Prediction of carotid artery in-stent restenosis by quantitative assessment of vulnerable plaque using computed tomography - 03/02/16
, Naoyuki Uchiyama a, Masanao Mohri a, Yutaka Hayashi a, Fumiaki Ueda b, Mitsutoshi Nakada aBienvenue sur EM-consulte, la référence des professionnels de santé.
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Summary |
Background and purpose |
To assess the relationship between plaque volume evaluated by multidetector computed tomographic angiography (MDCT) and in-stent restenosis (ISR) after carotid artery stenting (CAS).
Materials and methods |
From a retrospectively maintained database, data were collected for 52patients with carotid artery stenosis treated with CAS between 2007 and 2012. We defined ISR of≥50% as a peak systolic velocity≥200cm/s on echo-duplex scan. Carotid plaques were subdivided into four components according to radiodensity in Hounsfield units (HU) as follows: <0, 0–60, 60–130, and>600HU. Risk factors that influenced ISR were compared using univariate and multivariate Cox regression analyses.
Results |
During a median follow-up period of 36months, ISR of≥50% was detected in five patients (9.6%). In the univariate Cox proportional hazard regression analysis, renal insufficiency, coronary artery disease, total plaque volume, and plaque volumes with radiodensities<0 and≥600HU increased the risk for ISR (P<0.10). When the significant risk factors determined from the univariate analysis were subjected to a multivariate analysis, only the volumes of the plaque components with radiodensities<0 HU independently predicted the development of ISR (hazard ratio: 1.041; 95% confidence interval: 1.006–1.078; P=0.021).
Conclusion |
Our data suggest that the high volume of the plaque components with radiodensities<0HU was independently associated with the increased risk of ISR after CAS. Quantitative and qualitative tissue characterizations of carotid plaques using MDCT might be a useful predictive tool of the development of ISR.
Le texte complet de cet article est disponible en PDF.Keywords : Carotid plaque, Carotid artery stenting, In-stent restenosis, Multidetector computed tomography
Abbreviations : CAS, CEA, CI, HU, ISR, MDCT, PSV, ROI
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Vol 43 - N° 1
P. 18-24 - février 2016 Retour au numéro
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