Evaluating the Carotid Plaque: Going beyond Stenosis
Evaluating the Carotid Plaque: Going beyond Stenosis
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DOI：
10.1159/000200438
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发表时间：
2009-01-01
影响因子：
2.9
通讯作者：
Chalela, J. A.
中科院分区：
文献类型：
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作者：
Chalela, J. A.
背景：颈动脉疾病是缺血性脑卒中的重要病因。传统上，颈动脉疾病的治疗努力旨在识别有症状患者的颈动脉狭窄和治疗高度狭窄。新的研究表明，在有症状或无症状的患者中识别易损斑块可能是预防缺血性事件的更合理的方法。方法：回顾不同影像学方法及生物化学标志物鉴别颈动脉易损斑块的相关文献。讨论了这些工具的潜在应用。结果：颈动脉超声、计算机断层扫描和磁共振血管造影可以帮助识别与所谓易损斑块相关的斑块特征。颈动脉超声是研究最广泛的方式，也是最容易执行和解释的。同时测定与动脉粥样硬化、炎症和血栓形成相关的血清生化指标，可能有助于识别易损的颈动脉斑块。结论：研究颈动脉斑块的多模式方法似乎是识别易损颈动脉斑块的一个有前途的工具。目前的文献表明，除了狭窄程度外，其他影像学和生化检查也具有重要的临床意义。版权所有(C) 2009 S. Karger AG，巴塞尔
Background: Carotid disease is an important cause of ischemic stroke. Traditionally, therapeutic efforts in carotid disease have been aimed at identifying carotid stenosis in symptomatic patients and treating high-grade stenosis. New research suggests that identifying the vulnerable plaque in symptomatic or asymptomatic patients may be a more rational approach for the prevention of ischemic events. Methods: The author reviews some key references on identification of the vulnerable carotid plaque using different imaging modalities and using biochemical markers. The potential applications of such tools are discussed. Results: Carotid ultrasound, computed tomography, and magnetic resonance angiography can help identify plaque features associated with the so-called vulnerable plaque. Carotid ultrasound is the most widely studied modality and the easiest to perform and interpret. Concomitant measurement of serum biochemical markers associated with atherosclerosis, inflammation, and thrombosis may help identify the vulnerable carotid plaque. Conclusions: A multimodal approach to studying the carotid plaque appears to be a promising tool in identifying vulnerable carotid plaques. The current literature suggests that in addition to the degree of stenosis other imaging and biochemical findings have important clinical significance. Copyright (C) 2009 S. Karger AG, Basel