External ultrasound for carotid atherosclerotic plaque treatment
Yan Zhang1, Honglin Dong1, Yuming Xu1
1Departments of Ultrasound (Y.Z.), Neurology (Y.X.), and Radiology (J.Gao), First Affiliated Hospital of Zhengzhou University Zhengzhou, China; Department of Vascular Surgery, Second Hospital of Shanxi Medical University, Taiyuan, China (H.D.); Feist-Weiller Cancer Center, Louisiana State University School of Medicine, Shreveport, Louisiana USA (R.S.); Department of Neurology, First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China (J.Gu, H.L.); and Department of Vascular Surgery, Louisiana State University Health Science Center, Shreveport, Louisiana USA (W.W.Z.).
Objectives:
The purpose of this study was to evaluate the efficacy of external ultrasound in the treatment of carotid atherosclerotic plaques.
Methods:
In the prospective study, 357 patients with 363 carotid atherosclerotic plaques were divided into an ultrasound treatment group and a control group. For 30 days, conventional medical treatment was conducted on 54 plaques in the control group, whereas irradiation therapy in addition to conventional medical treatment was conducted on 309 plaques in the ultrasound group. Carotid sonography was conducted before and after treatment, and the maximum plaque thickness and area were measured in a longitudinal section.
Results:
No patients withdrew from the treatment because of related side effects. After treatment, the maximum thickness and area of 79.94% of the plaques in the ultrasound group were reduced, whereas in the control group, the thickness and area of 18.52% were reduced. The mean changes in plaque thickness and area ± SD in the ultrasound and control groups were 0.22 ± 0.19 mm (7.61% ± 5.67%) versus 0.02 ± 0.05 mm (0.74% ± 1.64%) and 0.047 ± 0.039 cm(2) (13.28% ± 9.8%) versus 0.0044 ± 0.0102 cm(2) (1.1% ± 2.46%), respectively. Changes in both plaque thickness and area in the ultrasound group were significantly greater than those in the control group (P< .0001). Furthermore, the plaque echo type was another prognostic factor affecting efficacy (P < .05).
Conclusions:
External ultrasound treatment is safe and effective for carotid atherosclerotic plaques and is worthy of further research and applications. The efficacy in anechoic/hypoechoic plaques is significantly higher than that in mixed echoic and calcified echoic plaques.
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