Plaque contact surface area and lumen volume predict stroke risk in extracranial carotid artery stenosis.

Carotid Artery, Internal Carotid Stenosis / complications Constriction, Pathologic Endarterectomy, Carotid Humans Plaque, Atherosclerotic Stroke / etiology
3D modeling Carotid artery stenosis Contact surface area Flow dynamics Lumen volume NASCET Stroke Vascular surgery

Journal

Journal of vascular surgery
ISSN: 1097-6809
Titre abrégé: J Vasc Surg
Pays: United States
ID NLM: 8407742

Informations de publication

Date de publication:
08 2022
Historique:
received: 02 10 2021
accepted: 11 03 2022
pubmed: 31 3 2022
medline: 27 7 2022
entrez: 30 3 2022
Statut: ppublish

Résumé

The standard indication for intervention in asymptomatic disease is currently percent stenosis in the internal carotid artery as measured by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method, which remains limited in discriminating power. Computed tomography angiography (CTA) is widely used to calculate NASCET stenosis, but also offers the opportunity to analyze carotid artery plaques from a morphological perspective that has not been widely used. We aim to improve stroke risk stratification of patients with carotid artery stenosis using plaque three-dimensional (3D) modeling and image analysis. Patients with computed tomography angiographies appropriate for 3D reconstruction were identified from a National Institutes of Health-designated stroke center database, and carotid arteries were segmented and analyzed using software algorithms to calculate contact surface area (CSA) between the plaque and blood flow, and volume of the flow lumen within the region of the plaque (lumen volume [LV]). These novel parameters factor in the 3D morphometry inherent to each carotid plaque and were compared between stroke and nonstroke groups. A total of 134 carotid arteries were analyzed, 33 of which were associated with an ipsilateral stroke. Plaques associated with stroke demonstrated statistically significant increases in average CSA (541.52 mm The data presented here demonstrate morphological features of carotid plaques that are independent of NASCET criteria stratification and may present an improved method in assessing stroke risk in patients with carotid artery stenosis.

Sections du résumé

BACKGROUND
The standard indication for intervention in asymptomatic disease is currently percent stenosis in the internal carotid artery as measured by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method, which remains limited in discriminating power. Computed tomography angiography (CTA) is widely used to calculate NASCET stenosis, but also offers the opportunity to analyze carotid artery plaques from a morphological perspective that has not been widely used. We aim to improve stroke risk stratification of patients with carotid artery stenosis using plaque three-dimensional (3D) modeling and image analysis.
METHODS
Patients with computed tomography angiographies appropriate for 3D reconstruction were identified from a National Institutes of Health-designated stroke center database, and carotid arteries were segmented and analyzed using software algorithms to calculate contact surface area (CSA) between the plaque and blood flow, and volume of the flow lumen within the region of the plaque (lumen volume [LV]). These novel parameters factor in the 3D morphometry inherent to each carotid plaque and were compared between stroke and nonstroke groups.
RESULTS
A total of 134 carotid arteries were analyzed, 33 of which were associated with an ipsilateral stroke. Plaques associated with stroke demonstrated statistically significant increases in average CSA (541.52 mm
CONCLUSIONS
The data presented here demonstrate morphological features of carotid plaques that are independent of NASCET criteria stratification and may present an improved method in assessing stroke risk in patients with carotid artery stenosis.

Identifiants

DOI: 10.1016/j.jvs.2022.03.008 PMID: 35351605
pubmed: 35351605
pii: S0741-5214(22)00448-7
doi: 10.1016/j.jvs.2022.03.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

482-488

Informations de copyright

Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Ryan Gedney (R)

Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC. Electronic address: gedneyj@musc.edu.

Ethan Kung (E)

Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC; Department of Mechanical Engineering, Clemson University, Clemson, SC; Department of Bioengineering, Clemson University, Clemson, SC.

Veena Mehta (V)

Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC.

Adam Brown (A)

Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC.

Matthew Bridges (M)

Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC.

Ravi Veeraswamy (R)

Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC; Department of Mechanical Engineering, Clemson University, Clemson, SC.

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Classifications MeSH

questionsmedicales.fr › Système cardiovasculaire › Vaisseaux sanguins › Artères › Artères carotides › Artère carotide commune › Artère carotide interne › Plaque contact surface area and lumen volume...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Artériopathies carotidiennes › Sténose carotidienne › Plaque contact surface area and lumen volume...
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Sténose pathologique › Plaque contact surface area and lumen volume...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie cardiovasculaire › Procédures de chirurgie vasculaire › Endartériectomie › Endartériectomie carotidienne › Plaque contact surface area and lumen volume...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Plaque contact surface area and lumen volume...
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Plaque d'athérosclérose › Plaque contact surface area and lumen volume...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Plaque contact surface area and lumen volume...