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Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study

Correct stratification of ischemic stroke risk allows for the proper treatment of carotid atherosclerotic disease. We seek to differentiate plaque types based on stenosis level and plaque morphology. The Chinese Atherosclerosis Risk Evaluation (CARE–II) study is a cross-sectional, observational, mul...

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Autores principales: Watase, Hiroko, Canton, Gador, Sun, Jie, Zhao, Xihai, Hatsukami, Thomas S., Yuan, Chun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963409/
https://www.ncbi.nlm.nih.gov/pubmed/31581663
http://dx.doi.org/10.3390/diagnostics9040137
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author Watase, Hiroko
Canton, Gador
Sun, Jie
Zhao, Xihai
Hatsukami, Thomas S.
Yuan, Chun
author_facet Watase, Hiroko
Canton, Gador
Sun, Jie
Zhao, Xihai
Hatsukami, Thomas S.
Yuan, Chun
author_sort Watase, Hiroko
collection PubMed
description Correct stratification of ischemic stroke risk allows for the proper treatment of carotid atherosclerotic disease. We seek to differentiate plaque types based on stenosis level and plaque morphology. The Chinese Atherosclerosis Risk Evaluation (CARE–II) study is a cross-sectional, observational, multicenter study to assess carotid atherosclerotic plaques in symptomatic subjects using vessel wall magnetic resonance imaging. Plaque morphology and presence of plaque components were reviewed using multi-contrast magnetic resonance imaging. The carotid arteries were divided into four groups based on stenosis level and plaque components. Out of 1072 ischemic stroke subjects, 452 ipsilateral side carotid arteries were included. Significant stenosis (SS) (≥50% stenosis) with high-risk plaque (HRP) features was present in 37 arteries (8.2%), SS(+)/HRP(−) in 29 arteries (6.4%), SS(−)/HRP(+) in 57 arteries (12.6%), and SS(−)/HRP(−) in 329 arteries (72.8%). The prevalence of SS(−)/HRP(+) arteries in this cohort was substantial and had greater wall thickness than the SS(+)/HRP(−) group. These arteries may be misclassified for carotid revascularization by current guidelines based on the degree of luminal stenosis only. These findings have implications for further studies to assess stroke risk using vessel wall imaging.
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spelling pubmed-69634092020-02-26 Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study Watase, Hiroko Canton, Gador Sun, Jie Zhao, Xihai Hatsukami, Thomas S. Yuan, Chun Diagnostics (Basel) Article Correct stratification of ischemic stroke risk allows for the proper treatment of carotid atherosclerotic disease. We seek to differentiate plaque types based on stenosis level and plaque morphology. The Chinese Atherosclerosis Risk Evaluation (CARE–II) study is a cross-sectional, observational, multicenter study to assess carotid atherosclerotic plaques in symptomatic subjects using vessel wall magnetic resonance imaging. Plaque morphology and presence of plaque components were reviewed using multi-contrast magnetic resonance imaging. The carotid arteries were divided into four groups based on stenosis level and plaque components. Out of 1072 ischemic stroke subjects, 452 ipsilateral side carotid arteries were included. Significant stenosis (SS) (≥50% stenosis) with high-risk plaque (HRP) features was present in 37 arteries (8.2%), SS(+)/HRP(−) in 29 arteries (6.4%), SS(−)/HRP(+) in 57 arteries (12.6%), and SS(−)/HRP(−) in 329 arteries (72.8%). The prevalence of SS(−)/HRP(+) arteries in this cohort was substantial and had greater wall thickness than the SS(+)/HRP(−) group. These arteries may be misclassified for carotid revascularization by current guidelines based on the degree of luminal stenosis only. These findings have implications for further studies to assess stroke risk using vessel wall imaging. MDPI 2019-10-02 /pmc/articles/PMC6963409/ /pubmed/31581663 http://dx.doi.org/10.3390/diagnostics9040137 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Watase, Hiroko
Canton, Gador
Sun, Jie
Zhao, Xihai
Hatsukami, Thomas S.
Yuan, Chun
Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study
title Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study
title_full Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study
title_fullStr Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study
title_full_unstemmed Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study
title_short Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study
title_sort four different carotid atherosclerotic behaviors based on luminal stenosis and plaque characteristics in symptomatic patients: an in vivo study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963409/
https://www.ncbi.nlm.nih.gov/pubmed/31581663
http://dx.doi.org/10.3390/diagnostics9040137
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