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1. Proximal Region of Carotid Atherosclerotic Plaque Shows More Intraplaque Hemorrhage: The Plaque at Risk Study

Author

G.A.J.C. Crombag, M. Aizaz, F.H.B.M. Schreuder, F. Benali, D.H.K. van Dam-Nolen, M.I. Liem, C. Lucci, A.F. van der Steen, M.J.A.P. Daemen, W.H. Mess, A. van der Lugt, P.J. Nederkoorn, J. Hendrikse, P.A.M. Hofman, R.J. van Oostenbrugge, J.E. Wildberger, M.E. Kooi, Radiology & Nuclear Medicine, Neurology, Cardiology, MUMC+: DA BV AIOS Radiologie (9), RS: Carim - Blood, Beeldvorming, RS: Carim - B06 Imaging, RS: Carim - B05 Cerebral small vessel disease, Klinische Neurowetenschappen, MUMC+: HZC Klinische Neurofysiologie (5), MUMC+: HZC Med Staf Spec Klinische Neurofys (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: MA Neurologie (3), MUMC+: Hersen en Zenuw Centrum (3), MUMC+: Diagnostiek en Advies (3), MUMC+: DA Beeldvorming (5), MUMC+: DA BV Klinisch Fysicus (9), Graduate School, ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Neurovascular Disorders, Pathology, and ACS - Heart failure & arrhythmias

Subjects
STROKE PATIENTS, VULNERABILITY, SHEAR-STRESS, SURFACE, PULSE PRESSURE, Hemorrhage, UPSTREAM, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Magnetic Resonance Imaging, Plaque, Atherosclerotic, Stroke, EVENTS, All institutes and research themes of the Radboud University Medical Center, Carotid Arteries, RUPTURE, Humans, Radiology, Nuclear Medicine and imaging, Carotid Stenosis, Neurology (clinical), Extracranial Vascular, DIRECTION, MRI
Abstract

BACKGROUND AND PURPOSE: Intraplaque hemorrhage contributes to lipid core enlargement and plaque progression, leading to plaque destabilization and stroke. The mechanisms that contribute to the development of intraplaque hemorrhage are not completely understood. A higher incidence of intraplaque hemorrhage and thin/ruptured fibrous cap (upstream of the maximum stenosis in patients with severe [?70%] carotid stenosis) has been reported. We aimed to noninvasively study the distribution of intraplaque hemorrhage and a thin/ruptured fibrous cap in patients with mild-to-moderate carotid stenosis. MATERIALS AND METHODS: Eighty-eight symptomatic patients with stroke (

Published
2022
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2. Intraplaque Hemorrhage and the Plaque Surface in Carotid Atherosclerosis: The Plaque At RISK Study (PARISK)

Author

M.I. Liem, Jeroen Hendrikse, A.A. de Rotte, A.F.W. van der Steen, Peter J. Koudstaal, Mat J.A.P. Daemen, Burhan Hussain, Ghesrouw Saiedie, A. van der Lugt, Martine T. B. Truijman, Paul J. Nederkoorn, ME Marianne Eline Kooi, A.C. van Dijk, Taihra Zadi, Pathologie, Beeldvorming, RS: NUTRIM - R1 - Metabolic Syndrome, RS: CARIM - R3 - Vascular biology, MUMC+: HZC Med Staf Spec Klinische Neurofys (9), Graduate School, ACS - Amsterdam Cardiovascular Sciences, Pathology, Neurology, Radiology & Nuclear Medicine, Erasmus MC other, and Cardiology

Subjects
Carotid atherosclerosis, Male, Pathology, Carotid arteries, SYMPTOMATIC PATIENTS, medicine.disease_cause, DEFINITIONS, Computer-Assisted, Risk Factors, Prevalence, Medicine, Carotid Stenosis, Prospective Studies, Prospective cohort study, Non-U.S. Gov't, Stroke, Plaque, Atherosclerotic, ENDARTERECTOMY, Research Support, Non-U.S. Gov't, Fibrous cap, Middle Aged, Clinical Trial, Plaque, Atherosclerotic, Multicenter Study, medicine.anatomical_structure, Carotid Arteries, Female, Radiology, Diagnostic Imaging, medicine.medical_specialty, Noninvasive imaging, Hemorrhage, Research Support, STENOSIS, SDG 3 - Good Health and Well-being, ROW CT ANGIOGRAPHY, ASSESSMENT STRATEGIES, Image Interpretation, Computer-Assisted, Journal Article, Humans, Radiology, Nuclear Medicine and imaging, Extracranial Vascular, Image Interpretation, Aged, IDENTIFICATION, business.industry, medicine.disease, Vulnerable plaque, CEREBROVASCULAR EVENTS, Stenosis, Logistic Models, VULNERABLE PATIENT, MORPHOLOGY, Neurology (clinical), business
Abstract

BACKGROUND AND PURPOSE: An important characteristic of vulnerable plaque, intraplaque hemorrhage, may predict plaque rupture. Plaque rupture can be visible on noninvasive imaging as a disruption of the plaque surface. We investigated the association between intraplaque hemorrhage and disruption of the plaque surface. MATERIALS AND METHODS: We selected the first 100 patients of the Plaque At RISK study, an ongoing prospective noninvasive plaque imaging study in patients with mild-to-moderate atherosclerotic lesions in the carotid artery. In carotid artery plaques, disruption of the plaque surface (defined as ulcerated plaques and/or fissured fibrous cap) and intraplaque hemorrhage were assessed by using MDCTA and 3T MR imaging, respectively. We used a chi2 test and multivariable logistic regression to assess the association between intraplaque hemorrhage and disrupted plaque surface. RESULTS: One hundred forty-nine carotid arteries in 78 patients could be used for the current analyses. Intraplaque hemorrhage and plaque ulcerations were more prevalent in symptomatic compared with contralateral vessels (hemorrhage, 38% versus 11%; P < .001; and ulcerations, 27% versus 7%; P = .001). Fissured fibrous cap was more prevalent in symptomatic compared with contralateral vessels (13% versus 4%; P = .06). After adjustment for age, sex, diabetes mellitus, and degree of stenosis, intraplaque hemorrhage was associated with disrupted plaque surface (OR, 3.13; 95% CI, 1.25-7.84) in all vessels. CONCLUSIONS: Intraplaque hemorrhage is associated with disruption of the plaque surface in patients with a carotid artery stenosis of

Published
2015
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