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Index
ABAQUS, 326
Abdominal aortic calcific deposits (AAC), 22
Abdominal obesity
atherosclerosis, 437
Acetazolamide
CBV, 387
infarcts, 407
OEF, 387
SPECT, 408
stroke, 409
Acetylsalicylic acid (ASA) and Carotid Endarterectomy
(ACE), 90
Activated clotting time (ACT), 100
Activated platelets, 48
Active targeting, 218
Activity-based costing (ABC), 171
Acute coronary syndromes (ACS), 227
IVUS, 455
Adenosine diphosphate (ADP), 46, 48, 52
postoperative embolisation, 53
Adherent platelets, 46
ADINA, 325, 327, 330
Adventitial neovessels
carotid endarterectomy, 292
Agatson score
coronary calcification, 197
Age
adjusted incidence rate of stroke, 39
CE, 66
dependence
carotid IMT, 27
Air embolisation, 352
Akaike Information Criterion, 280
Albunex, 216
Allele of matrix metalloproteinase 3 tA/6A promoter
polymorphism
IMT, 436
Amaurosis fugax
cerebral ischemia, 78
499
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American Heart Association (AHA)
atheromatous plaque, 42
carotid endarterectomy guidelines, 76
classification, 302, 336, 487
vs. histopathological plaque classification, 337
histological atherosclerotic classification, 181
progression, 302
Amlodipine
CAD, 457
Amplatz wire, 100
Amyloid A
serum
atherosclerosis, 437
Aneurysms
with DSA, 130
giant intracranial, 397
Angiogenesis in plaque progression, 8
molecular contrast agents, 290
Angiography
atherosclerosis imaging modalities, 451
conventional, 142
with 2D phase contrast, 145
experience
with DSA complications, 131
Angioplasty, 75, 91, 97, 98
complication rates, 96
cost, 96
Angioseal, 100
Angiotensin 1 converting enzyme
IMT, 436
Angiotensinogen
IMT, 436
Annexin-A5, 258
Anterior cerebral artery (ACA), 349, 363
Antihypertensive therapy
arterial wall thickness, 314
IMT, 438
Antioxidants
dietary, 65
Antiplatelet agents, 46
Antithrombotic Trialists Collaboration (ATC), 46
Aorta
MRI, 478
Aortic arch
atherosclerosis, 261
Aortic atheroma
MRA, 45999mTc-MDA2
gamma camera images, 257
Aortic atherosclerotic plaques
regression, 467
Aortic ulcer, 18
Aortic vessel wall area, 466
Apolipoprotein E
IMT, 35
Apoptosis
imaging, 257–8
plaques, 423
Arachidonic acid, 53
Arterial blood pressure (ABP), 377
Arterial carbon dioxide, 351
Arterial input function (AIF), 364, 366, 367
Arterial spin labeling (ASL), 360, 361, 363
carotid artery disease, 359–63
MRI, 362
selective, 362
Arterial wall
IVUS, 452
Arteriosclerosis Risk in Communities (ARIC), 26, 27, 435,
437
IMT, 439
Arteriotomy
carotid endarterectomy, 81
Arteriovenous malformations
with DSA, 130
Artifact
blooming, 490
Aspirin, 53, 61
balloon catheter, 403
carotid stenosis, 59, 60, 62
carotid stenting, 100
dipyridamole, 60
Asymptomatic carotid artery stenosis
prognosis, 127
Asymptomatic Carotid Atherosclerosis Study (ACAS), 2,
86, 87, 90
angiographic stenosis, 112
asymptomatic, 174
carotid endarterectomy vs. medical
therapy, 169
carotid surgery, 88
cost-effectiveness, 167
derived Doppler criteria
ICA stenosis, 118
ICA stenosis criteria, 110–2
selection, 87
stroke, 87
surgery, 94, 166
500 Index
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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Asymptomatic carotid plaque
USPIO, 278
Asymptomatic carotid stenosis
carotid bruits, 90
hypertension, 90
screening, 90–1
stroke, 90
surgery, 86–92
surgery vs. angioplasty, 90–1
Asymptomatic Carotid Surgery Trial (ACST), 87, 90
carotid surgery, 88
endarterectomy
asymptomatic carotid stenosis, 272
ICA stenosis criteria, 111
ischemic stroke, 89
perioperative death, 88
stroke, 95
asymptomatic patients, 95
Asymptomatic Carotid Surgery Trial II (ACSTII), 95
Asymptomatic disease
carotid stenosis
carotid endarterectomy, 88
economic analyses, 167
histograms, 281
imaging, 168
surgery, 91–2
evidence, 87–90
Asymptomatic stenosis
Doppler
ICA, 118
Atheroma
aortic99mTc-MDA2, 257
arterial remodelling, 273
carotid
USPIO-enhanced MRI, 272–84
carotid aortic, 267
imaging, 266
IVUS, 422
IVUS pullbacks, 454
natural history, 452
thin cap, 1, 15
Atheromatous plaque, 1
Atherosclerosis, 106, 185, 302
advanced
assessment, 211–18
aortic arch, 261
biomarkers, 464
cardiorespiratory fitness, 437
carotid artery
SPECT, 259
carotid plaque
carotid bifurcation, 204
histological specimen, 236
MDCT, 197, 199, 200
dietary fiber, 437
early
ultrasound, 210–1
familial cardiovascular disease, 25
imaging modalities, 451–2
increasing extent, 302
metabolic syndrome, 437
molecular contrast agents, 290
natural history, 205
passive smoking, 437
pathology, 1–2
pharmacological intervention, 205
progression, 186
pulmonary artery
lipid accumulation, 303
serum amyloid A, 437
statins, 248
subclinical, 22–3
thrombus, 263
vessel wall remodeling, 205
Atherosclerotic lesions
composition vs. size, 485
scintigraphic images, 266
Atherosclerotic plaque
aortic
regression, 467
bone formation, 11
calcification, 11
carotid artery
vs. coronary arteries, 198
classification, 4
high risk, 302
images, 492
imaging, 257–8
IPH, 310
IVUS, 454
mechanical analysis
3D structure-only papers, 326
MRI, 288, 306, 479
multiple contrast imaging, 182
nuclear imaging, 251–2
PET, 251, 252
progression and disruption, 306
Index 501
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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Atherosclerotic plaque (cont.)
SPECT, 251, 252
symptomatic carotid disease, 14
vasa vasorum microvessels, 217
Atherosclerotic plaques
gadolinium, 299
Atorvastatin, 457, 467
stroke, 63
TIA, 63
Atrial fibrillation
carotid stenosis, 62
DWI, 62
Automated algorithm, 240
Automated plaque analysis
CASCADE, 247
Automated pullbacks, 224
Balloon catheter
aspirin, 403
intravenous heparin, 403
Balloon test occlusion (BTO), 396, 400, 402, 410, 411
carotid sacrifice, 399
CBF, 412
complications, 403
exam, 398
heparinized saline, 403
responses, 399
Bernard-Soulier syndrome, 50
Biomarkers, 424
atherosclerosis, 464
clinical trials, 464
definition, 464
Black blood, 181
imaging, 485, 486
MRI
proximal carotid arteries, 315
sequence, 486, 489
T1-weighted, 183
T2-weighted, 183
Blood oxygen level-dependent (BOLD)
MRI, 410
Blood pressure
arterial, 377
brachial diastolic, 105
brachial systolic, 105
carotid endarterectomy, 82
elevated
stroke, 14
hyperperfusion syndrome, 392
plaque, 457
systolic
stroke, 64
Blooming artifact, 490
Blooming effect, 275
B-mode ultrasound, 430
baseline batch reading, 433
centralized sonography suites, 433
coronary artery disease, 432
IMT, 430
multiple sites, 431
operator dependence, 442
plaque volume, 442
reader drift, 433
reader variability, 433
reliability, 433
risk factors, 432
sonographer characteristics, 433
ultrasound equipment
variability, 433
Bolus tracking, 364
Bone
TCD monitoring, 348
Bone artifacts
CTA, 159
Boston filter devices
stenosis, 102
Boston Scientific EPI-A carotid stenting trial (BEACH), 97
Boston Scientific filter wire, 96
Boundary detection, 237–41
Brachiocephalic trunk, 127
Brain imaging
asymptomatic infarction, 62
