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Association between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis.

TitleAssociation between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis.
Publication TypeJournal Article
Year of Publication2017
AuthorsBaradaran H, Al-Dasuqi K, Knight-Greenfield A, Giambrone A, Delgado D, Ebani EJ, Kamel H, Gupta A
JournalAJNR Am J Neuroradiol
Volume38
Issue12
Pagination2321-2326
Date Published2017 Dec
ISSN1936-959X
Abstract

BACKGROUND: CTA is a widely available imaging examination that may allow the evaluation of high-risk carotid plaque features.

PURPOSE: Our aim was to evaluate the association between specific carotid plaque features on CTA and ipsilateral cerebrovascular ischemia.

DATA SOURCES: We performed a systematic review of Ovid MEDLINE, Ovid Embase, Scopus, and the Cochrane Library from inception to March 2016 for articles that evaluated the relationship between CTA-detected carotid plaque features and ischemic events, defined as ipsilateral ischemic stroke or transient ischemic attack.

STUDY SELECTION: Sixteen studies were ultimately included after screening 12,557.

DATA ANALYSIS: Two readers recorded data from each study and assessed the study quality with all disagreements resolved by a third reader. A random-effects OR was used to evaluate the association between cerebrovascular ischemia and each of the evaluated plaque features.

DATA SYNTHESIS: We found significant positive relationships with cerebrovascular ischemia for the presence of soft plaque (OR, 2.9; 95% CI, 1.4-6.0), plaque ulceration (OR, 2.2; 95% CI, 1.4-3.4), and increased common carotid artery wall thickness (OR, 6.2; 95% CI, 2.5-15.6). We found a significant negative relationship between calcified plaque and ipsilateral ischemia (OR, 0.5; 95% CI, 0.4-0.7).

LIMITATIONS: We found heterogeneity in the existing literature secondary to lack of standardized plaque features and clinical definitions.

CONCLUSIONS: Soft plaque, plaque ulceration, and increased common carotid artery wall thickness on CTA are associated with ipsilateral cerebrovascular ischemia, while calcified plaque is negatively associated with downstream ischemic events.

DOI10.3174/ajnr.A5436
Alternate JournalAJNR Am J Neuroradiol
PubMed ID29074638