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Open AccessArticle

Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study

1
Department of Surgery, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA
2
Department of Radiology, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA
3
Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, China Haidian District, Beijing 100084, China
*
Author to whom correspondence should be addressed.
On behalf of the CARE-II Study Collaborators.
Diagnostics 2019, 9(4), 137; https://doi.org/10.3390/diagnostics9040137
Received: 10 September 2019 / Revised: 29 September 2019 / Accepted: 30 September 2019 / Published: 2 October 2019
(This article belongs to the Special Issue Atherosclerosis and Vascular Imaging)
Correct stratification of ischemic stroke risk allows for the proper treatment of carotid atherosclerotic disease. We seek to differentiate plaque types based on stenosis level and plaque morphology. The Chinese Atherosclerosis Risk Evaluation (CARE–II) study is a cross-sectional, observational, multicenter study to assess carotid atherosclerotic plaques in symptomatic subjects using vessel wall magnetic resonance imaging. Plaque morphology and presence of plaque components were reviewed using multi-contrast magnetic resonance imaging. The carotid arteries were divided into four groups based on stenosis level and plaque components. Out of 1072 ischemic stroke subjects, 452 ipsilateral side carotid arteries were included. Significant stenosis (SS) (≥50% stenosis) with high-risk plaque (HRP) features was present in 37 arteries (8.2%), SS(+)/HRP(−) in 29 arteries (6.4%), SS(−)/HRP(+) in 57 arteries (12.6%), and SS(−)/HRP(−) in 329 arteries (72.8%). The prevalence of SS(−)/HRP(+) arteries in this cohort was substantial and had greater wall thickness than the SS(+)/HRP(−) group. These arteries may be misclassified for carotid revascularization by current guidelines based on the degree of luminal stenosis only. These findings have implications for further studies to assess stroke risk using vessel wall imaging. View Full-Text
Keywords: vessel wall magnetic resonance imaging; carotid atherosclerotic plaque; high-risk plaque; carotid stenosis vessel wall magnetic resonance imaging; carotid atherosclerotic plaque; high-risk plaque; carotid stenosis
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Watase, H.; Canton, G.; Sun, J.; Zhao, X.; Hatsukami, T.S.; Yuan, C. Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study. Diagnostics 2019, 9, 137.

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