Bright blood, 181
TOF, 183
British Government
stroke reduction, 86
British National Service Framework for Stroke, 86
B-spline snakes, 237, 239–41
CABERNET, 96
Calcification
abdominal aortic, 22
artery walls, 163
artifacts
CTA, 159
atherosclerotic plaque, 11
atherosclerotic plaque stability, 325
coronary vs. carotid arteries, 10
502 Index
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gadolinium, 292
MDCT, 196
mean value, 180
plaque content, 183
wall, 184
Calcific nodule
luminal thrombus, 12
Calcified nodule, 2
Calcium
mobilisation in platelets, 52
Calcium score
CT, 236
Candidate genes, 39, 52, 431
Canny edge map, 243
Cap erosion, 5, 335
Cap rupture, 5
Cap thickness
stress distributions, 332
Carbon dioxide
reactivity, 409
Cardiac-gating
black blood sequences, 486
Cardiorespiratory fitness
atherosclerosis, 437
Cardiovascular disease
familial
subclinical atherosclerosis, 25
Cardiovascular disease (CVD), 52
family history, 36
prediction, 26–8
Cardiovascular Health Study (CHS), 24, 27, 435
carotid IMT, 27
Cardiovascular risk factors, 24
Carotid and Vertebral Artery Transluminal Angioplasty
Study (CAVATAS), 91, 97–9
extracranial cerebrovascular disease, 97
Carotid aortic atheroma, 267
Carotid arteries. See also proximal carotid arteries
angioplasty
asymptomatic carotid stenosis, 90
CABG, 91
evidence, 95–9
perioperative risk, 79
symptomatic carotid disease, 73
trials, 73, 76
atherosclerosis, 22–30
nuclear imaging, 251–68
pathology, 1–18
plaque morphology, 3–4
SPECT, 259
total occlusion relative to coronary circulation, 6
atherosclerotic plaque, 192
vs. coronary arteries, 198
MDCT, 195
bifurcation, 185
CFD models, 317
3D ultrasound, 317
MRI, 475
sagittal CT image, 204
bilateral examination, 105
CT
calcification, 197
Doppler spectrum, 213
duplex scanning, 116–23
asymptomatic disease
surveillance, 116
extracranial segments
B-mode ultrasound, 432
histology/IVUS, 198
intravital microscopy, 49
MDCT image, 192
molecular MRI, 474
MRA, 140–53, 291
MRI, 238, 423, 477
occlusion
symptomatic
acetazolamide,, 387–93
percent stenosis, 10
phenotype heritability, 437
physical examination, 23
pixel-level kinetic modeling, 358
plaque
B-mode ultrasound, 214
contrast agents, 217
disruption, 7
four-dimensional (4D) ultrasonography, 216
high-resolution B-mode scanning, 214
MRI, 235
multi-contrast MRI, 473
quiescence, 472
surface motion, 216
ultrasound, 214
puncture, 127
registration algorithm, 242
stenting, 122
thresholds, 122
wall
B-mode ultrasound, 211
Index 503
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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Carotid arteries atheroma
rosuvastatin, 468
Carotid artery disease. See also Subclinical carotid artery
CBF, 359
CBV, 359
collateral flow, 362
CT, 359
DSC-MRI, 359
MR and CT perfusion
techniques, 359
MR bolus tracking, 359
MRI, 359
OEF, 359
perfusion MRI, 359
PET, 359
risk factors, 392
SPECT, 359
TCD, 350
Carotid artery plaque
genetic factors, 455
Carotid artery stenosis, 24
asymptomatic
prognosis, 127
CTA, 158–64
diagnostic accuracy, 163
new developments, 163–4
post-processing techniques, 159–61
DSA vs. CTA or MRA, 162
DUS, MRA
diagnostic accuracy, 162, 163
DUS, MRA CTA
diagnostic accuracy, 162–3
endovascular treatment
Cochrane systemic review, 97
measurements, 162
MRA, 158, 162
prediction, 203
surgery
ECST, 166
ultrasound, 212–13
Carotid atheroma
USPIO-enhanced MRI, 272–84
Carotid atherosclerosis, 7–10
diffusion modeling, 296
dynamic contrast enhanced-MRI, 294
familial aggregation and heritability, 218, 437
fibrous cap, 9
genetics, 35–43, 433
genome-wide linkage scans, 78
magnetic resonance imaging, 147
MRI, 464
platelets
gamma camera, 265
risk factors, 25
Carotid Atherosclerosis Progression Study, 27
Carotid atherosclerotic plaque
classification, 182
morphology, 191
MRI, 474
risk-stratify, 474
Carotid bruits
atherosclerosis markers, 23
Carotid clamping
TCD, 352
Carotid disease. See also Symptomatic carotid disease
B-mode flow imaging, 210
B-mode scanning, 208
color Doppler flow imaging, 209
contrast harmonic imaging, 210
conventional digital subtraction angiography,
126–35
CT, 358–67
CT perfusions imaging, 366–7
CW Doppler, 208, 211
Doppler sonography, 208, 212
DSA
indications and techniques, 126–8
3D ultrasound, 210
duplex sonography, 209
DUS
indications and techniques, 127
gender, 308
interventional management, 94–103
molecular imaging, 218–19
MR, 358–67
occlusive, 6
PDI, 209
plaque perfusion analysis, 217–18
PW Doppler, 208
real-time compound imaging, 209
recurrent, 17
risk, 28–9
stroke, 64
surgery, 94–5
ultrasound, 208–19
imaging techniques, 208–10
unstable
FDG-PET, 260
504 Index
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
http://www.cambridge.org/0521862264http://www.cambridge.orghttp://www.cambridge.org
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Carotid dissection
cerebral hemodynamics, 410–1
Carotid Doppler ultrasound, 105–23
technical points, 105–6
Carotid duplex ultrasound
examination, 105
Carotid endarterectomy (CE), 45, 117, 377, 396
age, 66
AHA guidelines, 76
anatomic, 117
ICA duplex scans, 117
intraoperative completion angiography, 117
angioplasty
cost, 96
arteriotomy closure, 82
asymptomatic carotid stenosis, 90, 307
blood pressure, 82
blood pressure lowering, 65
CABG, 91
carotid angioplasty, 76
CBF, 358
cerebral hyperfusion, 389–93
DUS, 134
early recurrences, 117
ECIC Bypass, 83
EEG, 80
gadolinium, 292
hemostasis, 80
heparin, 80
high-risk, 76
histological analysis, 67
hyperfusion, 390
ICA, 392
ICA stenosis, 358
internal carotid artery, 80
intraoperative monitoring, 82
IPH, 307
ipsilateral ischemic stroke, 75, 87
MDCT, 194
vs. medical therapy
ACAS, 169
ECST, 169
mental status, 376
near infrared spectroscopy, 372–83
NIRS, 376, 377
extracranial contamination, 373–4
instrumentation, 374
method, 379–80
principles, 373
results, 380
tissue oxygen saturation, 374
outcomes, 173
perioperative risk, 79
plaque, 81
pravastatin, 64
restenosis, 16
selection, 214
spatially resolved spectroscopy, 374
SPECT, 390
symptomatic carotid disease, 72–83
symptomatic stenosis, 86
TCD, 351–3
technique, 79–83
thromboembolic stroke, 53
TIA, 75, 87, 158
trials, 73, 76
USPIO, 275
USPIO-enhanced MRI, 478
Xenon CT, 411
Carotid imaging
cost-effectiveness, 166–76
decision analysis models, 167–71
CTA, 169
decision tree, 169
DSA, 169
DUS, 169
MRA, 169
protocol, 465
Carotid intima media thickness, 24, 27
age-dependence, 27
distribution and prevalence, 24–6
predicting CHD and stroke, 26
progression, 29
risk factors, 29
stenosis, 25
stroke and myocardial infarction risk, 27
Carotid intraplaque hemorrhage, 10
Carotid lesions
matrix metalloproteinase
SPECT, 264
Carotid magnetic resonance direct thrombus imaging,
302–10
Carotid occlusion
hemodynamic physiology, 412
infarcts, 407
stroke, 407
symptomatic
future, 412
Index 505
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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Carotid occlusion (cont.)
