scholarly journals Intraplaque Hemorrhage, Fibrous Cap Status, and Microembolic Signals in Symptomatic Patients With Mild to moderate Carotid Artery Stenosis: The Plaque At RISK Study

2015 ◽  
Vol 61 (2) ◽  
pp. 568 ◽  
Author(s):  
M.T.B. Truijman ◽  
A.A.J. de Rotte ◽  
R. Aaslid
Keyword(s):  
At Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Intraplaque Hemorrhage ◽  
Fibrous Cap

Intraplaque Hemorrhage, Fibrous Cap Status, and Microembolic Signals in Symptomatic Patients With Mild to Moderate Carotid Artery Stenosis

Stroke ◽  
2014 ◽  
Vol 45 (11) ◽  
pp. 3423-3426 ◽  
Author(s):  
Martine T.B. Truijman ◽  
Alexandra A.J. de Rotte ◽  
Rune Aaslid ◽  
Anouk C. van Dijk ◽  
Jeire Steinbuch ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Intraplaque Hemorrhage ◽  
Fibrous Cap

scholarly journals Association between Intraplaque Hemorrhage and Vascular Remodeling in Carotid Arteries: The Plaque at RISK (PARISK) Study

2020 ◽  
pp. 1-6
Author(s):  
Kristine Dilba ◽  
Anouk C. van Dijk ◽  
Geneviève A.J.C. Crombag ◽  
Anton F.W. van der Steen ◽  
Mat J. Daemen ◽  
...  
Keyword(s):  
At Risk ◽  
Carotid Artery ◽  
Cross Section ◽  
Carotid Artery Stenosis ◽  
Vascular Remodeling ◽  
Artery Stenosis ◽  
Intraplaque Hemorrhage ◽  
Plaque Size ◽  
Symptomatic Carotid ◽  
Wall Area

<b><i>Introduction:</i></b> Vascular remodeling is a compensatory enlargement of the vessel wall in response to atherosclerotic plaque growth. We aimed to investigate the association between intraplaque hemorrhage (IPH), vascular remodeling, and luminal dimensions in recently symptomatic patients with mild to moderate carotid artery stenosis in which the differences in plaque size were taken into account. <b><i>Materials and Methods:</i></b> We assessed vessel dimensions on MRI of the symptomatic carotid artery in 164 patients from the Plaque At RISK study. This study included patients with recent ischemic neurological event and ipsilateral carotid artery stenosis &#x3c;70%. The cross section with the largest wall area (WA) in the internal carotid artery (ICA) was selected for analysis. On this cross section, the following parameters were determined: WA, total vessel area (TVA), and lumen area (LA). Vascular remodeling was quantified as the remodeling ratio (RR) and was calculated as TVA at this position divided by the TVA in an unaffected distal portion of the ipsilateral ICA. Adjustment for WA was performed to correct for plaque size. <b><i>Results:</i></b> Plaques with IPH had a larger WA (0.56 vs. 0.46 cm<sup>2</sup>; <i>p</i> &#x3c; 0.001), a smaller LA (0.17 vs. 0.22 cm<sup>2</sup>; <i>p</i> = 0.03), and a higher RR (2.0 vs. 1.9; <i>p</i> = 0.03) than plaques without IPH. After adjustment for WA, plaques containing IPH had a smaller LA (<i>B</i> = −0.052, <i>p</i> = 0.01) than plaques without IPH, but the RR was not different. <b><i>Conclusion:</i></b> After correcting for plaque size, plaques containing IPH had a smaller LA than plaques without IPH. However, RR was not different.

scholarly journals Circulating Extracellular Vesicle Cargo as Bioinformants of ‘at-risk’ Carotid Artery Stenosis

2021 ◽  
Vol 74 (3) ◽  
pp. e237-e238
Author(s):  
Sneha Raju ◽  
Dakota Gustafson ◽  
Kamalben Prajapati ◽  
Natalie J. Galant ◽  
Steven R. Botts ◽  
...  
Keyword(s):  
At Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Extracellular Vesicle ◽  
Artery Stenosis

Pathophysiology of Acute Cerebrovascular Syndrome in Patients With Carotid Artery Stenosis

Neurosurgery ◽  
2015 ◽  
Vol 76 (4) ◽  
pp. 427-434 ◽  
Author(s):  
Daina Kashiwazaki ◽  
Naoki Akioka ◽  
Naoya Kuwayama ◽  
Kyo Noguchi ◽  
Kortaro Tanaka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Border Zone ◽  
Intraplaque Hemorrhage ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging ◽  
Mixed Pattern

Abstract BACKGROUND: The mechanisms underlying acute cerebrovascular syndrome in patients with carotid artery stenosis remain unclear. OBJECTIVE: To assess the relationships among infarct localization, hemodynamics, and plaque components. METHODS: This prospective study included 38 patients with acute cerebrovascular syndrome resulting from ipsilateral carotid artery stenosis. Cerebral infarct localization was categorized into 3 patterns (cortical, border zone, and mixed pattern). Carotid plaque components were evaluated with T1-weighted magnetic resonance imaging and time-of-flight imaging. Cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) were also quantified. RESULTS: Infarcts were identified in 38 patients with the use of diffusion-weighted magnetic resonance imaging. On the basis of the assessment of hemodynamics, the cortical pattern was seen in 18 of 21 patients with type 1 ischemia (normal CBF, normal CVR), whereas the mixed pattern was seen in 2 patients with type 2 ischemia (normal CBF, impaired CVR) and 12 of 15 patients with type 3 ischemia (impaired CBF, impaired CVR). The plaque components were categorized into fibrous (4 patients), lipid-rich (14 patients), and intraplaque hemorrhage (IPH; 20 patients). Of the patients with fibrous plaque, 2 had border-zone and 2 had mixed-pattern infarcts. Of the patients with lipid-rich plaque, 7 had cortical and 6 had mixed-pattern infarcts. Of patients with intraplaque hemorrhage, 11 had cortical and 9 had mixed-pattern infarcts. CONCLUSION: Cortical infarction occurs as a result of vulnerable plaque. Reduced cerebral perfusion induces border-zone infarction. Both factors are implicated in mixed-pattern infarction. Developments in noninvasive diagnostic modalities allow us to explore the mechanisms behind acute cerebrovascular syndrome in carotid artery stenosis and to determine the ideal therapies.

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