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Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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Updated: Apr 30, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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Identifying the high-risk carotid plaque.

A R Naylor1

  • 1Vascular Surgery Group Division of Cardiovascular Sciences Leicester Royal Infirmary, Leicester, UK - ross.naylor@uhl-tr.nhs.uk.

The Journal of Cardiovascular Surgery
|May 7, 2014
PubMed
Summary

Most patients treated for carotid artery disease do not benefit from surgery or stenting. Identifying high-risk stroke plaques using imaging and biomarkers is crucial for targeted, effective interventions.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Biomarkers

Background:

  • Randomized trials indicate most symptomatic and asymptomatic patients receiving medical treatment were unlikely to experience a stroke.
  • A significant proportion of carotid interventions, including surgery and stenting, are deemed unnecessary even with zero procedural risk.

Purpose of the Study:

  • To review the rationale for identifying patients with high-risk carotid plaques who would benefit from invasive therapies.
  • To explore the use of contemporary imaging and serum biomarkers for detecting unstable carotid plaques.

Main Methods:

  • Review of existing literature on carotid artery disease management and stroke risk stratification.
  • Discussion of pathophysiological mechanisms of unstable carotid plaques.
  • Evaluation of current imaging modalities and serum biomarkers for plaque assessment.

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Main Results:

  • The majority of patients undergoing medical treatment in trials did not progress to stroke.
  • A substantial percentage of carotid surgical procedures, particularly for asymptomatic disease, are unnecessary.
  • Current methods often fail to accurately select patients who will benefit from interventions.

Conclusions:

  • There is a critical need to identify patients with high-risk carotid plaques to optimize the use of invasive therapies.
  • Contemporary imaging and serum biomarkers hold promise for identifying unstable plaques and guiding treatment decisions.
  • Targeting interventions based on plaque risk stratification could improve patient outcomes and reduce unnecessary procedures.