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RT Journal Article
SR Electronic
T1 Association between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 2321
OP 2326
DO 10.3174/ajnr.A5436
VO 38
IS 12
A1 Baradaran, H.
A1 Al-Dasuqi, K.
A1 Knight-Greenfield, A.
A1 Giambrone, A.
A1 Delgado, D.
A1 Ebani, E.J.
A1 Kamel, H.
A1 Gupta, A.
YR 2017
UL http://www.ajnr.org/content/38/12/2321.abstract
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