The size of juxtaluminal hypoechoic area in ultrasound images of asymptomatic carotid plaques predicts the occurrence of stroke

6533b860fe1ef96bd12c3a4b

RESEARCH PRODUCT

The size of juxtaluminal hypoechoic area in ultrasound images of asymptomatic carotid plaques predicts the occurrence of stroke

Sk Kakkos Mb Griffin An Nicolaides E Kyriacou Mm Sabetai T Tegos Gc Makris Dj Thomas G Geroulakos Asymptomatic Carotid Stenosis Risk Of Stroke Study Group R Adovasio B Ziani F Alò C Cicilioni G Ambrosio A Andreev G Andreozzi F Verlato G Camporese E Arosio E Barkauskas A Barros P Brannigan V Batchvarova A Dramov P Belardi G Novelli G Simoni P Bell G Biasi P Mingazzini N Bornstein D Bouchier Hayes P Fitzgerald M Cairols P Cao P Derango G Carboni C Geoffredo M Catalano B Chambers M Goetzmann A Dickinson D Clement M Bobelyn S Coccheri E Conti E Diamantopoulos E Andreadis P Dimakakos T Kotsis B Eikelboom L Entz A Ferrari Bardile T Aloi M Salerno J Fernandes L Pedro D Fitzgerald A O'shaughnessy J Fletcher S Forconi R Cappeli M Bicchi S Arrigucci V Gallai G Cardaiolli G Geroulakos S Kakkos L Gomez Isaza G Gorgoyannis N Liasis M Graf P Guarini S Hardy P Harris S Aston G Iosa A Katsamouris A Giannoukas M Krzanowski G Ladurner J Leal Monedero B Lee C Liapis P Galanis W Liboni E Pavanelli E Mannarino G Vaudo P Mccollum R Levison G Micieli D Bosone L Middleton M Pantziaris T Tyllis E Minar A Willfort L Moggi P Derango G Nenci S Radicchia A Nicolaides S Kakkos D Thomas L Norgren E Ribbe S Novo R Tantillo D Olinic W Paaske A Pagnan P Pauletto V Pagliara G Pettina C Pratesi S Matticari J Polivka P Sevcik P Poredos A Blinc V Videcnik A Pujia A Raso Pietro Rispoli M Conforti T Robinson M Dennis S Rosfors G Rudofsky T Schroeder M Gronholdt G Simoni C Finocchi G Rodriguez C Spartera M Ventura P Scarpelli M Sprynger B Sadzot C Hottermans M Moonen P Taylor A Tovar Pardo J Negreira M Vayssairat J Faintuch J Valaikiené M Walker R. Wilkinson

subject

Asymptomatic carotid plaque Male Time Factors medicine.medical_treatment Carotid endarterectomy Kaplan-Meier Estimate Severity of Illness Index asymptomatic carotid artery stenosis; hypoecoic area; Stroke Risk Factors Carotid Stenosis Ultrasonography Doppler Color Prospective cohort study Stroke Aged 80 and over Neovascularization Pathologic hypoecoic area Middle Aged Prognosis Plaque Atherosclerotic Europe Stroke Ischemic Attack Transient Predictive value of tests Female Radiology medicine.symptom juxtaluminal hypoechoic area ultrasound images asymptomatic carotid plaques stroke Cardiology and Cardiovascular Medicine Carotid Artery Internal Adult medicine.medical_specialty Asymptomatic Risk Assessment Asymptomatic carotid plaque; Brain ischemia; Stroke; Echography Brain ischemia Predictive Value of Tests asymptomatic carotid artery stenosi medicine Humans cardiovascular diseases Aged Proportional Hazards Models business.industry Proportional hazards model medicine.disease Acoustic shadow Settore MED/11 - Malattie Dell'Apparato Cardiovascolare Stenosis ROC Curve Asymptomatic Diseases Linear Models Surgery asymptomatic carotid artery stenosis Echography business Follow-Up Studies

description

Abstract OBJECTIVE: To test the hypothesis that the size of a juxtaluminal black (hypoechoic) area (JBA) in ultrasound images of asymptomatic carotid artery plaques predicts future ipsilateral ischemic stroke. METHODS: A JBA was defined as an area of pixels with a grayscale value 10 mm(2) (P 8 mm(2)) was still significant after adjusting for other plaque features known to be associated with increased risk, including stenosis, grayscale median, presence of discrete white areas without acoustic shadowing indicating neovascularization, plaque area, and history of contralateral TIA or stroke. Plaque area and grayscale median were not significant. Using the significant variables (stenosis, discrete white areas without acoustic shadowing, JBA, and history of contralateral TIA or stroke), this model predicted the annual risk of stroke for each patient (range, 0.1%-10.0%). The average annual stroke risk was <1% in 734 patients, 1% to 1.9% in 94 patients, 2% to 3.9% in 134 patients, 4% to 5.9% in 125 patients, and 6% to 10% in 34 patients. CONCLUSIONS: The size of a JBA is linearly related to the risk of stroke and can be used in risk stratification models. These findings need to be confirmed in future prospective studies or in the medical arm of randomized controlled studies in the presence of optimal medical therapy. In the meantime, the JBA may be used to select asymptomatic patients at high stroke risk for carotid endarterectomy and spare patients at low risk from an unnecessary operation.

year	journal	country	edition	language
2013-03-01

10.1016/j.jvs.2012.09.045 http://hdl.handle.net/10447/94941