Key result
Vessel wall imaging identifies high-risk plaques and reveals surgical targets even in non-stenotic carotid atherosclerosis.
Why the study?
Stroke risk in carotid stenosis was traditionally assessed by lumen morphology, but vessel wall imaging has revealed that plaque characteristics play a critical role in ischemic events.
Vessel wall imaging enables the identification of vulnerable carotid plaques, such as those with intraplaque hemorrhage or expansive remodeling, improving risk stratification beyond luminal stenosis alone.
May aid risk stratification in non-stenotic carotid atherosclerosis; hypothesis-generating and should not yet change surgical practice.
頚動脈狭窄症における脳梗塞発症リスクは，おもに血管造影による狭窄率や潰瘍形成など，内腔形態に基づいて評価されてきた．近年，超音波検査・CT・MRIなどを用いたvessel wall imaging（VWI）の進歩により，プラークの性状・体積・形態など，「壁の性質」が虚血イベント発症にきわめて大きな役割を果たすことが明らかとなっており，たとえば非狭窄性動脈硬化症の一部にも外科治療対象となり得る高リスク病変が存在する．
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Yoshida et al. (2023) studied this question. Vessel wall imaging identifies high-risk plaque characteristics that strongly influence ischemic events, revealing surgical targets even in non-stenotic carotid atherosclerosis.
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