scholarly journals Carotid duplex ultrasound: interpretations and clinical applications

2021 ◽  
Vol 23 (2) ◽  
pp. 82-91
Author(s):  
Hye-Yeon Choi
Keyword(s):  
Carotid Atherosclerosis ◽  
Duplex Ultrasound ◽  
Intima Media Thickness ◽  
Clinical Applications ◽  
Clinical Indicators ◽  
Carotid Artery Diseases ◽  
Carotid Revascularization ◽  
Carotid Duplex ◽  
Standard Techniques

Carotid duplex ultrasound is commonly used to diagnose various carotid artery diseases due to it being noninvasive and easy to perform. Carotid atherosclerosis is a major indicator for the need to perform carotid duplex ultrasound, which can determine the degree of stenosis, plaque characteristics, and intima-media thickness. It can also be used to screen and follow-up after carotid revascularization. Here we discuss the standard techniques, interpretations, and clinical indicators for carotid duplex ultrasounds.

Abstract 14789: 2013 ACC/AHA Cholesterol Guideline Undertreats HIV-infected Adults With Carotid Atherosclerosis by Ultrasound

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Binh An P Phan ◽  
Bernard Weigel ◽  
Yifei Ma ◽  
Rebecca Scherzer ◽  
Danny Li ◽  
...  
Keyword(s):  
Carotid Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Cardiovascular Disease ◽  
Antiretroviral Medication ◽  
Increased Risk ◽  
History Of ◽  
Ascvd Risk ◽  
Increase In Risk

Background: While HIV infection is associated with increased risk of ASCVD (atherosclerotic cardiovascular disease), it is unknown whether guidelines can identify HIV-infected adults who may benefit from statins. The purpose of our study was to compare the 2013 ACC/AHA and 2004 ATP III recommendations in a HIV population, and to evaluate associations with carotid artery intima-media thickness (CIMT) and plaque. Methods: We used ultrasound to measure CIMT at baseline and 3 years later in 352 HIV-infected adults with no ASCVD and not on statins. Plaque was defined as IMT > 1.5 mm. We compared 2013 ACC/AHA and 2004 ATP III recommendations, and evaluated associations with CIMT and plaque. Results: At baseline, the median age was 43 (IQR 39-49), 85% were male, 74% were on antiretroviral medication, and 50% had plaque. At follow-up, the median IMT progression was 0.052 mm/yr, and 66% had plaque. The 2013 guideline was more likely to recommend statins compared with the 2004 guideline, both overall (26% vs. 14%, p<.001), in those with plaque (32% vs. 17%, p=.0002), and in those without plaque (16% vs. 7%, p=.025). In unadjusted linear regression, the 2004 and 2013 risk score were strongly associated with CIMT (0.01 mm per 10% increase in risk, p<.001) and with CIMT progression (0.01 mm/yr per 10% increase in risk, p<.001). In multivariate analysis, older age, higher LDL-C, pack-years of smoking, and history of opportunistic infection were associated with baseline plaque. Conclusions: While the 2013 ACC/AHA guideline recommended statins to a greater number of HIV-infected adults compared to the 2004 ATP III guideline, both failed to recommend therapy in the majority of HIV-affected adults with carotid plaque. Both the 2004 and 2013 guidelines predicted higher levels of baseline CIMT and faster progression. HIV-specific guidelines that include detection of subclinical atherosclerosis may help to identify HIV-infected adults who are at increased ASCVD risk and may benefit from statins.

scholarly journals Association of the ACE rs4646994 and rs4341 polymorphisms with the progression of carotid atherosclerosis in slovenian patients with type 2 diabetes mellitus

2015 ◽  
Vol 18 (2) ◽  
pp. 37-42 ◽  
Author(s):  
S Merlo ◽  
J Novák ◽  
N Tkáčová ◽  
J Nikolajević Starčević ◽  
M Šantl Letonja ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Kaspar Assays ◽  
Progression Of Atherosclerosis

