|Title||Association between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Baradaran H, Al-Dasuqi K, Knight-Greenfield A, Giambrone A, Delgado D, Ebani EJ, Kamel H, Gupta A|
|Journal||AJNR Am J Neuroradiol|
|Date Published||2017 Dec|
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.
|Alternate Journal||AJNR Am J Neuroradiol|