ischemic stroke, 72
Carotid occlusion surgery study (COSS), 78, 404
Carotid plaque
asymptomatic
USPIO, 278
atherosclerosis
carotid bifurcation, 204
histological specimen, 236
MDCT, 197, 199, 200
calcification, 472
calcification and bone formation, 12
cerebral ischemic symptoms, 309
6-channel coil, 491
clinical duplex imaging, 105
contrast-enhanced MRA, 492
3D MRI, 328
fibrous
aging, 15
diabetes, 15
instability, 1
ipsilateral TIA or stroke, 187
magnetic resonance imaging, 79
morphology, 1
B-mode imaging, 214
high flow, 4–6
ultrasound, 214–15
MR
imaging technique, 180–1
surface coil, 180–1
MRI, 237, 327, 466
composition, 183
protocol, 237
rupture
incidence, 3
surgically excised, 3
Carotid pseudoaneurysm, 101
Carotid restenosis, 117
Carotid revascularization
preoperative evaluation, 78–9
Carotid Revascularization Endarterectomy Versus Stent
Trial (CREST), 74, 76, 91, 98, 365
Carotid sacrifice
stroke after, 399–403
Carotid stenosis. See also Asymptomatic carotid stenosis;
Carotid artery stenosis
anticoagulants, 61–2
antiplatelet agents, 59–61
aspirin, 59, 60, 62
aspirin and dipyridamole, 60
asymptomatic disease
carotid endarterectomy, 88
atrial fibrillation, 62
blood pressure lowering drugs, 64–5
B-mode imaging with PW Doppler sonography,
212
carotid endarterectomy, 59
CE MRA, 151
cholesterol lowering, 63–4
color Doppler flow pattern, 213
dietary modification, 65
distribution and prevalence, 24–6
Doppler, 106
Doppler diagnosis, 106
Doppler frequency spectrum, 212
with DSA complications, 130
2D TOF, 151
3D TOF, 151
3D ultrasound
volumetric potential, 213
echo contrast studies, 216–17
endarterectomy
clinical subgroups, 81
selection, 66–9
extracranial
Doppler ultrasound, 327
grading, 110
interpretative criteria, 105
intima-media thickness, 65–6
lifestyle modification, 65
measurement
ECST, 132
measurement systems, 131–2
medical treatment, 59–69
risk groups, 67–9
prevalent cardiovascular disease, 26
recurrent, 117–8
residual vessel lumen, 212
spectral broadening, 109
stenting, 59
symptomatic
ischemic stroke, 72
ultrasound, 151
visualization, 217
Carotid stenting, 45, 91, 97, 98
anesthesia, 101
aspirin, 100
cerebral protection, 101–2
506 Index
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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death rates, 102
DWI, 102
ECG, 101
indications, 99–100
premedication, 101
TCD, 101, 102
technique, 100
training, 102–3
UK, 103
trial, 97
Carotid surgery
clinical neuromonitoring, 376–7
Carotid territory ischaemic strokes, 87
ACAS, 89
risk reduction, 89
Carotid vessel wall area, 466
Cartesian coordinate, 315
CD62P, 48, 50
knockout mice, 50
Cell-based model
haemostasis, 46
Cerebellar hypoperfusion
SPECT, 390
Cerebral angiography
carotid interventions, 397
evolution, 127
Cerebral artery
blood velocity, 376
MRI, 192
PI, 345
Cerebral blood flow (CBF), 78, 350, 360, 387, 396
BTO, 398
carotid artery disease, 359
carotid endarterectomy, 358
ICA stenosis, 365, 375
ipsilateral changes, 388
ipsilateral side, 398
maintaining, 404
MCA, 367
measurement, 393
OEF, 408
preoperative assessment, 389
Cerebral blood volume (CBV), 410
acetazolamide, 387
autoregulatory dilation, 409
carotid artery disease, 359
Cerebral ischemia, 1
angiography, 78
PET, 78
symptoms, 78–9
TIA, 78
Cerebral metabolic rate (CMR)
and oxygen, 405
tools and quadrant segmentation, 280
Cerebral oximetry
bilateral, 377
Cerebral oxygenation, 380
NIRS, 372
Cerebral oxygen saturation, 376
Cerebral perfusion pressure (CPP), 78, 411
cerebrovascular response, 404
decreasing, 404
Cerebral physiology in occlusion, 398–9
Cerebral revascularization
prospective randomized trials, 74–7
Cerebral vasculature
carotid BTO, 411
Cerebral vasodilatory response (CVR)
acetazolamide, 405
symptomatic occlusion, 406
Cerebral vasospasms
subarachnoid haemorrhage, 353
TCD, 354
Cerebrovascular events
atherothrombotic emboli, 45
Chandler loop, 48
Changes TOI (deltaTOI), 380, 382
Chemotactic protein-1 (MCP-1), 252
Childhood risk factors
IMT, 436
Chinese
necrotic cores, 14
Chlamydia pneumoniae
IMT, 436
Cholesterol, 303
ischemic stroke, 63
treatment guidelines, 28
Cholesterol Lowering Atherosclerosis Study (CLAS), 421,
438
Circle of Willis, 403
collateral flow, 406
MIP, 362
TCD, 349
Circulating monocytes, 252
Circulation
collateral, 409
Clinical endpoint
definition, 464
Index 507
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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Clopidogrel, 53, 61
carotid stenosis, 60
stroke, 61
Clopidogrel and Aspirin for Reduction of Emboli in
Symptomatic Carotid Stenosis (CARESS), 53, 61
Clopidogrel in Acute Stroke and TIA (CASTIA), 61
Clopidogrel Versus Aspirin in Patients at Risk of Ischemic
Events (CAPRIE), 52, 60
Closed head injury
TCD, 354
Clot
removal, 48, 49
structure, 51
Cochrane systemic review
carotid artery stenosis endovascular treatment, 97
Code of Federal Regulations, 425
Collateral circulation, 409
Color flow imaging, 107
Color flow sonography, 109
Combination strategies, 153
Committee for Medicinal Products for Human Use
(CHMP), 424–5
Common carotid artery (CCA), 105, 107, 127, 185
B-mode scan, 215
carotid stenosis, 131
centerline velocities, 319
ICA
EDV, 122
IMT, 28, 35
blood pressure and weight, 28
shear stress, 28
NIRS, 377
PSV, 111, 122
scan, 318
schematic representation, 432
stenosis, 122
wave form findings, 106–7
Common carotid method, 131
Comparison of Amlodipine vs. Enalapril to Limit
Occurrences of Thrombosis (CAMELOT), 457
Compositional indices, 236, 245–8
Computational fluid dynamics (CFD)
based haemodynamic studies of superficial arteries
MRI, 317
haemodynamics, 313
modeling, 326
Computational plaque vulnerability index, 324
Computed tomographic angiography (CTA)
high-resolution contrast enhanced, 121
Computed tomography (CT)
micro, 304
vs. MR, 459
Computed tomography angiography (CTA), 126, 152
accuracy, 128
bone masking, 163
carotid artery stenosis, 158
carotid imaging, 176
carotid luminal stenosis, 191
confirmatory, 168
vs. 2-D DSA, 128
vs. DUS, 134, 159
improving, 163
ionizing radiation, 159
vs. MRA, 159
multislice, 166
safety, 166
symptomatic carotid disease, 79
ulcers, 134
Computed tomography perfusion (CTP), 366
vs. DSC-MRI, 367
Computer-Aided System for Cardiovascular Disease
Evaluation (CASCADE), 235, 248, 327
automated plaque analysis, 247
Computer network security, 425
Confirmatory computerised tomography angiography,
168
Confirmatory digital subtraction angiography, 168
Confirmatory magnetic resonance angiography, 168
Continuous arterial spin labeling (CASL), 361
Contour methodology, 237
Contrast agents
brain tissue, 365
diffusion, 298
exchange
two-compartment model, 295
future, 492
novel, 149–50
Contrast-enhanced imaging pulse sequences, 489–90
Contrast enhanced magnetic resonance angiography
(CE MRA), 145, 174
advantages, 145
blood-pool agent, 149
dynamic, 148–9
fibrous cap, 185
increasing signals, 149
novel contrast agents, 149
phase encode ordering, 147–8
rapid 1D monitoring sequence, 147
508 Index
© Cambridge University Press www.cambridge.org
Cambridge University Press978-0-521-86226-4 - Carotid Disease: The Role of Imaging in Diagnosis and ManagementJonathan Gillard, Martin Graves, Thomas Hatsukami and Chun YuanIndexMore information
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retrospective method, 147
screening DUS, 166
technique, 146
3D, 146, 148
MIP, 150
timing, 147
triggering methods, 147
Contrast enhanced MRI (CE MRI), 289, 292, 293, 299
delayed, 293
Contrast-enhanced T1W (CE-T1W) magnetic resonance
imaging (MRI), 237
Conventional angiography, 142
Cordis filter devices
stenosis, 102
Coronal phase contrast survey, 362
Coronary angiography
quantitative, 420–2, 424, 426
widespread, 421
Coronary arteries
donor
IVUS, 453
histology/IVUS, 198
IVUS, 227, 452
palpography, 227
Coronary artery bypass graft (CABG), 116
asymptomatic carotid disease, 91
Coronary artery disease (CAD), 147
amlodipine, 457
B-mode ultrasound, 431
molecular imaging, 471–9
angiogenesis, 475–6
endothelial dysfunction, 474–5
Coronary atherosclerosis, 7–10
B-mode ultrasound, 204
IVUS
natural history, 223
Coronary atherosclerotic plaque
morphology, 191
Coronary heart disease (CHD), 422
calcification, 204
risk,
stroke, 63
TIA, 63
Cost, 170
calculation, 170
mean, 171
Cost-effectiveness, 167–71
ACAS, 167
DSA, 167, 173
ECST, 173, 175, 176
imaging protocols, 173
