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Article ; Online: Short-Term Outcomes of Elective High-Risk PCI with Extracorporeal Membrane Oxygenation Support: A Single-Centre Registry.

Griffioen, Alexander M / Van Den Oord, Stijn C H / Van Wely, Marleen H / Swart, Gerard C / Van Wetten, Herbert B / Danse, Peter W / Damman, Peter / Van Royen, Niels / Van Geuns, Robert Jan M

Journal of interventional cardiology

2022 Volume 2022, Page(s) 7245384

Abstract: Background: If surgical revascularization is not feasible, high-risk PCI is a viable option for patients with complex coronary artery disease. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides hemodynamic support in patients with a ... ...

Abstract	Background: If surgical revascularization is not feasible, high-risk PCI is a viable option for patients with complex coronary artery disease. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides hemodynamic support in patients with a high risk for periprocedural cardiogenic shock. Objective: This study aims to provide data about short-term outcomes of elective high-risk PCI with ECMO support. Methods: A retrospective single-center registry was performed on patients with high-risk PCI receiving VA-ECMO support. The short-term outcome was defined as the incidence of major adverse cardiac events (MACE) during the hospital stay and within 60 days after discharge. Results: Between January 2020 and December 2021, 14 patients underwent high-risk PCI with ECMO support. The mean age was 66.5 (±2.5) and the majority was male (71.4%) with a mean left ventricular ejection fraction of 33% (±3.0). Complexity indexes were high (STS-PROM risk score: 2.9 (IQR 1.5-5.8), SYNTAX score I: 35.5 (±2.0), SYNTAX score II (PCI): 49.8 (±3.2)). Femoral artery ECMO cannulation was performed in 13 patients (92.9%) requiring additional antegrade femoral artery cannula in one patient because of periprocedural limb ischemia. The mean duration of the ECMO run was 151 (±32) minutes. One patient required prolonged ECMO support and was weaned after 2 days. Successful revascularization was achieved in 13 patients (92.8%). Procedural success was achieved in 12 patients (85.7%) due to one unsuccessful revascularization and one procedural death. MACE during hospital stay occurred in 4 patients (28.6%) and within 60 days after discharge in 2 patients (16.7%). Conclusion: High-risk PCI with hemodynamic support using VA-ECMO is a feasible treatment option, if surgical revascularization is considered very high risk. Larger and prospective studies are awaited to confirm the benefits of ECMO support in elective high-risk PCI comparing ECMO with other mechanical circulatory support devices, including coaxial left cardiac support devices and IABP.
MeSH term(s)	Aged ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Male ; Percutaneous Coronary Intervention ; Prospective Studies ; Registries ; Retrospective Studies ; Shock, Cardiogenic/surgery ; Stroke Volume ; Ventricular Function, Left
Language	English
Publishing date	2022-09-16
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	1036325-7
ISSN	1540-8183 ; 0896-4327
ISSN (online)	1540-8183
ISSN	0896-4327
DOI	10.1155/2022/7245384
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Zs.A 2719: Show issues

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Article ; Online: Efficacy of Diltiazem to Improve Coronary Vasomotor Dysfunction in ANOCA: The EDIT-CMD Randomized Clinical Trial.

Jansen, Tijn P J / Konst, Regina E / de Vos, Annemiek / Paradies, Valeria / Teerenstra, Steven / van den Oord, Stijn C H / Dimitriu-Leen, Aukelien / Maas, Angela H E M / Smits, Pieter C / Damman, Peter / van Royen, Niels / Elias-Smale, Suzette E

JACC. Cardiovascular imaging

2022 Volume 15, Issue 8, Page(s) 1473–1484

Abstract: Background: Diltiazem is recommended and frequently prescribed in patients with angina and nonobstructive coronary artery disease (ANOCA), suspected of coronary vasomotor dysfunction (CVDys). However, studies substantiating its effect is this patient ... ...

