction or stroke,
are defined as “vulnerable” plaques/ lesions (3).
As carotid plaques are a major cause of ischemic stroke (Fig.
It would be beneficial to identify patients at high risk of...
Imaging findings OR Procedure details
In the background section,
I have discussed the formation of neovascularisation within Carotid Plaques,
its risk and the diagnostic management.
In what follows,
I present a novel study of combined non-invasive,
non-ionizing radiation methods to detect the neovascularisation.
These are dynamic contrast enhanced MRI (DCMR) and dynamic contrast enhanced ultrasound (DCUS) correlated with histopathology when applicable.
We are using a 1.5 tesla MRI machine.
Level of plaque stenosis is not the sole indicator of vulnerability of the plaques.
In fact more than 70% of plaque raptures occor on luminal stenosis of less than 50%.
the main risk factors which indicate carotid plaque vulnerability are the degree of stenosis,
plaque size and morphology,
and downstream effects of atherosclerosis.
As carotid plaques are a major cause of ischemic stroke,
it would be beneficial to identify patients at high risk of ischemic...
De Simone G,
Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
2009 Jan 27;119(3):e21-181.
van Dam GM,
Advanced carotid plaque imaging.
Eur J Vasc Endovasc Surg.