incremental ratio, 171
MRA, 173
screening, 167
stenting, 176
symptomatic patients, 171–4
Coupled fluid/wall interactions modelling, 318
Cox regression analysis, 187
C-reactive protein (CRP), 15, 25, 456
atherosclerosis, 437
IMT, 436
Critical sites, 336
Critical site selection method and computational plaque
vulnerability index (CPVI), 336
finite element model, 335–6
Crohn’s disease
genetic risk factors, 431
CURE, 52
Curved planar reconstructions (CPR), 159
Cyclooxygenase-1 (COX-1), 46
Cytochrome oxidase, 373
Dark spot
light, 282–4
Data management system, 425
2-D digital subtraction angiography (DSA)
vs. MRA, 128
Death
CABG, 91
carotid endarterectomy, 87
perioperative
ACST, 88
carotid endarterectomy, 87
Decision analysis modelling, 167
Decision trees, 168
DeltaFV, 380
Delta LDF, 380
DeltaTOI, 380, 382
Dense SNP map, 433
Deoxyglucose, 258
DESPOT1, 490
DESPOT2, 490
Dextran, 353
Diabetes mellitus, 147
IMT, 438
Dietary antioxidants, 65
Dietary fiber
atherosclerosis, 437
Index 509
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Dietary modification
carotid stenosis, 65
Dietary saturated fat intake
IMT, 436
Diffusion-based (DIFF) flow suppression pre-pulses, 490
Diffusion modeling, 298
vessel lumen, 297
Diffusion weighted imaging (DWI), 487
magnetic resonance
carotid stenting, 102
necrotic core, 487
Diffusion weighted magnetic resonance imaging
asymptomatic infarction, 62
Digital subtraction angiography (DSA), 126
accuracy, 167, 174
complications, 128–31
cause, 130
confirmatory, 168
conventional, 129
cost-effectiveness, 167, 173
current trends and controversies, 134
disparate results, 173
vs. DUS, 135
gold standard, 166
intravenous
replacing intra-arterial DSA, 127
limitations, 128
vs. MRA, 128, 140, 153
vs. MRI, 134
non-circular stenotic lumens, 128
risks, 167
rotational
ICA stenosis, 128
silent embolic events, 130
stenosis, 79, 158
symptomatic carotid disease, 79
with ultrasound and MRA, 152
Dimethylarginine
IMT, 436
Dipyridamole
aspirin, 60
Disability
stroke, 86
improvement, 98
Discounting, 171
Discount rates, 171
Distal embolic protection (DEP), 74, 75
carotid occlusive disease, 76
Distal internal carotid artery, 106
DNA
phenotype, 336, 487
polymorphic characterization, 337
polymorphisms, 35
Doppler angle, 109, 121
Doppler-derived velocity waveforms, 105
Doppler effect, 208
CW Doppler system, 208
Doppler sample volume, 107
Doppler shift, 342
Doppler signal, 349
Doppler spectral signal, 349
Doppler ultrasound (DUS), 317
accuracy, 175
carotid artery stenosis, 158
carotid endarterectomy, 134
carotid stenosis, 75
vs. CTA, 134, 159
diagnostic accuracy, 174
vs. DSA, 135, 174
historical development, 430
vs. MRA, 134, 175
safety, 166
screening, 168
confirmatory DSA, 175
with confirmatory DUS, MRA, or CTA, 134
confirmatory MRA, 135
sensitivity, 152
stenosis, 79
symptomatic carotid disease, 79
TOF MRA with DSA, 173
Doppler waveforms, 105, 107
Double inversion recovery (DIR), 290, 291, 485
FSE, 486
inversion packet, 485
Double inversions with proximal labeling of both tag and
control images (DIPLOMA), 360
Driven equilibrium single pulse observation in three
dimensions (DESPOD), 489
Drug development, 426
contrast-enhanced MRI, 299
Dual frequency methods, 347
Duplex criteria
carotid artery stenosis, 110
Duplex-derived waveforms
spectral analysis
ICA stenosis, 110
Duplex devices
phantom model, 149
510 Index
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Duplex velocity criteria
OHSU
ICA stenosis, 111
Dynamic contrast enhanced magnetic resonance
angiography, 148–9
Dynamic contrast-enhanced magnetic resonance
imaging, 289, 293–5
plaque imaging, 297
Dynamic susceptibility contrast magnetic resonant
imaging (DSC-MRI), 364
ASL, 366
deconvolution method, 365
PET, 366
post-processing, 366
spatial resolution, 365
temporal resolution, 365
Early atherosclerosis
ultrasound, 210–1
Echocardiography (ECG)
carotid thromboembolism, 62
with short TR gradient echoes, 142
Echo planar imaging (EPI), 316
Echoplanar imaging and signal targetting with alternating
RF (EPISTAR), 360
Echo time (TE), 142
long, 141
Electroencephalography (EEG)
carotid clamping, 344
carotid endarterectomy, 79, 80
carotid interventions, 396
CBF, 411
intraoperative monitoring, 82
Electromagnetic position and orientation measurement
(EPOM), 315
Elevated blood pressure
stroke, 14
Elliptic centric, 148
Embolisation
haemostatic factors, 48, 49
particulate, 352
risk, 52
Embolism
flow reversal techniques, 102
formation, 46, 50–2
clinical studies, 152
in vitro models and animal studies, 48–50
haematological formation, 45–53
symptomatic carotid disease, 455
Endarterectomy. See also Carotid endarterectomy (CE)
ACST
asymptomatic carotid stenosis, 272
benefits, 69
ECST, 66, 76
vs. stents, 74, 76, 91, 98
stroke, 2
symptomatic vs. asymptomatic, 305
Endarterectomy Versus Angioplasty in Patients with
Severe Symptomatic Carotid Stenosis (EVA), 98
3S Investigators, 91, 102, 153
End-diastolic velocity (EDV), 108, 116
CCA, 106
stenosis, 107
Endoplasmic reticular (ER) stress, 252
Endovascular treatment
evolution, 99
End point
myocardial infarction, 75
stroke, 75
End point studies, 424
EP-1242, 476
Epanechnikov kernel for density estimation, 239
Eph kinases, 50
Ephrins, 50
EP-2104R, 476
Erasmus Rucphen Family (ERF), 46
E selectin
IMT, 436
MRI, 475
ESTABLISH, 457
ETC-216, 455
Ethnic groups, 52
IMT, 436
European Carotid Surgery Trial (ECST), 60, 74
angiographic ulceration on DSA, 133
carotid artery stenosis surgery, 166
carotid endarterectomy
vs. medical therapy, 169
subtotal ICA stenosis, 217
carotid stenosis measurement, 132
carotid surgery, 94
time, 95
cost-effectiveness, 173, 175, 176
DSA, 126
endarterectomy, 66, 76
final results, 126
ICA measurement, 131
ICA stenosis criteria, 111
Index 511
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European Carotid Surgery Trial (ECST) (cont.)
luminal stenosis, 272
reliability, 67
secondary prevention, 94
stroke, 87
medical treatment, 67
stroke risk, 191
European Carotid Trialists Collaborative Group, 87
European Medicines Agency (EMEA), 424–6
European Stroke Prevention Study 2 (ESPS-2), 60
Everolimus
heart transplant, 458
intimal thickness, 458
IVUS, 458
Exercise
IMT, 439
External carotid artery (ECA), 80, 105, 381
centerline velocities, 319
dissection, 80
pressure conditions, 330
schematic representation, 432
sequential clamping, 378
stenosis, 122
scan, 318
External elastic membrane (EEM), 452
Extracellular matrix, 477
Extracranial carotid artery segments
B-mode ultrasound, 432
Extracranial carotid stenosis
Doppler ultrasound, 327
Extracranial-intracranial bypass (ECIC), 72, 73, 77–8, 397,
399, 412
carotid endarterectomy, 83
CBF, 412
cerebral hemodynamic reserve, 412
perioperative risk, 79
summary, 78
symptomatic carotid disease, 72–83
symptomatic internal carotic artery occlusion, 72
Extracranial vascular disease
TCD, 350
Extravascular extracellular space (EES), 295
Factor VII (FVIIa), 46
Factor XIII (FXIII), 48
Factor XIIIa (FXIIIa), 48
Familial Atherosclerosis Treatment Study (FATS), 15
Familial cardiovascular disease
subclinical atherosclerosis, 25
Familial predisposition, 25
Fast Assessment of Stroke and Transient
Ischemic Attack to Prevent Early Recurrency
(FASTER), 61
Fast Fourier transform, 347, 419
Fast-spin-echo (FSE)/rapid acquisition, 485
Fatty plaque, 1
Fatty streak, 1, 471
mature atherosclerotic plaque, 471
FE model, 325
Femoral artery
stents, 100
Ferumoxtran-10, 274
Fibrin
fibres, 48
imaging, 263–6
plaque, 266
Fibrinogen, 48, 51
embolisation risk, 51
plasma, 51
stabilising role, 51
Fibrinogen gamma-chain (QADVG), 51
Fibrinolysis, 48, 49
Fibroatheroma, 2
Fibronectin, 51, 476
Fibrous cap, 9, 183, 272, 458
asymptomatic plaque
vs. symptomatic plaque, 277
B-mode scan, 215
disruption, 236
erosions, 215
gadolinium enhanced plaque imaging, 293
MRI, 184, 187, 309
TIA vs. stroke, 187
vulnerable atheroma, 272
Fibrous caps
ruptured, 474
Fibrous connective tissue, 183
Fibrous-rich plaque
density values, 200
Fibrous-rich regions
MDCT, 199
Fibrous tissue
mean value, 180
Filter device
embolus, 99
Finite element mesh
fluid domain, 329
solid domain, 329
512 Index
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Finite element method
computational prediction clinical validation, 336
3D fluid-only MRI-based models, 326
3D structure-only plaque models, 326
mechanical image analysis, 324–38
