Top

The International Journal of Cardiovascular Imaging

Published in:

Open Access 21-08-2023 | Intravascular Ultrasound | Original Paper

Imaging modality-dependent carotid stenosis severity variations against intravascular ultrasound as a reference: Carotid Artery intravasculaR Ultrasound Study (CARUS)

Authors: Lukasz Tekieli, Anna Kablak-Ziembicka, Wladyslaw Dabrowski, Karolina Dzierwa, Zbigniew Moczulski, Malgorzata Urbanczyk-Zawadzka, Adam Mazurek, Justyna Stefaniak, Piotr Paluszek, Maciej Krupinski, Tadeusz Przewlocki, Piotr Pieniazek, Piotr Musialek

Published in: The International Journal of Cardiovascular Imaging | Issue 10/2023

Abstract

Purpose

Different non-invasive and invasive imaging modalities are used to determine carotid artery stenosis severity that remains a principal parameter in clinical decision-making. We compared stenosis degree obtained with different modalities against vascular imaging gold standard, intravascular ultrasound, IVUS.

Methods

300 consecutive patients (age 47–83 years, 192 men, 64% asymptomatic) with carotid artery stenosis of “ ≥ 50%” referred for potential revascularization received as per study protocol (i) duplex ultrasound (DUS), (ii) computed tomography angiography (CTA), (iii) intraarterial quantitative angiography (iQA) and (iv) and (iv) IVUS. Correlation of measurements with IVUS (r), proportion of those concordant (within 10%) and proportion of under/overestimated were calculated along with recipient-operating-characteristics (ROC).

Results

For IVUS area stenosis (AS) and IVUS minimal lumen area (MLA), there was only a moderate correlation with DUS velocities (peak-systolic, PSV; end-diastolic, EDV; r values of 0.42–0.51, p < 0.001 for all). CTA systematically underestimated both reference area and MLA (80.4% and 92.3% cases) but CTA error was lesser for AS (proportion concordant-57.4%; CTA under/overestimation-12.5%/30.1%). iQA diameter stenosis (DS) was found concordant with IVUS in 41.1% measurements (iQA under/overestimation 7.9%/51.0%). By univariate model, PSV (ROC area-under-the-curve, AUC, 0.77, cutoff 2.6 m/s), EDV (AUC 0.72, cutoff 0.71 m/s) and CTA-DS (AUC 0.83, cutoff 59.6%) were predictors of ≥ 50% DS by IVUS (p < 0.001 for all). Best predictor, however, of ≥ 50% DS by IVUS was stenosis severity evaluation by automated contrast column density measurement on iQA (AUC 0.87, cutoff 68%, p < 0.001). Regarding non-invasive techniques, CTA was the only independent diagnostic modality against IVUS on multivariate model (p = 0.008).

Conclusion

IVUS validation shows significant imaging modality-dependent variations in carotid stenosis severity determination.

Available only for authorised users

Brinjikji W, Huston J, Rabinstein AA, Kim GM, Lerman A, Lanzino G (2016) Contemporary carotid imaging: from degree of stenosis to plaque vulnerability. J Neurosurg 124(1):27–42. https://doi.org/10.3171/2015.1.JNS142452CrossRefPubMed

Aboyans V, Ricco JB, Bartelink MLEL et al (2018) Editor’s Choice – 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 55(3):305–368. https://doi.org/10.1016/j.ejvs.2017.07.018CrossRefPubMed

Bonati LH, Kakkos S, Berkefeld J et al (2021) European Stroke Organisation guideline on endarterectomy and stenting for carotid artery stenosis. Eur Stroke J 6(2):I–XLVII. https://doi.org/10.1177/23969873211012121

Thammongkolchai T, Riaz A, Sundararajan S (2017) Carotid stenosis: role of plaque morphology in recurrent stroke risk. Stroke 48(8):e197–e199. https://doi.org/10.1161/STROKEAHA.117.017779CrossRefPubMed

Kamtchum-Tatuene J, Noubiap JJ, Wilman AH, Saqqur M, Shuaib A, Jickling GC (2020) Prevalence of high-risk plaques and risk of stroke in patients with asymptomatic carotid stenosis: a meta-analysis. JAMA Neurol 77(12):1524–1535. https://doi.org/10.1001/JAMANEUROL.2020.2658CrossRefPubMed

