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Nies KPH, Aizaz M, van Dam-Nolen DHK, Goring TCD, Schreuder TAHCML, van Orshoven NP, Postma AA, Bos D, Hendrikse J, Nederkoorn P, van der Geest R, van Oostenbrugge RJ, Mess WH, Kooi ME. Signal intensity and volume of carotid intraplaque hemorrhage on magnetic resonance imaging and the risk of ipsilateral cerebrovascular events: The Plaque At RISK (PARISK) study. J Cardiovasc Magn Reson 2024; 26:101049. [PMID: 38878969 PMCID: PMC11282977 DOI: 10.1016/j.jocmr.2024.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/17/2024] [Accepted: 06/06/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND The Plaque At RISK (PARISK) study demonstrated that patients with a carotid plaque with intraplaque hemorrhage (IPH) have an increased risk of recurrent ipsilateral ischemic cerebrovascular events. It was previously reported that symptomatic carotid plaques with IPH showed higher IPH signal intensity ratios (SIR) and larger IPH volumes than asymptomatic plaques. We explored whether IPH SIR and IPH volume are associated with future ipsilateral ischemic cerebrovascular events beyond the presence of IPH. METHODS Transient ischemic attack and ischemic stroke patients with mild-to-moderate carotid stenosis and an ipsilateral IPH-positive carotid plaque (n = 89) from the PARISK study were included. The clinical endpoint was a new ipsilateral ischemic cerebrovascular event during 5 years of follow-up, while the imaging-based endpoint was a new ipsilateral brain infarct on brain magnetic resonance imaging (MRI) after 2 years (n = 69). Trained observers delineated IPH, a hyperintense region compared to surrounding muscle tissue on hyper T1-weighted magnetic resonance images. The IPH SIR was the maximal signal intensity in the IPH region divided by the mean signal intensity of adjacent muscle tissue. The associations between IPH SIR or volume and the clinical and imaging-based endpoint were investigated using Cox proportional hazard models and logistic regression, respectively. RESULTS During 5.1 (interquartile range: 3.1-5.6) years of follow-up, 21 ipsilateral cerebrovascular ischemic events were identified. Twelve new ipsilateral brain infarcts were identified on the 2-year neuro MRI. There was no association for IPH SIR or IPH volume with the clinical endpoint (hazard ratio (HR): 0.89 [95% confidence interval: 0.67-1.10] and HR: 0.91 [0.69-1.19] per 100-µL increase, respectively) nor with the imaging-based endpoint (odds ratio (OR): 1.04 [0.75-1.45] and OR: 1.21 [0.87-1.68] per 100-µL increase, respectively). CONCLUSION IPH SIR and IPH volume were not associated with future ipsilateral ischemic cerebrovascular events. Therefore, quantitative assessment of IPH of SIR and volume does not seem to provide additional value beyond the presence of IPH for stroke risk assessment. TRIAL REGISTRATION The PARISK study was registered on ClinicalTrials.gov with ID NCT01208025 on September 21, 2010 (https://clinicaltrials.gov/study/NCT01208025).
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Affiliation(s)
- Kelly P H Nies
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Mueez Aizaz
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Dianne H K van Dam-Nolen
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Timothy C D Goring
- Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | - Narender P van Orshoven
- Department of Neurology, Zuyderland Medical Center, Heerlen, the Netherlands; Department of Neurology, Zuyderland Medical Center, Sittard, the Netherlands
| | - Alida A Postma
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs) Maastricht University, Maastricht, the Netherlands
| | - Daniel Bos
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jeroen Hendrikse
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Paul Nederkoorn
- Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Rob van der Geest
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Robert J van Oostenbrugge
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Werner H Mess
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Clinical Neurophysiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M Eline Kooi
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