Abstract	Background: Diltiazem is recommended and frequently prescribed in patients with angina and nonobstructive coronary artery disease (ANOCA), suspected of coronary vasomotor dysfunction (CVDys). However, studies substantiating its effect is this patient group are lacking. Objectives: The randomized, placebo-controlled EDIT-CMD (Efficacy of Diltiazem to Improve Coronary Microvascular Dysfunction: A Randomized Clinical Trial) evaluated the effect of diltiazem on CVDys, as assessed by repeated coronary function testing (CFT), angina, and quality of life. Methods: A total of 126 patients with ANOCA were included and underwent CFT. CVDys, defined as the presence of vasospasm (after intracoronary acetylcholine provocation) and/or microvascular dysfunction (coronary flow reserve: <2.0, index of microvascular resistance: ≥25), was confirmed in 99 patients, of whom 85 were randomized to receive either oral diltiazem or placebo up to 360 mg/d. After 6 weeks, a second CFT was performed. The primary end point was the proportion of patients having a successful treatment, defined as normalization of 1 abnormal parameter of CVDys and no normal parameter becoming abnormal. Secondary end points were changes from baseline to 6-week follow-up in vasospasm, index of microvascular resistance, coronary flow reserve, symptoms (Seattle Angina Questionnaire), or quality of life (Research and Development Questionnaire 36). Results: In total, 73 patients (38 diltiazem vs 35 placebo) underwent the second CFT. Improvement of the CFT did not differ between the groups (diltiazem vs placebo: 21% vs 29%; P = 0.46). However, more patients on diltiazem treatment progressed from epicardial spasm to microvascular or no spasm (47% vs 6%; P = 0.006). No significant differences were observed between the diltiazem and placebo group in microvascular dysfunction, Seattle Angina Questionnaire, or Research and Development Questionnaire 36. Conclusions: This first performed randomized, placebo-controlled trial in patients with ANOCA showed that 6 weeks of therapy with diltiazem, when compared with placebo, did not substantially improve CVDys, symptoms, or quality of life, but diltiazem therapy did reduce prevalence of epicardial spasm. (Efficacy of Diltiazem to Improve Coronary Microvascular Dysfunction: A Randomized Clinical Trial [EDIT-CMD]; NCT04777045).
MeSH term(s)	Angina Pectoris/diagnostic imaging ; Angina Pectoris/drug therapy ; Coronary Angiography ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/drug therapy ; Coronary Vasospasm/diagnostic imaging ; Coronary Vasospasm/drug therapy ; Coronary Vessels ; Diltiazem/adverse effects ; Humans ; Myocardial Ischemia ; Predictive Value of Tests ; Quality of Life
Chemical Substances	Diltiazem (EE92BBP03H)
Language	English
Publishing date	2022-04-02
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2491503-8
ISSN	1876-7591 ; 1936-878X
ISSN (online)	1876-7591
ISSN	1936-878X
DOI	10.1016/j.jcmg.2022.03.012
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Zs.A 6846: Show issues

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Article ; Online: Utility of contrast-enhanced ultrasound for the assessment of the carotid artery wall in patients with Takayasu or giant cell arteritis.

Schinkel, Arend F L / van den Oord, Stijn C H / van der Steen, Antonius F W / van Laar, Jan A M / Sijbrands, Eric J G

European heart journal cardiovascular Imaging

2014 Volume 15, Issue 5, Page(s) 541–546

Abstract: Aims: Carotid contrast-enhanced ultrasound (CEUS) was recently proposed for the evaluation of large-vessel vasculitides (LVV), particularly to assess vascularization within the vessel wall. The aim of this pilot study was to evaluate the potential of ... ...

