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Gray-Scale Median in Patients with Symptomatic and Asymptomatic Carotid Atherosclerosis-Risk Factors and Diagnostic

Adam Płoński1, Dariusz Pawlak2, Adam F Płoński1

  • 1Department of Vascular Surgery and Transplantation, Medical University of Bialystok, 15-276 Bialystok, Poland.

Biomedicines
|July 27, 2024
PubMed

Insights

Gray-scale median (GSM) values differ significantly between symptomatic and asymptomatic internal carotid artery (ICA) stenosis patients. GSM can help differentiate between symptomatic and asymptomatic ICA stenosis, aiding clinical decisions.

Area of Science:

  • Vascular Medicine
  • Medical Imaging
  • Carotid Artery Disease

Background:

  • Internal carotid artery (ICA) stenosis poses a significant risk for stroke.
  • Differentiating symptomatic from asymptomatic stenosis is crucial for treatment decisions.
  • Gray-scale median (GSM) is an imaging parameter potentially useful in this differentiation.

Purpose of the Study:

  • To identify clinical factors influencing GSM in ICA stenosis.
  • To determine the diagnostic utility of GSM in distinguishing symptomatic from asymptomatic ICA stenosis.

Main Methods:

  • Analysis of 45 asymptomatic and 40 symptomatic ICA stenosis patients undergoing carotid endarterectomy (CEA).
  • Computerized echolucency analysis for GSM assessment.
  • Comparison of clinical risk factors, comorbidities, and pharmacotherapy between groups.

Main Results:

  • Symptomatic patients had significantly lower mean GSM values (p < 0.001).
  • GSM correlated with D-dimers, glucose, and certain medications (beta-blockers, metformin, sulfonylureas, statins) depending on symptom status.
  • Grade 3 hypertension and statin therapy were independent predictors of GSM in asymptomatic patients.
  • ROC analysis showed GSM sensitivity of 73% and specificity of 80% for differentiating stenosis types.

Conclusions:

  • Clinical factors affecting GSM differ between symptomatic and asymptomatic ICA stenosis.
  • GSM demonstrates potential as a valuable tool for differentiating symptomatic from asymptomatic ICA stenosis.
Abstract

Keywords:
asymptomatic carotid artery stenosiscarotid endarterectomycarotid plaquegray-scale medianrisk factorssymptomatic carotid artery stenosis

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