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PT  - JOURNAL ARTICLE
AU  - Baradaran, H.
AU  - Al-Dasuqi, K.
AU  - Knight-Greenfield, A.
AU  - Giambrone, A.
AU  - Delgado, D.
AU  - Ebani, E.J.
AU  - Kamel, H.
AU  - Gupta, A.
TI  - Association between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis
AID  - 10.3174/ajnr.A5436
DP  - 2017 Dec 01
TA  - American Journal of Neuroradiology
PG  - 2321--2326
VI  - 38
IP  - 12
4099  - http://www.ajnr.org/content/38/12/2321.short
4100  - http://www.ajnr.org/content/38/12/2321.full
SO  - Am. J. Neuroradiol.2017 Dec 01; 38
AB  - 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.USultrasound