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Li R, Zhang Y, Zheng S, Zhang W, Du K, He W, Zhang W. Biomechanical characteristics in the carotid artery: Noninvasive assessment using subharmonic emissions from microbubbles. Med Phys 2023; 50:6857-6863. [PMID: 37337456 DOI: 10.1002/mp.16542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Stroke is closely related to carotid atherosclerotic plaques, which tend to occur in specific parts of the arteries, especially at the bifurcations, and are considered to be caused by biomechanical factors. Quantitative analysis of hemodynamic stress characteristics of the carotid sinus in vivo provides a mechanical basis for the development of atherosclerotic plaque in the carotid sinus. Previous studies found that ultrasound (US) contrast agent microbubbles would vibrate nonlinearly under the excitation of sound pressure, generating subharmonics (transmission fundamental frequency, i.e., f0 and subharmonic frequency at f0 /2), which have the highest sensitivity to pressure changes and exhibit an inverse linear relationship with environmental pressure. PURPOSE This study employed subharmonic aided pressure estimation (SHAPE) technology to reflect carotid artery hydrodynamic characteristics in the carotid lumen. METHODS From May 2021 to December 2021, this prospective study reviewed a total of 26 normal carotid arteries of 13 participants, all of whom received bilateral carotid artery routine US and SHAPE US examinations. During this study, the lumen of the bilateral distal segment of the common carotid artery (Distal-CCA), carotid artery bifurcation (CAB), and carotid bulb (CB) were scanned section by section from bottom to top in longitudinal and transverse sections. Subsequently, the subharmonic amplitudes in the lumen of normal carotid arteries were collected and analyzed. RESULTS This study found that the amplitude of subharmonic amplitude in the carotid was distributed unevenly, with the amplitudes of subharmonic at the CAB being higher. Specifically, the subharmonic gradient of the carotid artery bifurcation apex plane was maximum (9.72 ± 4.31 dB), while the average subharmonic amplitude of the outer lateral layer of the carotid artery was higher (-56.40 ± 6.31 dB) (p < 0.001). CONCLUSION The SHAPE technique is capable of indirectly reflecting the pressure changes of vascular system tissues, which may provide a new monitoring method for evaluating mechanical characteristics obviating invasion.
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Affiliation(s)
- Rui Li
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yukang Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Zheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenkai Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kai Du
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Alzahrani A, Sultan SR, Aslam M. Reliability of tomographic 3D ultrasound in measuring internal carotid artery plaque volume. Acta Radiol 2023; 64:2931-2937. [PMID: 37722861 DOI: 10.1177/02841851231199222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
BACKGROUND Tomographic 3D ultrasound (t3DUS) is a promise imaging technique for quantifying carotid plaque through measuring the degree of stenosis and plaque volume. Carotid plaque volume (CPV) could add benefit in predicting the potential risk of stroke. PURPOSE To assess the reproducibility and accuracy of t3DUS for measuring CPV within the internal carotid artery in patients undergoing carotid endarterectomy. MATERIAL AND METHODS t3DUS was used to obtain CPV in vivo from 25 symptomatic patients prior to surgery. Ex vivo CPV from the carotid endarterectomy specimen was then measured using a validated saline displacement method as a reference standard. CPV for each patient was measured twice using both methods (total n = 50 per technique). Intraclass correlation coefficient (ICC) and Bland-Altman plot were used to establish bias and limit of agreement between CPV measurements. RESULTS There was an excellent agreement between t3DUS and reference test with respect to measuring CPV with an ICC value of 0.98 (95% confidence interval = 0.97-0.99, P < 0.001). Bias in measurements was 0.02 ± 0.11 cm3 (95% limit of agreement = -0.19 to 0.25). Intra-observer agreement of t3DUS CPV measurements was excellent with an ICC value of 0.95 (95% confidence interval = 0.92-0.97, P < 0.001). Bias in measurements was 0.004 ± 0.07 cm3 (95% limit of agreement = -0.14 to 0.15). CONCLUSION t3DUS is a reproducible imaging method and showed excellent agreement with the reference standard with respect to measuring CPV. These findings suggest that t3DUS has the potential to be a valuable non-invasive tool for assessing carotid plaque burden and predicting the risk of stroke.