Abstract	Aims: Carotid contrast-enhanced ultrasound (CEUS) was recently proposed for the evaluation of large-vessel vasculitides (LVV), particularly to assess vascularization within the vessel wall. The aim of this pilot study was to evaluate the potential of carotid colour Doppler ultrasound (CDUS) and CEUS in patients with LVV. Methods and results: This prospective study included seven patients (mean age 48 ± 14 years, all females) with established LVV (Takayasu arteritis or giant cell arteritis). All patients underwent CDUS and CEUS (14 carotid arteries). Intima-media thickness, lumen diameter, Doppler velocities, vessel wall thickening, and lesion thickness were assessed. CEUS was used to improve visualization of the lumen-to-vessel wall border, and to visualize carotid wall vascularization. Four (57%) patients [7 (50%) carotid arteries] exhibited lesions, and the average lesion thickness was 2.0 ± 0.5 mm. According to the Doppler peak systolic velocity, 5 (35%) carotid arteries had a <50% stenosis, 1 (7%) had a 50-70% stenosis, and 1 (7%) had a ≥70% stenosis. The contrast agent improved the image quality and the definition of the lumen-to-vascular wall border. Carotid wall vascularization was observed in 5 (71%) patients [9 (64%) carotid arteries]. Five (36%) carotid arteries had mild-to-moderate vascularization, and 4 (29%) had severe wall vascularization. Conclusion: Carotid CDUS allows the assessment of anatomical features of LVV, including vessel wall thickening and degree of stenosis. Carotid CEUS improves the visualization of the lumen border, and allows dynamic assessment of carotid wall vascularization, which is a potential marker of disease activity in patients with LVV.
MeSH term(s)	Adult ; Aged ; Carotid Arteries/diagnostic imaging ; Carotid Arteries/pathology ; Carotid Intima-Media Thickness ; Contrast Media ; Female ; Giant Cell Arteritis/diagnostic imaging ; Giant Cell Arteritis/pathology ; Humans ; Male ; Middle Aged ; Pilot Projects ; Prospective Studies ; Takayasu Arteritis/diagnostic imaging ; Takayasu Arteritis/pathology
Chemical Substances	Contrast Media
Language	English
Publishing date	2014-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jet243
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Zs.A 5614: Show issues

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Article ; Online: Effect of carotid plaque screening using contrast-enhanced ultrasound on cardiovascular risk stratification.

van den Oord, Stijn C H / ten Kate, Gerrit L / Sijbrands, Eric J G / van der Steen, Antonius F W / Schinkel, Arend F L

The American journal of cardiology

2013 Volume 111, Issue 5, Page(s) 754–759

Abstract: Cardiovascular risk stratification of asymptomatic patients is based on the assessment of risk factors. Noninvasive imaging of subclinical atherosclerosis may improve cardiovascular risk stratification, especially in patients with co-morbidities. The aim ...

Abstract	Cardiovascular risk stratification of asymptomatic patients is based on the assessment of risk factors. Noninvasive imaging of subclinical atherosclerosis may improve cardiovascular risk stratification, especially in patients with co-morbidities. The aim of this study was to investigate the effect of contrast-enhanced ultrasound (CEUS) of the carotid arteries on cardiovascular risk assessment. The study population consisted of 100 consecutive asymptomatic patients with ≥1 clinical risk factor for atherosclerosis. Cardiovascular risk was estimated by calculating the Prospective Cardiovascular Münster Heart Study (PROCAM) risk score. This score was divided into 3 subgroups: low (≤5%), intermediate (6% to 19%), and high (≥20%). Subclinical carotid atherosclerosis was assessed using standard ultrasound for intima-media thickness and plaque screening and CEUS for additional plaque screening. CEUS was performed using SonoVue contrast agent. Patients with subclinical atherosclerosis were considered to be at high cardiovascular risk. McNemar's test was used to compare PROCAM score to ultrasound findings. The mean PROCAM risk score was 9 ± 10; the PROCAM risk score was low in 72 patients (72%), intermediate in 17 patients (17%), and high in 11 patients (11%). A total of 21 patients (21%) had abnormal carotid intima-media thickness, 77% had plaques on conventional carotid ultrasound, and 88% had plaques on standard carotid ultrasound combined with CEUS. Detection of atherosclerosis led to the reclassification of 79 patients (79%) to high cardiovascular risk (p <0.001). In conclusion, CEUS changes the risk category as estimated by a traditional risk stratification model in most asymptomatic patients. CEUS may thus be an additional method for cardiovascular risk prediction in patient groups with co-morbidities.
MeSH term(s)	Cardiovascular Diseases/epidemiology ; Carotid Arteries/diagnostic imaging ; Carotid Artery Diseases/diagnostic imaging ; Carotid Intima-Media Thickness ; Contrast Media ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Netherlands/epidemiology ; Plaque, Atherosclerotic/diagnostic imaging ; Prospective Studies ; Risk Assessment/methods ; Risk Factors
Chemical Substances	Contrast Media
Language	English
Publishing date	2013-03-01
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2012.11.033
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Ui IV Zs.73: Show issues

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Article ; Online: Carotid intraplaque neovascularization quantification software (CINQS).