Hosseini AA, Simpson RJ, Altaf N, Bath PM, Macsweeney ST, Auer DP (2017) Magnetic resonance imaging plaque hemorrhage for risk stratification in carotid artery disease with moderate risk under current medical therapy. Stroke 48(3):678–685. https://doi.org/10.1161/STROKEAHA.116.015504CrossRefPubMed

Paprottka KJ, Saam D, Rübenthaler J et al (2017) Prevalence and distribution of calcified nodules in carotid arteries in correlation with clinical symptoms. Radiol Med 122(6):449–457. https://doi.org/10.1007/S11547-017-0740-ZCrossRefPubMed

Svoboda N, Voldřich R, Mandys V et al (2022) Histological analysis of carotid plaques: the predictors of stroke risk. J Stroke Cerebrovasc Dis. https://doi.org/10.1016/J.JSTROKECEREBROVASDIS.2021.106262CrossRefPubMed

Nakagawa I, Kotsugi M, Park HS et al (2021) Near-infrared spectroscopy carotid plaque characteristics and cerebral embolism in carotid artery stenting. EuroIntervention 17(7):599–606. https://doi.org/10.4244/EIJ-D-20-01050CrossRefPubMedPubMedCentral

10.

Štěchovský C, Hájek P, Roland R, Horváth M, Veselka J (2021) Long-term changes after carotid stenting assessed by intravascular ultrasound and near-infrared spectroscopy. Cardiovasc Diagn Ther 11(6):1180. https://doi.org/10.21037/CDT-21-160CrossRefPubMedPubMedCentral

11.

Kleindorfer DO, Towfighi A, Chaturvedi S et al (2021) Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke 2021:E364–E467. https://doi.org/10.1161/STR.0000000000000375CrossRef

12.

AbuRahma AF, Avgerinos ED, Chang RW et al (2022) Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease. J Vasc Surg 75(1S):4S-22S. https://doi.org/10.1016/J.JVS.2021.04.073CrossRefPubMed

13.

Naylor AR, Rantner B, Ancetti S et al (2022) European society for vascular surgery (ESVS) 2023 Clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease. Eur J Vasc Endovasc Surg https://doi.org/10.1016/J.EJVS.2022.04.011

14.

Taylor DW, Haynes RB, Sackett DL et al (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325(7):445–453. https://doi.org/10.1056/NEJM199108153250701CrossRefPubMed

15.

Foster DS (1995) Endarterectomy for asymptomatic carotid artery stenosis. JAMA J Am Med Assoc 274(19):1505b–11505. https://doi.org/10.1001/jama.274.19.1505bCrossRef

16.

Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W (2003) Neurologic complications of cerebral angiography: Prospective analysis of 2,899 procedures and review of the literature. Radiology 227(2):522–528. https://doi.org/10.1148/radiol.2272012071CrossRefPubMed

17.

Choudhri O, Schoen M, Mantha A et al (2016) Increased risk for complications following diagnostic cerebral angiography in older patients: trends from the Nationwide Inpatient Sample (1999–2009). J Clin Neurosci 32:109–114. https://doi.org/10.1016/J.JOCN.2016.04.007CrossRefPubMed

18.

Fifi JT, Meyers PM, Lavine SD et al (2009) Complications of modern diagnostic cerebral angiography in an academic medical center. J Vasc Interv Radiol 20(4):442–447. https://doi.org/10.1016/J.JVIR.2009.01.012CrossRefPubMed

19.

Kaufmann TJ, Huston J, Mandrekar JN, Schleck CD, Thielen KR, Kallmes DF (2007) Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 243(3):812–819. https://doi.org/10.1148/RADIOL.2433060536CrossRefPubMed

20.

Serruys PW, Reiber JHC, Wijns W et al (1984) Assessment of percutaneous transluminal coronary angioplasty by quantitative coronary angiography: diameter versus densitometric area measurements. Am J Cardiol 54(6):482–488. https://doi.org/10.1016/0002-9149(84)90235-2CrossRefPubMed

21.

Escaned J, Foley DP, Haase J et al (1993) Quantitative angiography during coronary angioplasty with a single angiographic view: a comparison of automated edge detection and videodensitometric techniques. Am Heart J 126(6):1326–1333. https://doi.org/10.1016/0002-8703(93)90530-MCrossRefPubMed

22.

