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Symptomatic Nonstenotic Carotids: A Topical Review.
Stroke
December 2024
Department of Neurology and Stroke Program, University of Maryland, Baltimore (S.C.).
Article Synopsis
- The management of carotid artery disease has predominantly relied on the degree of stenosis, but new research indicates that features like intraplaque hemorrhage can provide better diagnostic and treatment insights.
- Current guidelines often overlook less than 50% stenosis cases, which can lead to misdiagnosis and inadequate treatments for potential stroke causes, leaving many patients untreated.
- There is a push to reclassify certain strokes as symptomatic nonstenotic carotid disease when high-risk plaque features are present, and this review discusses historical practices, modern biomarkers of plaque vulnerability, imaging tools, and recent studies on this emerging classification.
The Prepetrous Segment of the Internal Carotid Artery as a Neglected Site of Symptomatic Atherosclerosis: A Single-Center Series.
J Clin Med
March 2024
Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
(1) Non-stenotic complicated plaques are a neglected cause of stroke, in particular in young patients. Atherosclerosis has some preferential sites in extracranial arteries and the prepetrous segment of the internal carotid artery has been rarely described as site of atheroma in general and of complicated atheroma in stroke patients. The aim of this study is to describe the rate of the prepetrous internal carotid artery's (ICA) involvement in a single-center case series of young stroke patients.
View Article and Find Full Text PDFVulnerable plaque of the petrous internal carotid artery in embolic stroke of undetermined source.
Eur J Neurol
March 2023
Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China.
Background And Purpose: The association between nonstenotic plaque at the petrous internal carotid artery (ICA) and embolic stroke of undetermined source (ESUS) remains unknown. We aimed to test the hypothesis that the presence of a larger build-up of petrous plaque is more prevalent in the ipsilateral versus the contralateral side among ESUS patients without plaque in the intracranial and proximal ICA.
Methods: From a total of 243 patients with ESUS and 160 patients with small-vessel disease (SVD) without proximal ICA plaque, we enrolled 88 ESUS and 103 SVD patients without ipsilateral nonstenotic intracranial and proximal ICA plaque in the present study.
Tic Movement of Thyroid Cartilage as a Cause for Localized Cerebral Embolism: Mimics of Embolic Stroke of Undetermined Source with Non-Stenotic Carotid Plaque.
J Stroke Cerebrovasc Dis
November 2020
Department of Neurology, Akita University Graduate School of Medicine, Japan.
Several studies have suggested that non-stenotic carotid plaque was a risk factor for embolic stroke of undetermined source in some patients. However, individual backgrounds of these patients is unclear. We encountered a 64-years-old female with cerebral emboli, from an apparently stable non-stenotic carotid plaque (only 1.
View Article and Find Full Text PDFIntegrated cardiovascular assessment of atherosclerosis using PET/MRI.
Br J Radiol
September 2020
Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom.
Atherosclerosis is a systemic inflammatory disease typified by the development of lipid-rich atheroma (plaques), the rupture of which are a major cause of myocardial infarction and stroke. Anatomical evaluation of the plaque considering only the degree of luminal stenosis overlooks features associated with vulnerable plaques, such as high-risk morphological features or pathophysiology, and hence risks missing vulnerable or ruptured non-stenotic plaques. Consequently, there has been interest in identifying these markers of vulnerability using either MRI for morphology, or positron emission tomography (PET) for physiological processes involved in atherogenesis.
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