Akkus, Zeynettin / van Burken, Gerard / van den Oord, Stijn C H / Schinkel, Arend F L / de Jong, Nico / van der Steen, Antonius F W / Bosch, Johan G

IEEE journal of biomedical and health informatics

2015 Volume 19, Issue 1, Page(s) 332–338

Abstract: Intraplaque neovascularization (IPN) is an important biomarker of atherosclerotic plaque vulnerability. As IPN can be detected by contrast enhanced ultrasound (CEUS), imaging-biomarkers derived from CEUS may allow early prediction of plaque vulnerability. ...

Abstract	Intraplaque neovascularization (IPN) is an important biomarker of atherosclerotic plaque vulnerability. As IPN can be detected by contrast enhanced ultrasound (CEUS), imaging-biomarkers derived from CEUS may allow early prediction of plaque vulnerability. To select the best quantitative imaging-biomarkers for prediction of plaque vulnerability, a systematic analysis of IPN with existing and new analysis algorithms is necessary. Currently available commercial contrast quantification tools are not applicable for quantitative analysis of carotid IPN due to substantial motion of the carotid artery, artifacts, and intermittent perfusion of plaques. We therefore developed a specialized software package called Carotid intraplaque neovascularization quantification software (CINQS). It was designed for effective and systematic comparison of sets of quantitative imaging biomarkers. CINQS includes several analysis algorithms for carotid IPN quantification and overcomes the limitations of current contrast quantification tools and existing carotid IPN quantification approaches. CINQS has a modular design which allows integrating new analysis tools. Wizard-like analysis tools and its graphical-user-interface facilitate its usage. In this paper, we describe the concept, analysis tools, and performance of CINQS and present analysis results of 45 plaques of 23 patients. The results in 45 plaques showed excellent agreement with visual IPN scores for two quantitative imaging-biomarkers (The area under the receiver operating characteristic curve was 0.92 and 0.93).
MeSH term(s)	Algorithms ; Artificial Intelligence ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Contrast Media ; Humans ; Image Interpretation, Computer-Assisted/methods ; Neovascularization, Pathologic/complications ; Neovascularization, Pathologic/diagnostic imaging ; Pattern Recognition, Automated/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Software ; Software Validation ; Ultrasonography/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2015-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2695320-1
ISSN	2168-2208 ; 2168-2194
ISSN (online)	2168-2208
ISSN	2168-2194
DOI	10.1109/JBHI.2014.2306454
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Zs.A 5483: Show issues

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Article ; Online: Fully automated carotid plaque segmentation in combined contrast-enhanced and B-mode ultrasound.

Akkus, Zeynettin / Carvalho, Diego D B / van den Oord, Stijn C H / Schinkel, Arend F L / Niessen, Wiro J / de Jong, Nico / van der Steen, Antonius F W / Klein, Stefan / Bosch, Johan G

Ultrasound in medicine & biology

2015 Volume 41, Issue 2, Page(s) 517–531

Abstract: Carotid plaque segmentation in B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) is crucial to the assessment of plaque morphology and composition, which are linked to plaque vulnerability. Segmentation in BMUS is challenging because of ... ...

Abstract	Carotid plaque segmentation in B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) is crucial to the assessment of plaque morphology and composition, which are linked to plaque vulnerability. Segmentation in BMUS is challenging because of noise, artifacts and echo-lucent plaques. CEUS allows better delineation of the lumen but contains artifacts and lacks tissue information. We describe a method that exploits the combined information from simultaneously acquired BMUS and CEUS images. Our method consists of non-rigid motion estimation, vessel detection, lumen-intima segmentation and media-adventitia segmentation. The evaluation was performed in training (n = 20 carotids) and test (n = 28) data sets by comparison with manually obtained ground truth. The average root-mean-square errors in the training and test data sets were comparable for media-adventitia (411 ± 224 and 393 ± 239 μm) and for lumen-intima (362 ± 192 and 388 ± 200 μm), and were comparable to inter-observer variability. To the best of our knowledge, this is the first method to perform fully automatic carotid plaque segmentation using combined BMUS and CEUS.
MeSH term(s)	Algorithms ; Carotid Arteries/diagnostic imaging ; Carotid Artery Diseases/diagnostic imaging ; Carotid Intima-Media Thickness ; Contrast Media ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted/methods ; Observer Variation ; Plaque, Atherosclerotic/diagnostic imaging ; Reproducibility of Results
Chemical Substances	Contrast Media
Language	English
Publishing date	2015-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2014.10.004
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Zs.A 963: Show issues

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Article ; Online: Lumen segmentation and motion estimation in B-mode and contrast-enhanced ultrasound images of the carotid artery in patients with atherosclerotic plaque.

