Ischemic Stroke Patients Demonstrate Increased Carotid Plaque Microvasculature Compared to (Ocular) Transient Ischemic Attack Patients

Raf H. M. van Hoof, Floris H. B. M. Schreuder, Patty Nelemans, Martine T. B. Truijman, Narender P. van Orshoven, Tobien H. Schreuder, Werner H. Mess, Sylvia Heeneman, Robert J. van Oostenbrugge, Joachim E. Wildberger, M. Eline Kooi*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Web of Science)

Abstract

Background: Patients with a recent ischemic stroke have a higher risk of recurrent stroke compared to (ocular) transient ischemic attack (TIA) patients. Plaque microvasculature is considered as a feature of plaque vulnerability and can be quantified with carotid dynamic contrast-enhanced MRI (DCE-MRI). The purpose of this cross-sectional study was to explore the association between plaque microvasculature and the type of recent cerebrovascular events in symptomatic patients with mild-to-moderate carotid stenosis. Methods: A total of 87 symptomatic patients with a recent stroke (n = 35) or (ocular) TIA (n = 52) underwent carotid DCE-MRI examination. Plaque microvasculature was studied in the vessel wall and adventitia using DCEMRI and the pharmacokinetic modeling parameter K trans. Statistical analysis was performed with logistic regression, correcting for associated clinical risk factors. Results: The 75th percentile adventitial (OR 1.97, 95% CI 1.18-3.29) K trans was significantly associated with a recent ischemic stroke compared to (ocular) TIA in multivariate analysis, while clinical risk factors were not significantly associated with the type of event. Conclusions: This study indicates a positive association of leaky plaque microvasculature with a recent ischemic stroke compared to (ocular) TIA. Prospective longitudinal studies are needed to investigate whether Kt rans or other plaque characteristics may serve as an imaging marker for predicting (the type of) future cerebrovascular events. (C) 2017 The Author(s) Published by S. Karger AG, Basel

Original languageEnglish
Pages (from-to)297-303
Number of pages7
JournalCerebrovascular Diseases
Volume44
Issue number5-6
DOIs
Publication statusPublished - 2017

Keywords

  • Atherosclerosis
  • Dynamic contrast-enhanced MRI
  • Microvasculature
  • Magnetic resonance imaging
  • Ischemic stroke
  • Transient ischemic attack
  • CONTRAST-ENHANCED MRI
  • ATHEROSCLEROTIC PLAQUE
  • INTRAPLAQUE HEMORRHAGE
  • INPUT FUNCTION
  • VASA-VASORUM
  • RISK
  • DIAGNOSIS
  • NEOVASCULARIZATION
  • EPIDEMIOLOGY
  • ANGIOGENESIS

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