Saxena A, Ng EYK, Lim ST (2019) Imaging modalities to diagnose carotid artery stenosis: progress and prospect. Biomed Eng. https://doi.org/10.1186/s12938-019-0685-7CrossRef

23.

Halliday A, Mansfield A, Marro J et al (2004) Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 363(9420):1491–1502. https://doi.org/10.1016/S0140-6736(04)16146-1CrossRefPubMed

24.

Rosenfield K, Matsumura JS, Chaturvedi S et al (2016) Randomized trial of stent versus surgery for asymptomatic carotid stenosis. N Engl J Med 374(11):1011–1020. https://doi.org/10.1056/NEJMOA1515706/SUPPL_FILE/NEJMOA1515706_DISCLOSURES.PDFCrossRefPubMed

25.

Halliday A, Bulbulia R, Bonati LH et al (2021) Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet (London, England) 398(10305):1065. https://doi.org/10.1016/S0140-6736(21)01910-3CrossRefPubMed

26.

Sheffet AJ, Roubin G, Howard G et al (2010) Design of the carotid revascularization endarterectomy vs. stenting trial (CREST). Int J Stroke 5(1):40–46. https://doi.org/10.1111/J.1747-4949.2009.00405.XCrossRefPubMedPubMedCentral

27.

Long A, Lepoutre A, Corbillon E, Branchereau A (2002) Critical review of non- or minimally invasive methods (duplex ultrasonography, MR- and CT-angiography) for evaluating stenosis of the proximal internal carotid artery. Eur J Vasc Endovasc Surg 24(1):43–52. https://doi.org/10.1053/ejvs.2002.1666CrossRefPubMed

28.

Nicolaides AN, Shifrin EG, Bradbury A et al (1996) Angiographic and duplex grading of internal carotid stenosis: Can we overcome the confusion? J Endovasc Surg 3(2):158–165. https://doi.org/10.1583/1074-6218(1996)003%3c0158:AADGIC%3e2.0.CO;2CrossRefPubMed

29.

Jogestrand T, Fredén-Lindqvist J, Lindqvist M, Lundgren S, Tillman AS, Zachrisson H (2016) Discrepancies in recommended criteria for grading of carotid stenosis with ultrasound. Clin Physiol Funct Imaging 36(4):326–329. https://doi.org/10.1111/cpf.12236CrossRefPubMed

30.

Waller BF, Pinkerton CA, Slack JD (1992) Intravascular ultrasound: a histological study of vessels during life. The new “gold standard” for vascular imaging. Circulation 85(6):2305–2310. https://doi.org/10.1161/01.CIR.85.6.2305CrossRefPubMed

31.

Bluth EI, Stavros AT, Marich KW, Wetzner SM, Aufrichtig D, Baker JD (1988) Carotid duplex sonography: a multicenter recommendation for standardized imaging and Doppler criteria. Radiographics 8(3):487–506. https://doi.org/10.1148/RADIOGRAPHICS.8.3.3289100CrossRefPubMed

32.

Grant EG, Benson CB, Moneta GL et al (2003) Carotid artery stenosis: gray-scale and Doppler US diagnosis—Society of Radiologists in Ultrasound Consensus Conference1. Radiology 229(2):340–346. https://doi.org/10.1148/RADIOL.2292030516CrossRefPubMed

33.

Oates CP, Naylor AR, Hartshorne T et al (2009) Joint recommendations for reporting carotid ultrasound investigations in the United Kingdom. Eur J Vasc Endovasc Surg 37(3):251–261. https://doi.org/10.1016/j.ejvs.2008.10.015CrossRefPubMed

34.

Filis KA, Arko FR, Johnson BL et al (2002) Duplex ultrasound criteria for defining the severity of carotid stenosis. Ann Vasc Surg 16(4):413–421. https://doi.org/10.1007/S10016-001-0175-8CrossRefPubMed

35.

Ota H, Takase K, Rikimaru H et al (2005) Quantitative vascular measurements in arterial occlusive disease. Radiographics 25(5):1141–1158. https://doi.org/10.1148/RG.255055014CrossRefPubMed

36.

Alexandrov AV, Bladin CF, Maggisano R, Norris JW (1993) Measuring carotid stenosis. Time for a reappraisal. Stroke 24(9):1292–1296. https://doi.org/10.1161/01.STR.24.9.1292CrossRefPubMed

37.