trends, 336
Finite element model
3D CFD models with fluid-structure interactions, 326–7
higher pressure and stenosis severity, 331
material parameters, 333
modeling assumptions, 332
MRI-based multicomponent models with FSI, 327–35
plaque samples, 332–5
plaque structure, lipid core cap thickness, cap erosion,
333–5
solid and fluid, 329–30
stress behaviors, 333
in vivo MRI images, 330
5A/6A polymorphisms, 430
MMP3 promoter, 430
FLAIR axial images, 308
Flow conditions
MRI, 313
Flow sensitive alternating inversion recovery (FAIR), 360
ITS, 361
Flow shear rates, 50
Flow simulations, 317
Flow velocity (FV), 108, 377
changes, 380
ICA, 382
Fluid structure interaction (FSI), 314
flow, 331
plaque mechanical analysis, 324
stress/strain, 331
Fluorine-18 labelled deoxyglucose positron emission
tomography (FDG-PET), 258, 423
atherosclerosis, 259, 260
plaque macrophages, 258
Fluvastatin (Lescol), 419
Foam cell generation
imaging, 253–7
Food and Drug Administration (FDA), 424
atherosclerosis markers, 431
IMT
B-mode ultrasound
clinical trials, 438
Fourier transform (FT), 142
Framingham Heart Study, 26, 29
carotid bruit incidence, 23
C-reactive protein, 25
offspring cohort, 25
risk factors, 24
stroke, 86
Framingham Offspring cohort, 76, 408, 433
Free MS-325, 149
French Study of Aortic Plaques in Stroke Group, 17
Frequency modulation, 347
Future technical developments, 484–93
FVIIa, 46
FXIII, 48
FXIIIa, 48
Gadobenate dimeglumine, 149
Gadofluorine, 289, 477, 490
atherosclerotic plaque, 477
Gadolinium (Gd)
atherosclerotic plaques, 299
atoms per nanoparticle, 289
atoms per particle, 290
based agents, 288–9
imaging techniques, 290–1
USPIO, 290
based enzyme pseudosubstrate, 492
calcification, 292
chelates, 475
delayed plaque enhancement, 290–3
enhanced plaque imaging, 288–300
adventitial vasa vasorum, 291
diffusion modeling, 296–7
histology vs. MRI, 292
image processing, 294–5
imaging techniques, 293–4
kinetic modeling, 295–6
carotid atherosclerosis, 296
molecular imaging agents, 289–90
plaque composition, 293
plaque enhancement, 293–7
tissue specific characteristics, 291–3
MRI, 291, 475
Gadolinium (Gd)-DTPA, 288, 289, 474
phospholipids, 479
standard, 146
Gadolinium (Gd)-DTPA-BMA, 288
Gadolinium (Gd)-DTPA-DMPE, 480
Gaussian function, 243
Gender
vascular biology, 308
Index 513
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Genetic factors, 35
carotid artery plaque, 455
IMT, 37
obesity, 37
Genetic polymorphisms
IMT, 431
Genetic studies
population, 26
Genetic variants
IMT, 35
Giant intracranial aneurysms, 397
Glanzmann’s thrombasthenia, 50
Global maximum Stress-P1, 338
Glucose intolerance
carotid IMT, 25
Glutathione peroxidase-1 (GPx-1), 432, 436
Glycoprotein (GP)
Ib alpha receptor, 46
IIb-III, 50
IIIa receptor, 334
lb-IIIa antagonists, 52
lb-IX-V, 50
Gradient ascent
estimated probability density function, 239
Gradient coils, 491
Gradient echo acquisition for superparamagnetic particles
with positive contrast (GRASP), 282
sequence, 283
Granulomatous plaque
hypertension, 15
GRAPPA, 148, 486
Gray-scale images, 105, 107
GRE spiral, 276
Haemorrhage
plaque, 306
Haemostasis, 46
Haeomdynamic forces
atherosclerosis, 313
Healed plaque ruptures, 11
Health economic modelling, 183
Health Technology Assessment, 176
Heart Protection Study (HPS), 63
Heart transplant
everolimus, 458
Hemorrhage, 8
MRI, 186
subarachnoid
with DSA, 130
Hemostasis
carotid endarterectomy, 80
Heparin
carotid endarterectomy, 80
intravenous
balloon catheter, 403
Hexamethyl propylene amine oxime (HMPAO)
carotid artery disease, 359
single photon computed tomography, 402, 403
High density lipoprotein (HDL)
IVUS, 455
plaque, 455
High density lipoprotein-cholesterol (HDL-C), 421
High pressure
stress distributions, 332
High-resolution contrast enhanced computed tomo-
graphic angiography, 121
Histology, 309
Histopathological plaque vulnerability index (HPVI), 336,
338
HMG-CoA reductase, 422
Homocysteine
carotid stenosis, 25
IMT, 436
Hormone replacement
IMT, 438
Hounsfield units (HU), 192
Human atheroma imaging, 266
Human immunodeficiency virus infection
atherosclerosis, 437
Hydrogen peroxide, 492
Hypercarbia, 399
Hypercholesterolemia
plaque rupture, 7
Hyperfibrinogenemia
carotid thrombosis predictor, 8
Hyperfusion
CT, 390
MRI, 390
Hyperfusion syndromes, 390
Hyperlipidemia
left vertebral ischemic events, 67
Hyperperfusion syndrome
blood pressure, 392
Hypertension
OSI, 320
pulmonary, 303
stroke, 17
TAWSS, 320
514 Index
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Hyperventilation, 351
Hypoechoic plaque, 439
Hypoxia, 399123I-IMP single photon computed tomography, 388, 409
Image acquisition, 425
Image analysis, 425
Image-based computational models, 313
atherosclerotic plaques, 325–7
Image post-processing, 235–48
Image quality (ImQ), 465
Imaging
asymptomatic, 174–5
standardised protocols, 318
Incremental cost effectiveness ratio (ICER), 171
Indirect immunofluorescence confirmed TRF1, 266
Inflammation
atherosclerosis progression, 303
Inflammatory atheroma burden
quantitative assessment, 282
Inflammatory disease
IMT, 436
Inflammatory process
vulnerable plaque, 272
Infrared (IR)
D-FLASH, 489
turboFLASH, 489111In-labeled tracer, 267
Innominate artery stenosis, 201
In-plane resolution, 309
Insulin sensitivity
IMT, 436
Intensive care unit
carotid endarterectomy, 82
Intensive Carotid Artery Stenosis Treatment Trial, 176
Intercellular adhesion molecule (ICAM), 304
IMT, 436
Interleukin 6 (IL-6 ) polymorphism, 66
Internal carotid artery (ICA), 169, 330, 381, 397
angiographic stenosis, 182
atherosclerotic carotid plaque
3D volume, 210
atherosclerotic stenosis, 185
B-mode scan, 215
carotid endarterectomy, 392
CBF, 366
changes TOI, 380
clamping, 376
coils and kinks, 197
contralateral to high-grade stenosis, 199
distal, 106
Doppler-derived flow velocities, 200
DSA, 133
EDV, 202
fibrous cap, 276
follow-up duplex imaging, 349
1623, 80
carotid endarterectomy, 80
stenosis, 14
IMT, 35
ipsilateral, 117
IVUS, 229
kinds and coils, 236
turbulence, 238
labeling, 362
MDCT, 193
MRA, 229
NIRS, 377
non-operated, 246
occlusion, 247
CBF ipsilateral, 366
Doppler, 257
ultrasound, 259
pressure conditions, 330
proximal plaque, 262
PSV, 111, 264
EDV, 441
scan, 318
schematic representation, 432
sequential clamping, 378
severity, 277
stenosis, 131
angiography, 97
tortuosity, 279
TURBO-TILT, 361
vulnerable plaque, 276
Internal carotid artery (ICA)/common carotid artery
(CCA) peak systolic velocity (PSV) ratio, 116
Internal carotid artery (ICA)/common carotid artery
(CCA) ratio, 115
Internal carotid artery (ICA) stenosis, 116, 292, 294, 358,
389
ACAS criteria, 110–2
asymptomatic patient
angiogram, 298
bilateral, 298
carotid endarterectomy, 158, 358
CBF, 365, 375
Index 515
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Internal carotid artery (ICA) stenosis (cont.)
consensus committee criteria, 318
Doppler measurements, 319, 320, 328
inaccuracies, 329
DSA, 160
ECIC bypass, 403
flow territory, 363
hyperfusion syndrome, 391
ICA/CCA, 113
ICA/CCA PSV, 334
ICA EDV, 113
ICA PSV, 113, 336–8
MIP, 160
power Doppler, 209
PSV ratio, 113
SPECT, 391
stratifying, 361
Internal carotid intima media thickness, 28
apolipoprotein B, 28
prevalent cardiovascular disease, 26
Internal jugular vein, 80
International Carotid Surgery and Stenting Carotid Study
(ICSS), 91, 98
International Symposium on Endovascular Therapy,
379
Intima media thickness (IMT), 24, 27, 35, 292, 424, 426.
See also Carotid intima media thickness
age-dependence, 27
biologic validity, 442
B-mode ultrasound, 406, 426, 431, 432
arterial dimensions, 452
clinical trials, 453
evaluation, 454
histology, 466
interadventitial diameter, 467
normative values, 468
predictor, 473
reproducibility, 475
validity, 477
cardiovascular risk factors, 478
clinical events, 480
common carotid artery, 28
blood pressure and weight, 28
shear stress, 28
coronary artery disease, 437
diabetes mellitus, 438
dietary saturated fat intake, 436
dimethylarginine, 436
distribution and prevalence, 24–6
heritable risk factors, 436
internal carotid, 28
apolipoprotein B, 28
CAD, 440
prevalent cardiovascular disease, 26
IVUS, 422
magnetic resonance imaging, 28
Mannheim consensus statement, 211
mean, 434
MRI, 242
near wall, 433
pharmaceutical interventions, 430–42
predicting CHD and stroke, 26
progression, 29, 437–8
risk factors, 29
quantification
