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Wall motion in the stenotic carotid artery: association with greyscale plaque characteristics, the degree of stenosis and cerebrovascular symptoms.

Kanber B, Hartshorne TC, Horsfield MA, Naylor AR, Robinson TG, Ramnarine KV - Cardiovasc Ultrasound (2013)

Bottom Line: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment.The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%).Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW UK. kumar.ramnarine@uhl-tr.nhs.uk.

ABSTRACT

Background: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment. The purpose of this study was to quantify wall motion in stenotic carotid arteries and investigate any associations with the ultrasound greyscale plaque characteristics, the degree of stenosis, and the presence of cerebrovascular symptoms.

Methods: Variations in the lumen diameters of 61 stenotic carotid arteries (stenosis range 10%-95%) from 47 patients were measured before the proximal shoulder of the atherosclerotic plaque using ultrasound image sequences over several cardiac cycles. Absolute and percentage diameter changes from diastole to systole were calculated and their relationship to the degree of stenosis, greyscale plaque characteristics, and the presence of ipsilateral hemispheric symptoms were studied.

Results: The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%). Absolute and percentage diameter changes did not have a statistically significant relationship to the degree of stenosis, greyscale plaque characteristics, or the presence of ipsilateral hemispheric symptoms (p > 0.05). Parameters significantly correlated with the presence of symptoms were the degree of stenosis (p = 0.01), plaque greyscale median (p = 0.02) and the plaque surface irregularity index (p = 0.02).

Conclusions: Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

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Related in: MedlinePlus

A carotid bifurcation plaque and illustration of the location of the diameter measurements. In this case, the plaque appears on the carotid bulb, and diameter measurements are taken in the distal common carotid artery immediately before the proximal shoulder of the plaque.
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Figure 2: A carotid bifurcation plaque and illustration of the location of the diameter measurements. In this case, the plaque appears on the carotid bulb, and diameter measurements are taken in the distal common carotid artery immediately before the proximal shoulder of the plaque.

Mentions: Arterial diameter variation waveforms (Figure 1) were obtained before the proximal shoulder of the plaque, but as close to it as possible, and averaged over a region approximately 3 mm long for each image frame (Figure 2). The measurements were made without prior knowledge of the patient’s symptomatic status. The peaks of the diameter variation waveforms (Figure 1) were taken to be the (peak) systolic values and the troughs as the (end) diastolic. The absolute value of the systolic arterial dilation was calculated as the increase in the arterial lumen diameter from diastole to systole and percentage systolic dilation as the same figure divided by the diastolic diameter. The same calculations were carried out for all the cardiac cycles observed on the arterial diameter variation waveforms and averages were taken. Normalized and un-normalized plaque GSM and surface irregularity indices (SII) were obtained using previously described methods [8,10] while the degree of stenosis of the corresponding arteries were measured using criteria consistent with the NASCET method utilizing blood flow velocities in conjunction with the B-Mode and colour flow imaging [30-32].


Wall motion in the stenotic carotid artery: association with greyscale plaque characteristics, the degree of stenosis and cerebrovascular symptoms.

Kanber B, Hartshorne TC, Horsfield MA, Naylor AR, Robinson TG, Ramnarine KV - Cardiovasc Ultrasound (2013)

A carotid bifurcation plaque and illustration of the location of the diameter measurements. In this case, the plaque appears on the carotid bulb, and diameter measurements are taken in the distal common carotid artery immediately before the proximal shoulder of the plaque.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3818684&req=5

Figure 2: A carotid bifurcation plaque and illustration of the location of the diameter measurements. In this case, the plaque appears on the carotid bulb, and diameter measurements are taken in the distal common carotid artery immediately before the proximal shoulder of the plaque.
Mentions: Arterial diameter variation waveforms (Figure 1) were obtained before the proximal shoulder of the plaque, but as close to it as possible, and averaged over a region approximately 3 mm long for each image frame (Figure 2). The measurements were made without prior knowledge of the patient’s symptomatic status. The peaks of the diameter variation waveforms (Figure 1) were taken to be the (peak) systolic values and the troughs as the (end) diastolic. The absolute value of the systolic arterial dilation was calculated as the increase in the arterial lumen diameter from diastole to systole and percentage systolic dilation as the same figure divided by the diastolic diameter. The same calculations were carried out for all the cardiac cycles observed on the arterial diameter variation waveforms and averages were taken. Normalized and un-normalized plaque GSM and surface irregularity indices (SII) were obtained using previously described methods [8,10] while the degree of stenosis of the corresponding arteries were measured using criteria consistent with the NASCET method utilizing blood flow velocities in conjunction with the B-Mode and colour flow imaging [30-32].

Bottom Line: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment.The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%).Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW UK. kumar.ramnarine@uhl-tr.nhs.uk.

ABSTRACT

Background: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment. The purpose of this study was to quantify wall motion in stenotic carotid arteries and investigate any associations with the ultrasound greyscale plaque characteristics, the degree of stenosis, and the presence of cerebrovascular symptoms.

Methods: Variations in the lumen diameters of 61 stenotic carotid arteries (stenosis range 10%-95%) from 47 patients were measured before the proximal shoulder of the atherosclerotic plaque using ultrasound image sequences over several cardiac cycles. Absolute and percentage diameter changes from diastole to systole were calculated and their relationship to the degree of stenosis, greyscale plaque characteristics, and the presence of ipsilateral hemispheric symptoms were studied.

Results: The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%). Absolute and percentage diameter changes did not have a statistically significant relationship to the degree of stenosis, greyscale plaque characteristics, or the presence of ipsilateral hemispheric symptoms (p > 0.05). Parameters significantly correlated with the presence of symptoms were the degree of stenosis (p = 0.01), plaque greyscale median (p = 0.02) and the plaque surface irregularity index (p = 0.02).

Conclusions: Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

Show MeSH
Related in: MedlinePlus