Differentiating Carotid Free-Floating Thrombus From Atheromatous Plaque Using Intraluminal Filling Defect Length on CTA: A Validation Study.

Aged Aged, 80 and over Carotid Artery Diseases / diagnostic imaging Computed Tomography Angiography / methods Female Humans Ischemic Attack, Transient / diagnostic imaging Ischemic Stroke / diagnostic imaging Male Middle Aged Plaque, Atherosclerotic / diagnostic imaging Prospective Studies Sensitivity and Specificity Thrombosis / diagnostic imaging

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
24 08 2021
Historique:
received: 30 12 2020
accepted: 26 05 2021
entrez: 24 8 2021
pubmed: 25 8 2021
medline: 4 9 2021
Statut: ppublish

Résumé

To validate a previously proposed filling defect length threshold of >3.8 mm on CT angiography (CTA) to discriminate between free-floating thrombus (FFT) and plaque of atheroma. This was a prospective multicenter observational study of 100 participants presenting with TIA/stroke symptoms and a carotid intraluminal filling defect on initial CTA. Follow-up CTA was obtained within 1 week and at weeks 2 and 4 if the intraluminal filling defect was unchanged in length. Resolution or decreased length was diagnostic of FFT, whereas its static appearance after 4 weeks was indicative of plaque. Diagnostic accuracy of FFT length was assessed by receiver operating characteristic analysis. Ninety-five participants (mean [SD] age 68 [13] years, 61 men, 83 participants with FFT, 12 participants with a plaque) were evaluated. The >3.8-mm threshold had a sensitivity of 88% (73 of 83) (95% confidence interval [CI] 78%-94%) and specificity of 83% (10 of 12) (95% CI 51%-97%) (area under the curve 0.91, CTA enables accurate differentiation of FFT vs plaque using craniocaudal length thresholds. ClinicalTrials.gov Identifier: NCT02405845. This study provides Class I evidence that in patients with TIA/stroke symptoms, the presence of CTA-identified filling defects of lengths >3.8 mm accurately discriminates FFT from atheromatous plaque.

Identifiants

DOI: 10.1212/WNL.0000000000012368 PMID: 34426550
pubmed: 34426550
pii: WNL.0000000000012368
doi: 10.1212/WNL.0000000000012368
doi:

Banques de données

ClinicalTrials.gov
['NCT02405845']

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e785-e793

Informations de copyright

© 2021 American Academy of Neurology.

Auteurs

Carlos Torres (C)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada. catorres@toh.ca.
ORCID: 0000-0003-4104-7115

Cheemun Lum (C)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.

Paulo Puac-Polanco (P)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0003-2510-7608

Grant Stotts (G)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0001-8226-4883

Michel Christopher Frank Shamy (MCF)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0002-0085-6816

Dylan Blacquiere (D)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0002-8421-2646

Ronda Lun (R)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0001-8455-8201

Prasham Dave (P)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0003-4478-4858

Aditya Bharatha (A)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0002-7923-7865

Bijoy K Menon (BK)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0002-3466-496X

Rebecca Thornhill (R)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0001-5308-5106

Franco Momoli (F)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0002-6234-3178

Dar Dowlatshahi (D)

From the Division of Neuroradiology (C.T., P.P.-P.), Department of Radiology, Division of Neurology (G.S., M.C.F.S., D.B., R.L., P.D., D.D.), Department of Medicine, Division of Medical Physics (R.T.), Department of Radiology, and School of Epidemiology and Public Health (F.M.), University of Ottawa; Neuroscience Program (C.T., G.S., M.C.F.S., D.B., D.D.), The Ottawa Hospital Research Institute; Division of Neuroradiology (A.B.), Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Ontario; and Departments of Clinical Neurosciences, Radiology, and Community Health Sciences (B.K.M.), University of Calgary, Foothills Medical Centre, Alberta, Canada.
ORCID: 0000-0003-1379-3612

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Artériopathies carotidiennes › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Tomographie à rayons X › Tomodensitométrie › Angiographie par tomodensitométrie › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Encéphalopathie ischémique › Accident ischémique transitoire › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Accident vasculaire cérébral ischémique › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Plaque d'athérosclérose › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Sensibilité et spécificité › Differentiating Carotid Free-Floating Thrombus...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thrombose › Differentiating Carotid Free-Floating Thrombus...