variability, 78
risk factors, 421
stable measure, 441
stenosis, 25
stroke
ARIC, 439
stroke and myocardial infarction risk, 27
surrogate outcome, 441
symptomatic coronary artery disease, 439
symptomatic vascular disease, 439
ultrasound, 28, 211
methodology, 39
Intracellular adhesion molecule-1 (ICAM-1), 334
receptors, 475
Intra-class correlation coefficients (ICC), 183
Intra-coronary thrombus, 476
Intracranial vascular disease
TCD, 353–4
Intraluminal shunt
general anesthesia, 376
ischaemia prevention, 376
Intraplaque hemorrhage (IPH), 10, 183, 304
atheromatous plaque, 303
carotid, 10, 308
carotid endarterectomy, 214
disease progression, 307
fibrous cap, 304
gender, 308
increased risk, 305
initial presentation, 308
vs. juxtaluminal hemorrhage, 185–6
localization, 309
LRNC, 186
516 Index
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mean value, 180
MRI, 307, 308
neovessels, 304
noninvasive identification, 310
plaque inflammation, 305
plaque pathophysiology, 306
repetitive, 306
sensitivity, 307
symptoms, 307, 310
vessel density, 305
Intravascular thrombus, 306
Intravascular ultrasound (IVUS), 223–9, 422
acute coronary syndrome, 455
aggressive lipid lowering, 456
angiography
limitations, 224
applications, 228
arterial wall remodeling, 454
atheroma, 422
atherosclerosis imaging modalities, 452
atherosclerotic plaque, 454
automated pullback system, 422
blood pressure
plaque, 457
clinical, 223
coronary plaque characterization, 225
coronary remodeling, 228
future directions, 228
history, 223
lessons, 453–5
lipid lowering
atherosclerotic plaque, 455–6
mechanical catheters, 224
natural history, 455
pharmaceutical interventions,
plaque composition, 458–9
plaque regression, 456
progression-regression, 225–6
quantitative and qualitative, 224–5
radiofrequency backscatter, 458
restenosis, 458
RF, 226–8
safety, 224, 452
serial, 455
everolimus, 458
shear stress, 228
stable ischemia, 1
statins, 456–7
early administration, 457
technology, 223–4
transducer, 453
vascular pathology, 457
VH
vs. palpography, 228
vulnerable plaque, 226, 228
Intravenous digital subtraction angiography
replacing intra-arterial DSA, 127
Intravenous heparin
balloon catheter, 403
Intravital microscopy, 49
Inversion-recovery (IR), 490
Inversion recovery on-resonance water suppression
(IRON), 282
INVOS 3100, 376
INVOS 4100, 376
Ipsilateral internal carotid artery (ICA), 117
Ipsilateral ischemic stroke, 67
absolute risk, 68
carotid endarterectomy, 75, 87
improvement, 98
Ipsilateral major stroke
vs. TIA
thrombotically active plaque, 3
Ipsilateral stroke
OEF, 407
women, 66
Iron-specific pulse sequences, 490
Ischemia
NIRS, 377
stable
IVUS, 454
Ischemic attack, 474
Ischemic events, 458
Ischemic stroke, 261
ACST, 89
aspirin and dipyridamole, 60
carotid territory, 87
cholesterol, 63
DWI, 62
extracranial plaque rupture, 272
ipsilateral, 67
absolute risk, 68
carotid endarterectomy, 75, 87
improvement, 98
symptomatic carotid stenosis or occlusion, 72
vitamin B12, 65
warfarin, 62
ITS-flow sensitive alternating inversion recovery, 361
Index 517
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Jugular vein
overlapping carotid bifurcation, 159
pixel-level kinetic modeling, 358
Kalman filter, 294
Kalman Filtering Registration and Smoothing (KFRS)
algorithm, 294
Kalman smoother, 295
Kentucky trial, 98
k-space, 148
Lagrangian-Eulerian formulation, 329
Laminar flow, 4
Laser Doppler flow (LDF), 377, 379, 381
changes, 380
Leicester trial, 98
Leptomengial vessels
collateral flow, 406
Lescol, 419
Lesion indices, 236–7
Levovist, 216
Lifestyle management
IMT, 438, 439
Light
extracerebral layers, 373
Linear minimum mean square error (LMMSE), 294
Linear orthotropic elastic models, 325
Lipid
serum, 15
Lipid core, 473
carotid endarterectomy, 214
Lipid-lowering therapies
carotid IMT progression, 29
IMT, 438
Lipid-rich necrotic core (LRNC), 183, 227, 465, 468,
469
identification, 183
mean value, 180
MRI, 184
percent, 465, 469
Lipid-rich plaques
density values, 200
Lipid-rich regions
MDCT, 199
Lipoprotein phagocytosis
imaging, 253–7
Local stress/strain, 336
Long echo times, 141
Lovastatin (Mevacor), 419
Low-density lipoprotein (LDL), 471
apheresis
plaque regression, 456
cell death, 303
IVUS, 455
MRI, 467
statins, 455
uptake, 471
VCAN, 304
vulnerable lesions, 253
Low-density lipoprotein-cholesterol (LDL-C), 421, 468, 469
IMT, 437
lowering, 422
MRI, 466
plaque, 467
Lumen detection, 239–40
modes, 240
Luminology, 159
Lymph node metastatic disease, 274
Macrophage accumulation, 274
Macrophage colony-stimulating factor (M-CSF), 471
Macrophages, 458, 478
gadolinium imaging, 479
loose matrix, 293
markers, 284
neovasculature, 293
Macrophage scavenger receptor (MSR), 479
Macrophage stress
imaging, 257–8
Magnetic resonance (MR)
contrast-weightings, 488
direct thrombus image, 310
hardware, 490
pulse sequences, 485
scanner and field strength, 490–1
virtual histology
atherosclerosis, 484–5
Magnetic resonance angiography (MRA), 126, 288
accuracy, 128, 174, 175
CBF, 78
clinical perspectives, 150–3
confirmatory, 168
cost-effectiveness, 173
vs. CTA, 159
current state, 140
vs. 2-D DSA, 128
vs. DSA, 128, 140, 152, 153
vs. DUS, 134
518 Index
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high-resolution contrast enhanced, 121
overestimation, 153
phase-contrast, 143–4
bipolar imaging gradient, 143
directionally sensitivity, 143
popularity, 262–3
promise, 289
proximal carotid arteries, 314
safety, 166
sequence, 147
stenosis, 79
symptomatic carotid disease, 79
3D TOF, 142
ulcers, 134
Magnetic resonance diffusion weighted imaging
carotid stenting, 102
Magnetic resonance imaging (MRI)
advantages, 180, 485
artifacts
smoothing, 329
based FSI models, 327
based multicomponent models with FSI
image acquisition and 3D geometry reconstruction,
327–9
benefits, 242
carotid
clinical studies, 465
carotid interventions, 397
compositional indices, 245
contrast agents, 476
DCE, 289
diffusion weighted
asymptomatic infarction, 62
vs. DSA, 134
dynamic contrast-enhanced, 289, 293–5
plaque imaging, 297
effectiveness, 484
effect on new compounds, 465
five-site carotid, 465
gadolinium contrast-enhanced
fibrous cap, 185
lipid-rich necrotic core, 185
gadolinum-enhanced, 475
haemodynamics, 313
high-risk patients, 472
IMT, 242
IPH, 307, 308
multi-contrast, 472–4, 484, 486–7
carotid artery, 473
plaque, 472
PC, 326
PDW, 237
phase contrast, 326
plaque, 180, 465
plaque imaging
multi-center trials, 465
pharmaceutical interventions, 464–9
plaque structure cellular content, 485
thrombosis, 306
T1W, 237, 242
T2W, 237
virtual histology, 485
vulnerable plaque, 188
Magnitude image, 144
Malondialdehyde-2 (MDA2), 253
Management of Atherothrombosis with Clopidogrel in
High-risk (MATCH), 60, 61
Mannheim intima media thickness consensus statement,
211
Markers
macrophages, 284
Markov models, 168, 170, 173, 240
cycles, 168
evaluation, 168
Matched Mask Bone Elimination (MMBE), 163
Mathaemoglobin, 306
Matrix
gadolinium, 292
Matrix metalloproteinase (MMP), 253, 263, 478
inhibitor, 263
Matrix metalloproteinase 1 (MMP1), 261, 471
Matrix metalloproteinase 3 (MMP3), 46, 53, 252
genes
mapping, 327
location, 325
tA/6A promoter polymorphism
IMT, 436
Matrix metalloproteinase 7 (MMP7), 284
Matrix metalloproteinase 9 (MMP9), 284
Maximum intensity projection (MIP), 161
cervical arteries, 163
stenosis, 141
Maximum intimal medial thickness (M-IMT)
revascularized vessels, 16
MCA signal, 349, 351
MCP-1, 252
Mean arterial pressure (MAP), 402
Mean blood flow velocity (MBFV), 402
Index 519
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Mean cost, 171
Mean fibrous cap thickness, 7
Mean transit time (MTT), 367
MCA, 367
Mechanical forces
plaque progression and rupture, 324
Mechanical image analysis
computations models
motivation, 324
Medical Decision Making, 168
Medical Research Council (MRC)
surgery, 94
Mediterranean diet, 65
Medtronic AVE Self-expanding Carotid Stent System with
Distal Protection in the Treatment of Carotid Stenosis
(MAVERICK), 97
Mesh analysis, 330
Metabolic syndrome
atherosclerosis, 437
IMT, 436
Methylene tetrahydrofolate reductase
IMT, 35
Mevacor, 419
Micro computerized tomography, 304
Micro-embolic signals (MES), 61
Microscopy
intravital, 49
Middle cerebral artery (MCA), 363
CBF, 367
MES, 61
MITT, 375
occlusions, 389
scatter plot, 382
stenosis
ECIC bypass, 403
TCD, 341
TTP, 367
