Aarli Sander Johan, Thomassen Lars, Waje-Andreassen Ulrike, Logallo Nicola, Kvistad Christopher Elnan, Næss Halvor, Fromm Annette
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Front Neurol. 2021 Aug 20;12:702657. doi: 10.3389/fneur.2021.702657. eCollection 2021.
Carotid artery atherosclerosis is a major risk factor for ischemic stroke. This risk is related to plaque vulnerability and is characterized by plaque morphology, intraplaque neovascularization, and cerebral microembolization. Advanced neurosonology can identify vulnerable plaques and aid in preventing subsequent stroke. We aimed to assess the time course of cerebral microembolization and intraplaque neovascularization during 6 months of follow-up and to explore the utility of advanced neurosonology in patients with acute cerebral ischemia. Fifteen patients with acute cerebral ischemia and carotid artery plaques underwent comprehensive extra- and intracranial ultrasound examinations, including microemboli detection and contrast-enhanced ultrasound. The examinations were repeated after 3 and 6 months. We examined 28 plaques in 15 patients. The ultrasonographic features of plaque vulnerability were frequent in symptomatic and asymptomatic plaques. There were no significant differences in stenosis degree, plaque composition, plaque surface, neovascularization, or cerebral microembolization between symptomatic and asymptomatic plaques, but symptomatic plaques had a higher number of vulnerable features. None of the patients had recurrent clinical stroke or transient ischemic attack during the follow-up period. We observed a decrease in cerebral microembolization at 6 months, but no significant change in intraplaque neovascularization. In patients with acute cerebral ischemia and carotid artery plaques, cerebral microembolization decreased during 6 months of follow-up, indicating plaque stabilization. ClinicalTrial.gov, identifier NCT02759653.
颈动脉粥样硬化是缺血性卒中的主要危险因素。这种风险与斑块易损性相关，其特征包括斑块形态、斑块内新生血管形成和脑微栓塞。先进的神经超声检查能够识别易损斑块，并有助于预防后续卒中。我们旨在评估随访6个月期间脑微栓塞和斑块内新生血管形成的时间进程，并探讨先进神经超声检查在急性脑缺血患者中的应用价值。15例患有急性脑缺血和颈动脉斑块的患者接受了全面的颅外和颅内超声检查，包括微栓子检测和超声造影。在3个月和6个月后重复检查。我们检查了15例患者的28个斑块。有症状和无症状斑块中斑块易损性的超声特征均较为常见。有症状和无症状斑块在狭窄程度、斑块成分、斑块表面、新生血管形成或脑微栓塞方面无显著差异，但有症状斑块具有更多的易损特征。在随访期间，没有患者发生复发性临床卒中或短暂性脑缺血发作。我们观察到6个月时脑微栓塞减少，但斑块内新生血管形成无显著变化。在患有急性脑缺血和颈动脉斑块的患者中，随访6个月期间脑微栓塞减少，表明斑块趋于稳定。ClinicalTrial.gov标识符：NCT02759653。