Abstract The current study was designed to reveal possible associations between the angiotensin-converting-enzyme (ACE) gene polymorphisms (rs4646994 and rs4341) with markers of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM) in a 4-year-long follow-up study. Five hundred and ninety-five T2DM subjects and 200 control subjects were enrolled. Genotyping of ACE polymorphisms was performed using KASPar assays, and ultrasound examinations were performed twice (at the enrollment and at follow-up). With regard to the progression of atherosclerosis in subjects with T2DM, statistically significant differences were demonstrated in the change of the sum of carotid plaques thickness for the rs4646994 polymorphism. We did not demonstrate an association between the tested polymorphisms (rs4646994 and rs4341) and either carotid intima media thickness (CIMT) or CIMT progression in a 3.8-year period. In our study, we demonstrated that subjects with T2DM with the DD genotype of the rs4646994 [ACE insertion/deletion (I/D)] polymorphism had faster progression of atherosclerosis in comparison to subjects with other genotypes.

Abstract WP197: Increased Carotid Intima-Media Thickness is Associated ith Incident Coronary Heart Disease and Stroke in a Japanese General Population With a 12.6-year Follow-up: The Suita Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yoshihiro Kokubo ◽  
Makoto Watanabe ◽  
Aya Higashiyama ◽  
Yoko M. Nakao ◽  
Misa Takegami ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Imt ◽  
Incident Coronary Heart Disease ◽  
The Mean

Introduction: Carotid intima-media thickness (IMT) is increasingly used as a subclinical marker of cardiovascular disease. However, few studies have examined the association between IMT and incident coronary heart disease (CHD) and stroke in non-Westerners. We assessed the hypothesis that carotid atherosclerosis is a predictor of CHD and stroke events in a general urban Japanese population. Methods: We studied 4,751 Japanese (2181 men and 2570 women, mean age 59.8 years, without stroke or CHD at the baseline) who completed a baseline survey and carotid atherosclerosis in the Suita Study, and were then followed for an average of 12.6 years. Carotid atherosclerosis was evaluated by high-resolution ultrasonography with atherosclerotic indexes of IMT in the common carotid artery (CCA) and the carotid artery bulb. Mean IMT was defined as the mean of the IMT of the proximal and distal walls for both sides of the CCA at a point 10 mm proximal to the beginning of the dilation of each carotid artery bulb. Max-CCA and Max-Bulb were defined as the maximum IMT in the CCA and bulb areas, respectively. We used adjusted Cox proportional-hazards models to compare the risk of CHD and stroke by use of mean and maximum carotid IMT in the CCA and bulb areas. Results: During the follow-up, we documented 145 cerebral infarctions, 58 hemorrhagic strokes, 20 unclassified strokes, and 159 CHD. The adjusted hazard ratios (HRs; 95% confidence intervals [CI], P for trend [P trend]) in the fourth quartile (≥ 0.95 mm) of the mean IMT for strokes, cerebral infarction, and CHD were 3.13 (1.48-6.63, P trend = 0.002), 3.34 (1.33-8.37, P trend = 0.002), and 1.93 (0.96-3.88, P trend <0.0001), respectively, compared with the first quartile (<0.775 mm). The adjusted HRs (95% CI) in the fourth quartiles of Max-CCA (≥1.10 mm) and Max-BIF (≥1.55 mm) were 2.48 (1.10-5.62, P trend = 0.07) and 3.28 (1.40-7.69, P trend <0.0001) in stroke, 1.87 (0.75-4.659, P trend = 0.07) and 2.83 (1.05-7.63, P trend = 0.005) in cerebral infarction, and 3.07 (1.18-8.04, P trend <0.0001) and 6.01 (2.02-17.9, P trend <0.0001) in CHD, respectively, compared with the first quartiles (<0.9 mm). Conclusions: Carotid IMT, especially Max-BIF was a strong predictor of stroke, cerebral infarction, and CHD in a Japanese urban general population.

scholarly journals Effect of Ipsilateral Carotid Revascularization on Contralateral Carotid Duplex Ultrasound Parameters