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Affiliation(s)
- Adel Alzahrani
- Department of Diagnostic Radiology, King Abdullah Medical City, Makkah, Saudi Arabia
- Vascular Laboratory, Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, UK
| | - Salahaden R Sultan
- Department of Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Aslam
- Vascular Laboratory, Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, UK
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Chemaly M, Marlevi D, Iglesias MJ, Lengquist M, Kronqvist M, Bos D, van Dam-Nolen DHK, van der Kolk A, Hendrikse J, Kassem M, Matic L, Odeberg J, de Vries MR, Kooi ME, Hedin U. Biliverdin Reductase B Is a Plasma Biomarker for Intraplaque Hemorrhage and a Predictor of Ischemic Stroke in Patients with Symptomatic Carotid Atherosclerosis. Biomolecules 2023; 13:882. [PMID: 37371462 DOI: 10.3390/biom13060882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Intraplaque hemorrhage (IPH) is a hallmark of atherosclerotic plaque instability. Biliverdin reductase B (BLVRB) is enriched in plasma and plaques from patients with symptomatic carotid atherosclerosis and functionally associated with IPH. OBJECTIVE We explored the biomarker potential of plasma BLVRB through (1) its correlation with IPH in carotid plaques assessed by magnetic resonance imaging (MRI), and with recurrent ischemic stroke, and (2) its use for monitoring pharmacotherapy targeting IPH in a preclinical setting. METHODS Plasma BLVRB levels were measured in patients with symptomatic carotid atherosclerosis from the PARISK study (n = 177, 5 year follow-up) with and without IPH as indicated by MRI. Plasma BLVRB levels were also measured in a mouse vein graft model of IPH at baseline and following antiangiogenic therapy targeting vascular endothelial growth factor receptor 2 (VEGFR-2). RESULTS Plasma BLVRB levels were significantly higher in patients with IPH (737.32 ± 693.21 vs. 520.94 ± 499.43 mean fluorescent intensity (MFI), p = 0.033), but had no association with baseline clinical and biological parameters. Plasma BLVRB levels were also significantly higher in patients who developed recurrent ischemic stroke (1099.34 ± 928.49 vs. 582.07 ± 545.34 MFI, HR = 1.600, CI [1.092-2.344]; p = 0.016). Plasma BLVRB levels were significantly reduced following prevention of IPH by anti-VEGFR-2 therapy in mouse vein grafts (1189 ± 258.73 vs. 1752 ± 366.84 MFI; p = 0.004). CONCLUSIONS Plasma BLVRB was associated with IPH and increased risk of recurrent ischemic stroke in patients with symptomatic low- to moderate-grade carotid stenosis, indicating the capacity to monitor the efficacy of IPH-preventive pharmacotherapy in an animal model. Together, these results suggest the utility of plasma BLVRB as a biomarker for atherosclerotic plaque instability.
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Affiliation(s)
- Melody Chemaly
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
| | - David Marlevi
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Maria-Jesus Iglesias
- Science for Life Laboratory, Department of Protein Science, School of Engineering Sciences in Chemistry/Biotechnology and Health, KTH Royal Institute of Technology, 11428 Stockholm, Sweden
| | - Mariette Lengquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Malin Kronqvist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Daniel Bos
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Dianne H K van Dam-Nolen
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Anja van der Kolk
- Department of Medical Imaging, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
- Department of Radiology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Mohamed Kassem
- Department of Radiology and Nuclear Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Ljubica Matic
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Jacob Odeberg
- Science for Life Laboratory, Department of Protein Science, School of Engineering Sciences in Chemistry/Biotechnology and Health, KTH Royal Institute of Technology, 11428 Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Huddinge, 14152 Stockholm, Sweden
- Department of Clinical Medicine, UiT-The Arctic University of Norway, 9019 Tromsø, Norway
| | - Margreet R de Vries
- Einthoven Laboratory, Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - M Eline Kooi
- Department of Radiology and Nuclear Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Ulf Hedin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Vascular Surgery, Karolinska University Hospital, 17176 Stockholm, Sweden
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Li R, Zhang Y, Zheng S, Cheng L, Zhang Y, Chen Z, He W, Zhang W. Noninvasive assessment of carotid plaque with subharmonic aided pressure estimation from a US contrast agent: A preliminary study. Clin Transl Sci 2023; 16:502-511. [PMID: 36606307 PMCID: PMC10014698 DOI: 10.1111/cts.13465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/06/2022] [Accepted: 11/12/2022] [Indexed: 01/07/2023] Open
Abstract
Stroke is closely associated with carotid plaques. The assessment of carotid plaque is still the key issue of stroke prevention in clinical practice. This prospective cross-sectional study included patients with carotid plaque evaluated by ultrasonography (US). The intima-media thickness (IMT), lumen stenosis severity, thickness, and length of carotid plaque were measured by the routine US, and the amplitudes of subharmonics in the upstream shoulder, top, and downstream shoulder of all plaques and corresponding lumens were observed by Subharmonic Aided Pressure Estimation (SHAPE) US examination from the US contrast agent perflubutane microbubbles (Sonazoid), which analyzed the clinical parameters of patients, the subharmonic amplitude characteristics of all plaques and lumens, and the parameter differences between the ischemic stroke (IS) group and control group. From May 2021 to February 2022, 46 carotid plaques of 23 patients were included. For plaques, the subharmonic amplitude in the plaque (-60.52 ± 4.46) was lower than that in the opposing level lumen (-56.82 ± 5.68 dB), the subharmonic gradient across the plaque cap was negatively correlated with plaque thickness (r = -0.51, p < 0.001), and with the lumen stenosis severity (r = -0.42, p = 0.003). The median IMT of the IS group was thicker than the control group. The subharmonic gradient of the intraplaque of the IS group was larger than the control group (p = 0.004). In this analysis, we use the receiver operating characteristic (ROC) curve to establish the cutoff value of the difference to predict a new monitoring method for plaque without invasion to predict IS. It still needs a large-scale study with long-term follow-up to validate these findings.