Latchaw RE, Alberts MJ, Lev MH et al (2009) Recommendations for imaging of acute ischemic stroke: a scientific statement from the American heart association. Stroke 40(11):3646–3678. https://doi.org/10.1161/STROKEAHA.108.192616CrossRefPubMed

38.

Diethrich EB, Margolis MP, Reid DB et al (2007) Virtual Histology Intravascular Ultrasound Assessment of Carotid Artery Disease: The Carotid Artery Plaque Virtual Histology Evaluation (CAPITAL) Study. J Endovasc Ther 14(5):676–686. https://doi.org/10.1177/152660280701400512CrossRefPubMed

39.

Musialek P, Dabrowski W, Mazurek A et al (2020) Quantitative Virtual Histology for In Vivo Evaluation of Human Atherosclerosis—a Plaque Biomechanics-Based Novel Image Analysis Algorithm: validation and applications to atherosclerosis research. In: Intravascular ultrasound. Elsevier, pp 71–96. https://doi.org/10.1016/B978-0-12-818833-0.00005-9

40.

Mazurek A, Partyka L, Trystula M et al (2019) Highly-calcific carotid lesions endovascular management in symptomatic and increased-stroke-risk asymptomatic patients using the CGuardTM dual-layer carotid stent system: analysis from the PARADIGM study. Catheter Cardiovasc Interv 94(1):149–156. https://doi.org/10.1002/CCD.28219CrossRefPubMed

41.

Musialek P, Pieniazek P, Tracz W et al (2012) Safety of embolic protection device-assisted and unprotected intravascular ultrasound in evaluating carotid artery atherosclerotic lesions. Med Sci Monit. https://doi.org/10.12659/msm.882452CrossRefPubMedPubMedCentral

42.

Zacharatos H, Hassan AE, Qureshi AI (2010) Intravascular ultrasound: principles and cerebrovascular applications. Am J Neuroradiol 31(4):586–597. https://doi.org/10.3174/ajnr.A1810CrossRefPubMedPubMedCentral

43.

Lee JT, White RA (2004) Basics of intravascular ultrasound: an essential tool for the endovascular surgeon. Semin Vasc Surg 17(2):110–118. https://doi.org/10.1053/j.semvascsurg.2004.03.009CrossRefPubMed

44.

Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327(8476):307–310. https://doi.org/10.1016/S0140-6736(86)90837-8CrossRef

45.

Mohebali J, Patel VI, Romero JM et al (2015) Acoustic shadowing impairs accurate characterization of stenosis in carotid ultrasound examinations. J Vasc Surg 62(5):1236–1244. https://doi.org/10.1016/J.JVS.2015.06.137CrossRefPubMed

46.

Morales MM, Anacleto A, Filho CM, Ledesma S, Aldrovani M, Wolosker N (2019) Peak systolic velocity for calcified plaques fails to estimate carotid stenosis degree. Ann Vasc Surg 59:1–4. https://doi.org/10.1016/j.avsg.2018.12.086CrossRefPubMed

47.

Wardlaw JM, Lewis S (2005) Carotid stenosis measurement on colour Doppler ultrasound: agreement of ECST, NASCET and CCA methods applied to ultrasound with intra-arterial angiographic stenosis measurement. Eur J Radiol 56(2):205–211. https://doi.org/10.1016/j.ejrad.2005.04.021CrossRefPubMed

48.

Warlow C, Farrell B, Fraser A, Sandercock P, Slattery J (1998) Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 351(9113):1379–1387. https://doi.org/10.1016/s0140-6736(97)09292-1CrossRef

49.

Rosenfield K, Matsumura J, Chaturvedi S et al (2016) Randomized trial of stent versus surgery for asymptomatic carotid stenosis. N Engl J Med 374:1011–1020CrossRefPubMed

50.

Met R, Bipat S, Legemate DA, Reekers JA, Koelemay MJW (2009) Diagnostic performance of computed tomography angiography in peripheral arterial disease a systematic review and meta-analysis. JAMA J Am Med Assoc 301(4):415–424. https://doi.org/10.1001/jama.301.4.415CrossRef

51.

Jahromi AS, Cinà CS, Liu Y, Clase CM (2005) Sensitivity and specificity of color duplex ultrasound measurement in the estimation of internal carotid artery stenosis: a systematic review and meta-analysis. J Vasc Surg 41(6):962–972. https://doi.org/10.1016/j.jvs.2005.02.044CrossRefPubMed

52.