2021 ◽  
Vol 74 (4) ◽  
pp. e365
Author(s):  
Karan Garg ◽  
Glenn Jacobowitz ◽  
Neal Cayne ◽  
Thomas Maldonado ◽  
Patrick Lamparello ◽  
...  
Keyword(s):  
Duplex Ultrasound ◽  
Carotid Revascularization ◽  
Carotid Duplex ◽  
Ultrasound Parameters

scholarly journals Carotid Duplex Ultrasound Findings in Patients with Coronary Artery Disease (CAD)- A Study in 50 Cases

1970 ◽  
Vol 1 (1) ◽  
pp. 44-47
Author(s):  
MS Bari ◽  
MS Kabir ◽  
MA Ali ◽  
SAN Alam ◽  
AAS Majumder ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Atherosclerosis ◽  
Duplex Ultrasound ◽  
Carotid Duplex ◽  
Ultrasound Study ◽  
History Of ◽  
Artery Disease ◽  
Age Range

Background: Patients with angina pectoris or myocardial infarction are more likely to experience stroke. Ischaemic stroke has been found to develop in approximately 2-5% of patients in the first 1- 2 weeks after myocardial infarction Methods: Fifty patients with coronary artery disease admitted to the National Institute of Cardiovascular Diseases (NICVD), Dhaka, were screened for presence of carotid atherosclerosis by duplex ultrasound study during the period of July 98 to August 98. Results: Carotid lesion were found in 34 patients (68%) and normal carotids found in 16 patients (32%). Age range of patients with and without carotid lesions was 56±5.39 yrs and 47±7.91 yrs respectively. Out of 34 patients, 30 were male (88.2%) and 4 were female (11.7%). 29 patients (85.3%) were smokers, 22 patients (64.7%) were hypertensive and 9 patients (26.4%) were diabetic. Dyslipidaemia was found in 16 patients (47%) and a history of transient ischaemic attack (TIA) was found in 10 patients (29.4%). A coexistent CAD on coronary (CAG) was found in 31 patients (91.1%). Conclusion: Cortaid duplex ultrasound study findings of atherosclerotic lesions in Carotid arteries are good predictors of CAD.Keywords: Carotid atherosclerosis, Carotid duplex ultrasound, Coronary artery disease. DOI: http://dx.doi.org/10.3329/cardio.v1i1.8203 Cardiovasc. j. 2008; 1(1) : 44-47

C-reactive protein as a marker of progression of carotid atherosclerosis in subjects with type 2 diabetes mellitus

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Aleš Pleskovič ◽  
Marija Šantl Letonja ◽  
Andreja Cokan Vujkovac ◽  
Jovana Nikolajević Starčević ◽  
Katarina Gazdikova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Carotid Atherosclerosis ◽  
Inflammatory Marker ◽  
Progression Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp ◽  
Unstable Plaques

Abstract. Background: This prospective study was designed to evaluate the effect of inflammatory markers on the presence and progression of subclinical markers of carotid atherosclerosis in a 3.8-year follow-up period in patients with type 2 diabetes mellitus (T2DM). Patients and methods: A total of 595 subjects with T2DM were enrolled. Subclinical markers of carotid atherosclerosis (carotid intima media thickness (CIMT), plaque thickness, and plaques presence) were assessed with ultrasound at the time of recruitment and again after 3.8 years. Subjects with T2DM were divided into 2 groups according to the plasma high sensitive C-reactive protein (hs-CRP) levels (subjects with hs-CRP ≥ 2 mg/L and subjects with hs-CRP below 2 mg/L). Results: Subjects with T2DM and hs-CRP levels ≥ 2 mg/L had higher CIMT in comparison with subjects with T2DM and hs-CRP levels below 2 mg/L, and higher incidence of plaques/unstable plaques in comparison with subjects with T2DM and hs-CRP levels below 2 mg/L. Multivariate logistic regression analysis found the association between the HDL cholesterol level and presence of plaques, whereas the inflammatory marker hs-CRP was not associated with subclinical markers of progression of carotid atherosclerosis. Multiple linear regression analysis found the association between the hs-CRP levels and either CIMT progression rate or a change in the number of sites with plaques in a 3.8-year follow-up. Conclusions: We demonstrated an association between the inflammatory marker hs-CRP and either CIMT or incidence of plaques/unstable plaques at the time of recruitment in Caucasians with T2DM. Moreover, we found the association between hs-CRP levels and either CIMT progression rate or a change in the number of sites with plaques in a 3.8-year follow-up in subjects with T2DM.

