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Unstable Carotid Artery Plaque Evaluation by Ultrasound

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Translational Research in Stroke

Part of the book series: Translational Medicine Research ((TRAMERE))

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Abstract

Although evaluation of carotid stenosis has been traditionally focused on degree of stenosis, there is a growing evidence about the importance of the evaluation of morphological features of carotid plaques. Unstable plaques can lead to stroke regardless of the degree of stenosis they cause. Ultrasound is a useful, easy-to-use, and widely available technique to assess both degree of stenosis and morphological characteristics. Unstable plaques are classically described by ultrasound as irregular and hypoechoic. Further, new ultrasound techniques have been developed to detect plaque neovascularization, one of the most important features which confer instability to atheroma plaques. Besides carotid ultrasound, other image techniques, such as computed tomography angiography, magnetic resonance imaging, and positron emission tomography, have proven their usefulness in the evaluation of unstable carotid plaques in several studies. Due to the growing knowledge of unstable carotid plaques and the improvements achieved in their evaluation, a yield of investigation is emerging: non-stenotic but unstable carotid plaques as a source of cryptogenic strokes.

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Abbreviations

18-FDG:

18-Fluorodeoxyglucose

ACA:

Anterior cerebral artery

CCA:

Common carotid artery

CEUS:

Contrast-enhanced ultrasound sonography

CTA:

Computed tomography angiography

ECA:

External carotid artery

ECST:

European Carotid Surgery Trial

EDV:

End-diastolic velocity

GSM:

Gray-scale median

HITS:

High-intensity transient signals

ICA:

Internal carotid artery

MCA:

Middle cerebral artery

MDCT:

Multidetector-row CT

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

NASCET:

North American Symptomatic Carotid Endarterectomy Trial

PCA:

Posterior cerebral artery

PET:

Positron emission tomography

PSV:

Peak systolic velocity

RI:

Resistance index

TOAST:

Trial of Org 10172 in Acute Stroke Treatment

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Authors and Affiliations

  1. Stroke Unit, Department of Neurology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Ps. Vall d’Hebron 119, Barcelona, 08035, Spain

    Noelia Rodriguez-Villatoro & David Rodriguez-Luna

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  1. Noelia Rodriguez-Villatoro
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  2. David Rodriguez-Luna
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Editors and Affiliations

  1. Department of Neurology & Neurosurgery, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, Los Angeles, California, USA

    Paul A. Lapchak

  2. Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China

    Guo-Yuan Yang

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Rodriguez-Villatoro, N., Rodriguez-Luna, D. (2017). Unstable Carotid Artery Plaque Evaluation by Ultrasound. In: Lapchak, P., Yang, GY. (eds) Translational Research in Stroke. Translational Medicine Research. Springer, Singapore. https://doi.org/10.1007/978-981-10-5804-2_7

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