Why the study?
Features of vulnerable carotid plaques offer better prognostication than stenosis alone, motivating the exploration of non-invasive tools to image the vascular wall and plaque characteristics.
Multidetector computed tomographic angiography plays an increasingly important role in the non-invasive characterization of vulnerable carotid atherosclerotic plaques beyond simple stenosis grading.
May support non-invasive carotid plaque risk stratification; leaves open prospective validation before practice change.
Despite steady advances in medical care, cardiovascular disease remains one of the main causes of death and long-term morbidity worldwide. Up to 30% of strokes are associated with the presence of carotid atherosclerotic plaques. While the degree of stenosis has long been recognized as the main guiding factor in risk stratification and therapeutical decisions, recent evidence suggests that features of unstable, or 'vulnerable', plaques offer better prognostication capabilities. This paradigmatic shift has motivated researchers to explore the potentialities of non-invasive diagnostic tools to image not only the lumen, but also the vascular wall and the structural characteristics of the plaque. The present review will offer a panoramic on the imaging modalities currently available to characterize carotid atherosclerotic plaques and, in particular, it will focus on the increasingly important role covered by multidetector computed tomographic angiography.
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Murgia et al. (2020) studied this question.
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