Modulation of carotid strain by statin therapy in atherosclerosis patients

VASA ◽  
2017 ◽  
Vol 46 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Christian Alexander Schaefer ◽  
Anna Katharina Blatzheim ◽  
Sebastian Gorgonius Passon ◽  
Kristin Solveig Pausewang ◽  
Nadjib Schahab ◽  
...  
Keyword(s):  
Statin Therapy ◽  
Pulse Wave ◽  
Ultrasound Examination ◽  
Ankle Brachial Index ◽  
Radial Strain ◽  
Strain Analysis ◽  
Duplex Ultrasound ◽  
Strain Imaging ◽  
The Common

Abstract. Background: The beneficial effect of statin therapy on the progress of atherosclerotic disease has been demonstrated by numerous studies. Vascular strain imaging is an arising method to evaluate arterial stiffness. Our study examined whether an influence of statin therapy on the vessel wall could be detected by vascular strain imaging. Patients and methods: 88 patients with recently detected atherosclerosis underwent an angiological examination including ankle-brachial index (ABI), pulse wave index (PWI), central puls ewave velocity and duplex ultrasound. Captures for vascular strain analysis were taken in B-mode during ultrasound examination of the common carotid artery and evaluated using a workstation equipped with a speckle tracking based software. A statin therapy was recommended and after six months a follow-up examination took place. Meanwhile, the non-adherence of a group of patients (N = 18) lead to a possibility to observe statin effects on the vascular strain. Results: In the statin non-adherent group the ABI decreased significantly to a still non-pathological level (1.2 ± 0.2 vs. 1.0 ± 0.2; p = 0.016) whereas it stagnated in the adherent group (1.0 ± 0.2 vs. 1.0 ± 0.2; p = 0.383). The PWI did not differ in the non-adherent group (180.5 ± 71.9 vs. 164.4 ± 75.8; p = 0.436) but under statin therapy it decreased significantly (261.8 ± 238.6 vs. 196.4 ± 137.4; p = 0.016). In comparison to the adherent group (4.2 ± 2.0 vs. 4.0 ± 1.8; p = 0.548) under statin therapy the radial strain decreased significantly in the non-adherent group (4.7 ± 2.0 vs. 3.3 ± 1.1; p = 0.014). Conclusions: Our findings reveal a beneficial influence of statin therapy on the arterial wall detected by vascular strain analysis.

Endovenous radiofrequency powered segmental thermal ablation (Closure FAST) of great saphenous veins

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 69-71 ◽  
Author(s):  
T. M. Proebstle ◽  
Keyword(s):  
Side Effects ◽  
Thermal Ablation ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Duplex Ultrasound ◽  
Multicenter Trial ◽  
Saphenous Veins ◽  
Clinical Control ◽  
Prospective Multicenter Trial

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.

Apolipoprotein(a), Fibrinopeptide A and Carotid Atherosclerosis in Middle-Aged Men

1994 ◽  
Vol 72 (04) ◽  
pp. 563-566 ◽  
Author(s):  
Tuomo Rankinen ◽  
Sari Väisänen ◽  
Michele Mercuri ◽  
Rainer Rauramaa
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Bifurcation ◽  
Carotid Intima Media Thickness ◽  
Fibrinopeptide A ◽  
Carotid Imt ◽  
Apolipoprotein A ◽  
The Difference

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.

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