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Affiliation(s)
- Rui Li
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yukang Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Zheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Linggang Cheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanfen Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiguang Chen
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Vasavada AM, Singh P, Firdaus A, Meenashi Sundaram D, Patel M, Singh G, Palanisamy L, Ansari SA, Thummala S, Pandya H. Carotid Endarterectomy Versus Stenting for the Treatment of Patients With Carotid Artery Stenosis: An Updated Systematic Review and Meta-Analysis. Cureus 2023; 15:e35070. [PMID: 36942176 PMCID: PMC10024598 DOI: 10.7759/cureus.35070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 02/18/2023] Open
Abstract
Carotid endarterectomy (CEA) is a surgical procedure that treats the narrowed carotid arteries, which may be narrowed by atherosclerosis. Stenting is the insertion of a wire mesh scaffold into the narrowed portion of the carotid artery to keep it open by preventing blood from clotting. Using the study done over 10 years back as a point of reference, this study will seek an update on an assessment comparing CEA and stenting in studies carried out between 2015 and to date. The PICOS (population, intervention, control, outcome, and study designs) criteria were used to construct a set of inclusion and exclusion guidelines. This meta-analysis and systematic review used two forms of investigative analysis; both quantitative and qualitative assessments. From the studies, stroke (95% CI: 0.51-0.71, P < 0.001), myocardial infarction (95% CI: 1.49-3.42, P = 0.001), and stroke or death analysis (95% CI: 0.53-0.77, P < 0.001) were noted to be significant. From the analysis, CEA was observed as having better treatment results in terms of stroke events and stroke or death incidences when compared to stenting. Carotid stenting was observed as having lower cases of myocardial infarctions when compared to endarterectomy.
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Affiliation(s)
- Advait M Vasavada
- Internal Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Priyansha Singh
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND
| | - Arshia Firdaus
- Surgery, Deccan College of Medical Sciences, Hyderabad, IND
| | - Dakshin Meenashi Sundaram
- Internal Medicine, Employees' State Insurance Corporation (ESIC) Medical College & Post Graduate Institute of Medical Sciences and Research (PGIMSR), Chennai, IND
| | - Malvik Patel
- Surgery, Government Medical College, Vadodara, IND
| | - Ganeev Singh
- Surgery, Sri Guru Ram Das Institute of Medical Sciences & Research, Amritsar, IND
| | - Logesh Palanisamy
- Internal Medicine, Government Mohan Kumaramangalam Medical College, Salem, IND
| | | | - Sumaina Thummala
- Internal Medicine, Karpaga Vinayaga Institute of Medical Sciences and Research Center, Maduranthakam, IND
| | - Harsh Pandya
- General Surgery, Shardaben General Hospital, Ahmedabad, IND
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van Dam-Nolen DH, Truijman MT, van der Kolk AG, Liem MI, Schreuder FH, Boersma E, Daemen MJ, Mess WH, van Oostenbrugge RJ, van der Steen AF, Bos D, Koudstaal PJ, Nederkoorn PJ, Hendrikse J, van der Lugt A, Kooi ME. Carotid Plaque Characteristics Predict Recurrent Ischemic Stroke and TIA. JACC Cardiovasc Imaging 2022; 15:1715-1726. [DOI: 10.1016/j.jcmg.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/18/2022] [Accepted: 04/01/2022] [Indexed: 01/01/2023]
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Saba L, Antignani PL, Gupta A, Cau R, Paraskevas KI, Poredos P, Wasserman B, Kamel H, Avgerinos ED, Salgado R, Caobelli F, Aluigi L, Savastano L, Brown M, Hatsukami T, Hussein E, Suri JS, Mansilha A, Wintermark M, Staub D, Montequin JF, Rodriguez RTT, Balu N, Pitha J, Kooi ME, Lal BK, Spence JD, Lanzino G, Marcus HS, Mancini M, Chaturvedi S, Blinc A. International Union of Angiology (IUA) consensus paper on imaging strategies in atherosclerotic carotid artery imaging: From basic strategies to advanced approaches. Atherosclerosis 2022; 354:23-40. [DOI: 10.1016/j.atherosclerosis.2022.06.1014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 12/24/2022]
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