Abstract Details

Early Cerebral ischemic events in Symptomatic Carotid Stenosis are related to Plaque Inflammation
Cerebrovascular Disease and Interventional Neurology
S52 - Acute Non-Interventional Stroke Care (4:58 PM-5:09 PM)
009

we investigated the role of plaque imaging in stroke recurrence in our patients with recently symptomatic carotid stenosis using 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET)/computed tomography (CT) and high-resolution magnetic resonance imaging (HR-MRI), .
Severity of symptomatic carotid stenosis often determines the treatment approach. However, severity explains only the regional hypoperfusion as the mechanism of cerebral ischemia. Artery-to-artery embolisation remains an important pathogenic mechanism in patients with high-risk carotid plaques. Inflammation is considered as the initiating event for plaque rupture and cerebral embolism. 
This prospective study included consecutive patients within 30-days of recent stroke and ipsilateral carotid stenosis (≥50%). FDG uptake was quantified as mean standardized uptake values (SUV, g/ml). The ratio of T1 hyperintensity of carotid plaque to the ipsilateral sternocleidomastoid muscle (SCM) was recorded on T1-weighted fat suppressed HR-MRI. Patients were followed-up for stroke recurrence within 90-days. 
Of the 96 patients included in the study, 14 (14.6%) suffered from recurrent cerebral ischemic event in the stenosed carotid territory within 90-days. Compared to patients who remained asymptomatic, patients with recurrent cerebral ischemia showed higher mean T1 carotid-SCM ratio (2.14 versus 1.37; p<0.0001) and higher mean SUV value in the carotid plaque (3.14g/ml versus 1.27g/ml; p<0.0001). Higher T1 carotid-SCM ratio on HR-MRI (OR 3.242, 95%CI 1.224-4.978; p<0.0001) and higher mean SUV on FDG-PET (OR 3.216, 95%CI 2.962-8.721; p=0.005) were independent predictors of recurrent cerebral ischemia

FDG-PET/CT and HR-MRI of carotid stenosis are useful tools for risk stratification and may aid in better therapeutic decision-making.

Authors/Disclosures
Blanca Marquez de Prado
PRESENTER 		An immediate family member of Blanca Marquez de Prado has stock in Latus Bio. An immediate family member of Blanca Marquez de Prado has received intellectual property interests from a discovery or technology relating to health care.
Prakash R. Paliwal, MD No disclosure on file
Hock Luen Teoh No disclosure on file
No disclosure on file
No disclosure on file
Vijay Sharma No disclosure on file