Preiss JE, Itum DS, Reeves JG et al (2015) Carotid duplex criteria for patients with contralateral occlusion. J Surg Res 193(1):28–32. https://doi.org/10.1016/j.jss.2014.08.037CrossRefPubMed

53.

Van Everdingen KJ, Van der Grond J, Kappelle LJ (1998) Overestimation of a stenosis in the internal carotid artery by duplex sonography caused by an increase in volume flow. J Vasc Surg 27(3):479–485. https://doi.org/10.1016/S0741-5214(98)99999-2CrossRefPubMed

54.

Chappell FM, Wardlaw JM, Young GR et al (2009) Carotid artery stenosis: accuracy of noninvasive tests - individual patient data meta-analysis. Radiology 251(2):493–502. https://doi.org/10.1148/radiol.2512080284CrossRefPubMed

55.

Arous EJ, Judelson DR, Malka KT et al (2019) Carotid duplex velocity criteria recommended by the Society of Radiologists in Ultrasound and Endorsed by the Intersocietal Accreditation Commission Lack Predictive Ability for Identifying High-Grade Carotid Artery Stenosis. Ann Vasc Surg 61:227–232. https://doi.org/10.1016/j.avsg.2019.05.051CrossRefPubMed

56.

Bryant C, Pugh N, Coleman D, Morris R, Williams P, Humphries K (2013) Comparison of Doppler ultrasound velocity parameters in the determination of internal carotid artery stenosis. Ultrasound 21(3):124–131. https://doi.org/10.1177/1742271X13496680CrossRef

57.

Norris JW, Morriello F, Rowed DW, Maggisano R (2003) Vascular imaging before carotid endarterectomy. Stroke. https://doi.org/10.1161/01.STR.0000069423.21542.61CrossRefPubMed

58.

Zavanone C, Ragone E, Samson Y (2012) Concordance rates of Doppler ultrasound and CT angiography in the grading of carotid artery stenosis: a systematic literature review. J Neurol 259(6):1015–1018. https://doi.org/10.1007/s00415-011-6265-9CrossRefPubMed

59.

Von Reutern GM, Goertler MW, Bornstein NM et al (2012) Grading carotid stenosis using ultrasonic methods. Stroke 43(3):916–921. https://doi.org/10.1161/STROKEAHA.111.636084CrossRef

60.

Wardlaw JM, Chappell FM, Stevenson M et al (2006) Accurate, practical and cost-effective assessment of carotid stenosis in the UK. Health Technol Assess. https://doi.org/10.3310/HTA10300CrossRefPubMed

61.

Wardlaw J, Chappell F, Best J, Wartolowska K, Berry E (2006) Non-invasive imaging compared with intra-arterial angiography in the diagnosis of symptomatic carotid stenosis: a meta-analysis. Lancet 367(9521):1503–1512. https://doi.org/10.1016/S0140-6736(06)68650-9CrossRefPubMed

62.

Columbo JA, Zwolak RM, Arous EJ, Goodney PP, Lilly MP, Welch HG (2020) Variation in ultrasound diagnostic thresholds for carotid stenosis in the United States. Circulation 141(12):946–953. https://doi.org/10.1161/CIRCULATIONAHA.119.043963CrossRefPubMed

63.

Shaw JA, Kingwell BA, Walton AS et al (2002) Determinants of coronary artery compliance in subjects with and without angiographic coronary artery disease. J Am Coll Cardiol 39(10):1637–1643. https://doi.org/10.1016/S0735-1097(02)01842-9CrossRefPubMed

64.

Brodoefel H, Burgstahler C, Tsiflikas I et al (2008) Dual-source CT: effect of heart rate, heart rate variability, and calcification on image quality and diagnostic accuracy. Radiology 247(2):346–355. https://doi.org/10.1148/radiol.2472070906CrossRefPubMed

65.

Meng L, Cui L, Cheng Y et al (2009) Effect of heart rate and coronary calcification on the diagnostic accuracy of the dual-source CT coronary angiography in patients with suspected coronary artery disease. Korean J Radiol 10(4):347–354. https://doi.org/10.3348/kjr.2009.10.4.347CrossRefPubMedPubMedCentral

66.