Middle cerebral artery velocity (MCmV), 344
Mild stenosis
ultrasound, 212
Misery perfusion, 387
risk factors, 389
Moderate stenosis
ultrasound, 212
Modifiable risk factors
stroke, 14
Monoclonal antibodies, 266
Monocytes
circulating, 252
recruitment
imaging, 261–2
Monte-Carlo simulations, 168, 374
Mooney-Rivlin model, 329, 330
Morphological indices, 241–2
Morphology-Enhanced Probabilistic Plaque Segmentation
(MEPPS), 243, 247
core task, 243
histology-guided measurements, 245
manual review, 243
MS-325
albumin, 289
MRA, 289
Multicomponent computational models
MRI, 324
Multicomponent plaque model, 330
Multi-contrast magnetic resonance imaging, 472–4, 484,
486–7
carotid artery, 473
plaque, 472
Multi-contrast weighted imaging
protocol, 181
Multidisciplinary team (MDT)
stenosis, 95
Multiethnic Study of Atherosclerosis, 29
Multiplanar reconstructions (MPR), 159
Multiple Overlapping Thin Slab Acquisition (MOTSA),
142, 148
Multiple regression analysis
statin therapy, 186
Multislice computerised tomography (MSCT), 423
plaque, 192
Multislice computerised tomography angiography, 166
Multivitamin supplementation, 65
Myeloperoxidase (MPO), 492
inflammation, 493
Myocardial infarction (MI)
family history, 36
N-acetyl aspartate (NAA), 405, 406
National Cholesterol Education Program Expert Panel on
Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults
cholesterol lowering treatment guidelines, 28
National Instituted of Health
standardized terminology, 464
Navier-Stokes equations, 315, 316, 329
Near infrared spectroscopy (NIRS), 372, 379
brain, 372
520 Index
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clinically useful, 372
deoxyhemoglobin, 377
optodes, 379
oxyhemoglobin, 377
reflectance mode oximetry, 373
signal, 373
Necrotic core
carotid endarterectomy, 214
gadolinium, 292
intraplaque hemorrhage, 236
vulnerable atheroma, 272
Negative local gradient, 283
Negative predictive value (NPV), 399
Neointimal hyperplasia
solid organ transplantation, 458
Neovasculature I
gadolinium, 292
Neovessels, 475
Nerve of Hering, 293
Neurological deficit
metabolic parameters, 404
New pharmaceuticals
angiography, 420–1
clinical criteria, 420
clinical validation, 426
congruency, 420
efficiency, 420
hardware, 425
intervention, 420
linkage, 420
surrogate marker, 420
technical validation, 425–6
ultrasound, 421–3
vascular imaging and clinical development, 418–26
vascular imaging technologies and endpoints,
420–3
Niacin, 419
IMT, 438
Niaspan, 419
IMT, 43899mTc-annexin-A5, 258
NIRO 300, 374–5, 377
cerebral ischaemia, 377
N-isopropyl-p[123I]-iodoamphetamine (123I-IMP), 388
Nitric oxide, 471
Nitric oxide synthase
IMT, 35
Nodular calcified plaque, 12
Nonlinear isotropic models, 325
Non-stenotic plaque
FDG-PET, 262
Normalized wall index (NWI), 465
North American Symptomatic Carotid Endarterectomy
Trial (NASCET), 2, 59, 74
angiographic stenosis, 112
angiographic ulceration on DSA, 132
angioplasty, 96
asymptomatic, 191
carotid artery stenosis CTA
post-processing techniques, 159
carotid artery stenosis measurement, 132, 162
carotid artery stenosis surgery, 166
carotid endarterectomy vs. medical therapy, 169
carotid surgery, 94
time, 95
clinical efficacy, 173
cost-effectiveness, 173, 175, 176
criteria, 133
DSA, 126, 127
DSA complications, 130
DSA ulcers, 133
sensitivity, 133
endarterectomy, 66, 76
ICA measurement, 131
ICA stenosis criteria, 110–2
luminal stenosis, 272
outcomes, 173
randomization, 75
risk, 67
stenosis, 94
identification, 111
stroke, 67
Northern Manhattan Family Study, 48, 409
Novel contrast agents, 149–50
Novel ultrasound reagents, 423
Obesity
abdominal
atherosclerosis, 437
genetic factors, 37
Occlusion
Doppler measurements, 113
hemodynamic effects, 387
vs. stenosis, 410
Occlusive carotid disease, 6
Occlusive lesions
color Doppler imaging, 115
Omohyoid muscle, 80
Index 521
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Ophthalmic artery
collateral flow, 406
Optical coherence tomography (OCT), 459
Optode spacing, 379
Oregon Health and Science University (OHSU)
ICA stenosis, 111
OSI, 168
centerline velocities, 319
Outcome of Rosuvastatin Treatment on Carotid Artery
Atheroma (ORION), 468
Outer wall detection, 240–1
Oxford Community Stroke Project, 94
Oxidized LDL (oxLDL), 253, 257, 471
Oxygen extraction fraction (OEF), 78, 406
acetazolamide, 387
carotid interventions, 397
CVR, 405
defined, 405
dynamic nature, 405
increasing, 404
normal, 408
PET, 404
P792,
Parallel imaging techniques, 148
Paramagnetic agents, 475
Paraoxonase system, 431
IMT, 35
Particulate embolisation, 352
Passive smoking
atherosclerosis, 437
IMT, 436
Passive targeting, 218
Pathologic intimal thickening, 2
Peak systolic velocity (PSV), 108, 116
common carotid, 106
Doppler flow quality, 122
stenosis, 107
Percent lipid-rich necrotic core (%LRNC), 465, 469
Percent stenosis
stroke risk, 2
Perclose, 100
Periodically overlapping parallel lines with enhanced
reconstruction (PROPELLER), 487
Perioperative death
ACST, 88
carotid endarterectomy, 87
Perioperative stroke
carotid endarterectomy, 87, 95
Peripheral pulse gate
with short TR gradient echoes, 142
Phagocytosis
lipoprotein
imaging, 253–7
Pharmaceuticals. See New pharmaceuticals
Phase contrast (PC), 316
Phase contrast magnetic resonance angiography, 143–4
bipolar imaging gradient, 143
directionally sensitivity, 143
Phase contrast magnetic resonance imaging, 326
Phenotype, 35, 433
alleles, 42
Philips Achieva, 327
Phosphatidyl serine (PS), 252
Phospholipid bilayer, 46
Plaque, See also specific plaque, 171, 227
analysis automated
CASCADE, 247
blood pressure, 457
B-mode ultrasound, 435
3D, 435
burden
IVUS, 452
calcification, 472
carotid endarterectomy, 214
thromboembolic events, 236
cap erosion, 335
circumferential dissection, 81
composition, 242–8
computational mechanical models
controlling factors, 337
CT, 191–205
blooming artifact, 194
calcification, 197–8, 201, 204–5
carotid bifurcation, 203
characterization, 195
clinical applications, 203–5
component quantification, 202–3
contrast material, 194–5
history, 191–2
imaging protocol, 196
intraluminal attenuation, 195
lipid, 203–4
lumen surface morphology, 197, 203
non-calcified components, 198–200
quantification, 200–3
reconstruction algorithms, 195
reconstruction parameters, 193–6
522 Index
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risk prediction, 203
SNR, 194, 195
thickness, 193
tube current, 194
tube energy (kVp), 193–4
validation, 197–200
vascular remodeling, 205
volume, 205
volume quantification, 200–2
window-level setting, 196
CTA, 196
calcification, 205
carotid arteries, 203
vs. DSA, 197
lumen surface morphology, 197
CTA protocol, 196
CT vs. PET, 261
DSA, 203
with DSA complications, 130
duplex ultrasonography
lipid, 203
EBCT
calcification, 197
echogenicity, 214
erosion, 2
stroke vs. TIA, 3
fibrous cap
MRI, 185
gross and microscopic plaque, 5
HDL, 455
healed ruptures, 11
hemorrhage
carotid artery, 8
necrotic core, 9
histological validation, 181–6
histopathological vulnerability index, 336, 338
hypoechoic, 439
imaging
contrast agents, 288–90
MRI
multi-center trials, 465
vs. IMT, 434
inflammation, 478–9
biology, 252–3
nuclear imaging, 254
IVUS, 198, 452
Ktrans value, 297
linear regression analysis, 202
MDCT, 201, 202
MMP
imaging, 262–3
morphology, 3–4, 159
cerebral infarction, 203
imaging, 180–8
IVUS, 452
symptomatic carotid disease risk factors, 14–16
symptomatic vs. asymptomatic disease, 3
motion, 215–16
MRI, 180, 337, 465
clinical implications and future directions, 187–8
clinical studies, 186–7
composition, 183–5
vs. histological classification, 181
total wall volume, 183
vessel wall size, 181–3
MSCT, 192, 198, 199, 293–4
carotid endarterectomy, 198
vs. IVUS, 202
necrotic core, 3
nodular calcified, 12
non-stenotic
FDG-PET, 262
nuclear imaging, 261
progression, 22
angiogenesis in, 8, 290
repeated silent ruptures, 10–1
progression and rupture
mechanical forces, 324
quantitative mapping, 487–9
rapid progression, 186
RMI, 184
rupture, 7, 227, 314
healed, 14
predisposed, 22
segmented contour plots, 337
single slice CT, 191–2, 198
spontaneous rupture
thrombus formation, 45
stenotic, 488
vs. stroke, 187
structure cellular content
MRI, 485
surface morphology
angiographic determination, 132
symptomatic
double stained, 277
signal drop, 277
USPIO, 279
Index 523
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Plaque (cont.)
