scholarly journals Stratifying risk: asymptomatic carotid disease

2012 ◽  
Vol 11 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Rafael D. Malgor ◽  
Emily A. Wood ◽  
Otavio A. Iavarone ◽  
Nicos Labropoulos
Keyword(s):  
Carotid Artery ◽  
Critical Analysis ◽  
Carotid Artery Disease ◽  
Plaque Morphology ◽  
Carotid Disease ◽  
Asymptomatic Carotid ◽  
Plaque Instability ◽  
Artery Disease ◽  
Healthcare Expenses ◽  
Annual Risk

Stroke generates significant healthcare expenses and it is also a social and economic burden. The carotid artery atherosclerotic plaque instability is responsible for a third of all embolic strokes. The degree of stenosis has been deliberately used to justify carotid artery interventions in thousands of patients worldwide. However, the annual risk of stroke in asymptomatic carotid artery disease is low. Plaque morphology and its kinetics have gained ground to explain cerebrovascular and retinal embolic events. This review provides the readers with an insightful and critical analysis of the risk stratification of asymptomatic carotid artery disease in order to assist in selecting potential candidates for a carotid intervention.

Contrast Enhanced Ultrasound: Visualization of Far Field and Classification of Plaque in the Extracranial Carotid Arteries

2018 ◽  
Vol 42 (3) ◽  
pp. 109-115 ◽  
Author(s):  
Paige L. Rowland ◽  
Michelle Colpitts ◽  
Angela Malone ◽  
Munis Raza ◽  
Lenora L. Eberhart ◽  
...  
Keyword(s):  
Image Quality ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Carotid Artery Disease ◽  
Plaque Morphology ◽  
Far Field ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Imaging ◽  
Contrast Enhanced ◽  
Artery Disease

Ultrasound stratification for the degree of carotid artery disease based solely on lumen reduction has poorly predicted patient outcomes. This pilot study focused on patients with moderate carotid artery stenosis. Our purpose was to use contrast imaging with ultrasound to improve carotid field. A total of 10 patients diagnosed with moderate carotid artery stenosis were rescanned with an administration of a contrast imaging agent. Two-dimensional (2D) imaging, color, and Doppler were utilized to scan the patients. The 20 carotid arteries were blindly read by 2 experienced physicians. Visualization of far field, quality of Doppler envelope, plaque morphology, and overall image quality were semi-quantifiably assessed. With the use of a contrast imaging agent, there was a reduction in interphysician interpretation variability. The Kappa coefficient yielded an increase in agreement for postcontrast imaging in the majority of variables. The Doppler envelope showed improvement from precontrast (0.06) to postcontrast (0.63). The visualization of the far fields demonstrated a significant increase in agreement (0.77, 0.71, and 0.67) postcontrast. Plaque morphology demonstrated enhancement in characterization with contrast (–0.09 to 0.66). In this study, contrast-enhanced ultrasound (CEUS) was found to increase overall image quality. Improved interpretation can enhance risk stratification and with further exploration could be used to guide treatment plans for patients with asymptomatic moderate carotid artery disease.

29 ASYMPTOMATIC CAROTID ARTERY DISEASE IN VALVULAR HEART SURGERY

2011 ◽  
Vol 12 (1) ◽  
pp. 7
Author(s):  
A. Anselmi ◽  
M. Morelli ◽  
C. Pragliola ◽  
N. Pavone ◽  
V. Tsiopoulos ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Heart Surgery ◽  
Carotid Artery Disease ◽  
Asymptomatic Carotid ◽  
Artery Disease
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