Kotsugi M, Takayama K, Myouchin K et al (2017) Carotid artery stenting: investigation of plaque protrusion incidence and prognosis. JACC Cardiovasc Interv 10(8):824–831. https://doi.org/10.1016/J.JCIN.2017.01.029CrossRefPubMed

67.

Okazaki T, Sakamoto S, Shinagawa K et al (2019) Detection of in-stent protrusion (ISP) by intravascular ultrasound during carotid stenting: usefulness of stent-in-stent placement for ISP. Eur Radiol 29(1):77–84. https://doi.org/10.1007/S00330-018-5636-3CrossRefPubMed

68.

Clark DJ, Lessio S, O’Donoghue M, Schainfeld R, Rosenfield K (2004) Safety and utility of intravascular ultrasound-guided carotid artery stenting. Catheter Cardiovasc Interv 63(3):355–362. https://doi.org/10.1002/CCD.20188CrossRefPubMed

69.

Musialek P, Rosenfield K, Siddiqui A, Grunwald IQ. Thrombosis and haemostasis carotid stenosis and stroke: medicines, stents, surgery-"Wait-and-See" or protect? Thromb Haemost. 2022 https://doi.org/10.1055/a-1952-1159

70.

Arous EJ, Simons JP, Flahive JM et al (2015) National variation in preoperative imaging, carotid duplex ultrasound criteria, and threshold for surgery for asymptomatic carotid artery stenosis. J Vasc Surg 62(4):937–944. https://doi.org/10.1016/J.JVS.2015.04.438CrossRefPubMed

71.

Musialek P (2013) Virtual histology intravascular ultrasound evaluation of atherosclerotic carotid artery stenosis: time for fully quantitative image analysis. J Endovasc Ther 20(4):589–594. https://doi.org/10.1583/13-4303L.1CrossRefPubMed

72.

Alfonso F, Hernando L, Dutary J (2010) Virtual histology assessment of atheroma at coronary bifurcations: colours at the crossroads? Euro-Intervention 6:295–301. https://doi.org/10.4244/EIJV6I3A50. (PMID: 20884405)CrossRefPubMed

73.

Horev A, Honig A, Cohen JE et al (2021) Overestimation of carotid stenosis on CTA - real world experience. J Clin Neurosci 85:36–40. https://doi.org/10.1016/J.JOCN.2020.12.018CrossRefPubMed

74.

Mannil M, Ramachandran J, Vittoria De Martini I et al (2017) Modified dual-energy algorithm for calcified plaque removal: evaluation in carotid computed tomography angiography and comparison with digital subtraction angiography. Invest Radiol 52(11):680–685. https://doi.org/10.1097/RLI.0000000000000391

Title: Imaging modality-dependent carotid stenosis severity variations against intravascular ultrasound as a reference: Carotid Artery intravasculaR Ultrasound Study (CARUS)
Authors: Lukasz Tekieli
Anna Kablak-Ziembicka
Wladyslaw Dabrowski
Karolina Dzierwa
Zbigniew Moczulski
Malgorzata Urbanczyk-Zawadzka
Adam Mazurek
Justyna Stefaniak
Piotr Paluszek
Maciej Krupinski
Tadeusz Przewlocki
Piotr Pieniazek
Piotr Musialek
Publication date: 21-08-2023
Publisher: Springer Netherlands
Keywords: Intravascular Ultrasound
CT Angiography
Carotid Stenosis
Carotid Stenosis
Angiography
Ultrasound
Ultrasound
Published in: The International Journal of Cardiovascular Imaging / Issue 10/2023
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-023-02875-1

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Imaging modality-dependent carotid stenosis severity variations against intravascular ultrasound as a reference: Carotid Artery intravasculaR Ultrasound Study (CARUS)

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2023

Challenges in the evaluation of Covid-19 related cardiac alterations early after recovery from acute infection associated with severe lung involvement

Incidence, risk factors, and clinical sequelae of incomplete stent apposition after sirolimus-eluting stent

Myocardial deformation analysis using cardiac magnetic resonance in apical hypertrophic cardiomyopathy: is it an useful tool to predict adverse outcomes?

Characterization of plaque phenotypes exhibiting an elevated pericoronary adipose tissue attenuation: insights from the REASSURE-NIRS registry

Chemotherapy-related cardiac dysfunction: the usefulness of myocardial work indices

Angiography and optical coherence tomography derived shear stress: are they equivalent in my opinion?

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page