symptomatic vs. asymptomatic, 3
vs. TIA, 187
ulcerated, 6
B-mode imaging, 215
ulceration, 7
unstable, 435
validation, 202
vascularity, 8
vulnerability
luminal narrowing, 10
Plasma fibrinogen, 51
Plasminogen inhibitor type-1 (PAI-1), 48
platelets, 51
Platelets
activation, 46, 267
adhesion, 50
adhesion receptors, 50
agonists and emboli, 51–2
deposition, 48
embolisation, 52
imaging, 266–7
ligands, 50–1
thromboxane
inhibition, 52
Polymorphism(s), 66
5A/6A, 66
MMP3 promoter, 330
IL-6, 66
IMT
allele MMP3 tA/6A promoter, 436
genetic, 431
6A allele of the matrix metalloproteinase 3 (MMP3)
tA/6A promoter, 436
MMP3 promoter, 330
restriction fragment length, 35
Polymorphism 174/C, 39
Population genetic studies, 26
Positive predictive value (PPV), 399
Positron emission tomography (PET), 459
carotid interventions, 397
CBF, 78
cerebral ischemia, 78
OEF, 404
Posterior cerebral artery (PCA), 363
Postoperative stroke
cause, 45
Postprandial lipids
IMT, 436
Poststenotic flow, 110
Poststenotic zones, 314
Pravachol, 419
Pravastatin, 419
Pravastatin or Atorvastatin Evaluation and Infection
Therapy (PROVE-IT), 457
Pre-occlusive lesions
ICA near occlusion, 115
Preoperative carotid imaging
symptomatic patients, 175
Preset pulse repetition frequency (PRF), 343
Pressure distribution, 316
Probability
estimation, 244
Probucol, 438
Protein kinase A (PKA), 51
Proton-density-weighted (PDW) magnetic resonance
imaging, 237
Proximal carotid arteries
black blood MRI, 315
boundary conditions, 316
CFD modeling, 315–17
computational mesh, 316
examples, 317–20
governing equations, 315–16
image-based computational modeling, 313–20
imaging, 314–15
parameters simulated, 316
solution methods and accuracy, 316
P-selectin (CD62P), 48, 50
knockout mice, 50
Psychosocial factors
IMT, 436
Psychosocial stress
atherosclerosis, 437
PSY12 receptor, 52
Pulmonary artery atherosclerosis
lipid accumulation, 303
Pulmonary hypertension, 303
PULSAR, 360
Pulsed arterial spin labeling (PASL), 360
Pulse inversion harmonic imaging (PICHI)
plaque, 217
advantages, 218
p-value, 280
Quadruple inversion recovery (QIR), 275, 290, 291
FSE, 490
pulses, 490
524 Index
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Quality-adjusted-life-years (QALY), 169, 170, 175
asymptomatic, 175
Quantitative coronary angiography (QCA), 420–2, 424,
426
Quantitative imaging of perfusion using a single
subtraction (QUIPSS), 360, 361
Quantitative mapping techniques, 490
Quantitative-trait loci (QTL), 76, 433
Radiofrequency coil, 491–2
inhomogeneity, 487
Radionuclide tracers, 253
Randomized clinical trials (RCT), 59
stations, 63
Rapid extended coverage (REX) double inversion recovery
(DIR)-RARE, 486
gating, 486
Rapid screening technique, 308
Receiver-operator characteristics (ROC) curves, 111
Recombinant high-density lipoprotein (rHDL), 479
Red blood cells
lipid core, 307
Regional cerebrovascular reactivity (rCVR), 387, 389
Registration, 242–4
algorithm
carotid artery, 242
Relative risk reduction (RRR), 61
Relaxation enhancement sequence, 485
Restriction fragment length polymorphisms
(RFLP), 35
Reticuloendothelial system (RES), 273
Reversal of Atherosclerosis with Aggressive Lipid Lowering
(REVERSAL), 456
Rigid wall models, 318
Rosuvastatin, 468, 469
Rotational digital subtraction angiography
ICA stenosis, 128
Rotterdam Heart Study, 24, 439
carotid IMT, 26
C-reactive protein, 25
Rupture
biology, 252–3
Ruptured fibrous caps, 474
Safety
CTA, 166
DUS, 166
IVUS, 224, 452
MRA, 166
Salt restriction, 65
Sample volume length (SVL), 343, 347
Scavenger receptor type 1 (SCARB1), 26, 39
Screening
asymptomatic carotid stenosis, 90–1
complicated plaque, 309
cost-effectiveness, 167
3D multicomponent computational models, 324
DUS
confirmatory DSA, 175
with confirmatory DUS, MRA, or CTA, 134
confirmatory MRA, 135
rapid technique, 308
ultrasound
with confirmatory MRA, 151
Segmentation, 243–5
MEPPS, 246
Selectiva wire, 100
Selective arterial spin labeling, 362
SENSE, 148, 486
Sensitivity analyses, 171
Serial intravascular ultrasound
everolimus, 458
Serum amyloid A
atherosclerosis, 437
Serum lipids, 15
Severe stenosis
ultrasound, 212
Shaded Surface Display (SSD), 160
Shear forces, 6
Shear stress, 471, 472
IVUS, 228
Shunts
carotid endarterectomy, 80
Signal decrease, 275
Signal loss, 281
Signal-to-noise ratio (SNR), 144, 147, 180, 295, 487,
491
Simvastatin (Zocor), 419
aortic atherosclerotic plaques, 467
Sinerem
human carotid atheroma, 275
Single photon computed tomography (SPECT), 387–93,
402
acetazolamide, 408
CBF, 78
cerebral ischemia, 78
HMPAO, 402, 403
123I-IMP, 388, 409
Index 525
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6A allele of the matrix metalloproteinase 3 (MMP3) tA/6A
promoter polymorphisms
IMT, 436
Skull
TCD, 347
Slab boundary artefact (SBA), 142
Sleep apnea, 399
SMASH, 148
Smokers, 51
Smoking, 197
lifestyle modification, 65
passive
atherosclerosis, 437
stroke, 15
Smoking cessation, 65
Snakes, 237
SNP
polymorphic site, 40, 41
structure, 40
Soluble factors, 50–1
Somatosensory evoked potentials (SEP), 376, 377
Space Protected Angioplasty versus Carotid
Endarterectomy (SPACE), 91, 98
Specific targeting, 218
Spectrally selective RF pulse, 283
Speed image, 144
SPIRIT, 61
Spontaneous plaque rupture
thrombus formation, 45
St. Louis Carotid Occlusion Study (STLCOS), 407
stroke, 408
St. Louis Carotid Trial
CBV, 405
Stable ischemia
IVUS, 454
STA/middle cerebral artery (MCA) bypass, 83
Standard gadolinium (Gd)-DTPA, 146
Standards for the Reporting and Design of Studies of
Diagnostic Accuracy (STARD), 151, 174
Statins, 15, 472
atherosclerosis, 248
carotid plaques, 473
cerebral vasoreactivity, 64
IVUS, 456–7
early administration, 457
Steady-state free precession (SSFP), 315
Steal phenomenon, 405, 408
Stenosis, 74, 75, 107. See also Internal carotid artery (ICA)
stenosis
angiography
surgical benefit, 75
asymptomatic
Doppler, 118
bilateral high-grade, 118–19
continuous wave Doppler, 24
3D CE MRA, 152
detecting and assessing, 106
Doppler, 107–10
DSA, 79, 158
DSA vs. 3D CE MRA, 152
DUS, 79
ECA, 122
scan, 318
EDV, 107
ICA
classification, 110
ICA angiographic, 110
inflated balloon, 96
innominate artery, 107
internal carotid artery, 14
low pressure, 304
MCA
ECIC bypass, 403
mild
ultrasound, 212
moderate
ultrasound, 212
MRA, 79
NASCET, 94
identification, 111
nonsevere, 302
vs. occlusion, 410
percent
stroke risk, 2
post radiation, 100
PSV, 107
stenosis, 122
pulse wave Doppler, 24
severe
ultrasound, 212
severity
stress distributions, 332
stenosis, 25
subtotal
ultrasound, 212
symptomatic lesions, 2
Stenotic plaque
imaging, 488
526 Index
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Stent and Angioplasty With Protection for Patients at High
Risk for Endarterectomy (SAPPHIRE), 75, 98
Stenting, 97. See also Carotid stenting
advantages, 99
carotid arteries, 122
thresholds, 122
cost-effectiveness, 176
drawbacks, 99
evidence, 95–9
perioperative risk, 79
symptomatic carotid disease, 73
TCD, 351
trials, 73
Stenting of High Risk Patients Extracranial Lesions Trial
with Embolic Removal (SHELTER), 97
Stent Protected Percutaneous Angioplastyversus Carotid
Endarterectomy (SPACE), 98
Stents, 96
carotid endarterectomy, 74
vs. endarterectomy, 74, 76, 91, 98
femoral artery, 100
Symbiot covered, 101
Sternocleidomastoid muscle, 80
Strain-P1, 335
Stress
behaviors
finite element model, 333
ER, 252
FSI model, 331
high pressure, 332
local, 336
macrophage
imaging, 257–8
psychosocial
atherosclerosis, 437
reduction
IMT, 439
shear, 471, 472
IVUS, 228
thinner plaque cap, 334
wall shear, 314, 317
Stress-P1, 332, 334, 336, 338
Stress-stretch curve, 330
Stroke, 52, 94. See also Ipsilateral ischemic stroke;
Ischemic stroke
ACAS, 87
ACST, 95
asymptomatic patients, 95
age-adjusted incidence rate of, 39
angioplasty, 96
aortic plaque, 17
asymptomatic carotid stenosis, 90
atorvastatin, 63
blood pressure lowering,
CABG, 91
calcification, 204
carotid artery stenosis, 94
carotid disease, 64
carotid endarterectomy, 87, 95
carotid IMT, 27
carotid occlusion, 407
carotid plaque, 187
carotid sacrifice, 399–403
carotid stenosis, 59
CBV, 409
cerebral ischemia, 78
cerebral revascularization, 74
cerebral TIA, 66
CHD, 63
clopidogrel, 61
coronary atherosclerosis
B-mode ultrasound, 204
CT, 191
disability, 86
with DSA complications, 129–31
ECST, 87
medical treatment, 67
elevated blood pressure, 14
endarterectomy, 2
end point, 75
Framingham Heart Study, 86
hypertension, 14
IMT, 440
ARIC, 439
incidence, 1, 72, 86
ipsilateral
OEF, 407
women, 66
ischaemic
carotid territory, 87
ischemic, 261
ACST, 89
aspirin and dipyridamole, 60
carotid territory, 87
cholesterol, 63
DWI, 62
IVUS, 273
modifiable risk factors, 14
Index 527
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Stroke (cont.)
mortality, 86
MRI, 273
NASCET, 67
OEF, 78
Oxford, 94
percent stenosis, 2
perioperative
carotid endarterectomy, 87, 95
plaque ulcerations
DSA, 203
postoperative
cause, 45
prevention, 60
reduction, 88
British Government, 86
retinal events, 66
risk
ECST, 191
percent stenosis, 2
risk factors, 14, 64