Carvalho, Diego D B / Akkus, Zeynettin / van den Oord, Stijn C H / Schinkel, Arend F L / van der Steen, Antonius F W / Niessen, Wiro J / Bosch, Johan G / Klein, Stefan

IEEE transactions on medical imaging

2015 Volume 34, Issue 4, Page(s) 983–993

Abstract: In standard B-mode ultrasound (BMUS), segmentation of the lumen of atherosclerotic carotid arteries and studying the lumen geometry over time are difficult owing to irregular lumen shapes, noise, artifacts, and echolucent plaques. Contrast enhanced ... ...

Abstract	In standard B-mode ultrasound (BMUS), segmentation of the lumen of atherosclerotic carotid arteries and studying the lumen geometry over time are difficult owing to irregular lumen shapes, noise, artifacts, and echolucent plaques. Contrast enhanced ultrasound (CEUS) improves lumen visualization, but lumen segmentation remains challenging owing to varying intensities, CEUS-specific artifacts and lack of tissue visualization. To overcome these challenges, we propose a novel method using simultaneously acquired BMUS&CEUS image sequences. Initially, the method estimates nonrigid motion (NME) from the image sequences, using intensity-based image registration. The motion-compensated image sequence is then averaged to obtain a single "epitome" image with improved signal-to-noise ratio. The lumen is segmented from the epitome image through an intensity joint-histogram classification and a graph-based segmentation. NME was validated by comparing displacements with manual annotations in 11 carotids. The average root mean square error (RMSE) was 112±73 μm . Segmentation results were validated against manual delineations in the epitome images of two different datasets, respectively containing 11 (RMSE 191±43 μm) and 10 (RMSE 351±176 μm ) carotids. From the deformation fields, we derived arterial distensibility with values comparable to the literature. The average errors in all experiments were in the inter-observer variability range. To the best of our knowledge, this is the first study exploiting combined BMUS&CEUS images for atherosclerotic carotid lumen segmentation.
MeSH term(s)	Carotid Arteries/diagnostic imaging ; Carotid Artery Diseases/diagnostic imaging ; Databases, Factual ; Humans ; Image Processing, Computer-Assisted/methods ; Movement/physiology ; Plaque, Atherosclerotic/diagnostic imaging ; Ultrasonography
Language	English
Publishing date	2015-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	622531-7
ISSN	1558-254X ; 0278-0062
ISSN (online)	1558-254X
ISSN	0278-0062
DOI	10.1109/TMI.2014.2372784
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Zs.A 2546: Show issues

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Article ; Online: Assessment of carotid atherosclerosis, intraplaque neovascularization, and plaque ulceration using quantitative contrast-enhanced ultrasound in asymptomatic patients with diabetes mellitus.

van den Oord, Stijn C H / Akkus, Zeynettin / Renaud, Guillaume / Bosch, Johan G / van der Steen, Antonius F W / Sijbrands, Eric J G / Schinkel, Arend F L

European heart journal cardiovascular Imaging

2014 Volume 15, Issue 11, Page(s) 1213–1218

Abstract: Aims: Patients with diabetes mellitus (DM) are at severely increased risk of developing atherosclerosis. Intraplaque neovascularization (IPN) and plaque ulceration are markers of the vulnerable plaque, which is at an increased risk of rupture and may ... ...

Abstract	Aims: Patients with diabetes mellitus (DM) are at severely increased risk of developing atherosclerosis. Intraplaque neovascularization (IPN) and plaque ulceration are markers of the vulnerable plaque, which is at an increased risk of rupture and may lead to cardiovascular events. The aim of this study was to assess the prevalence of subclinical carotid atherosclerosis, intraplaque neovascularization (IPN), and plaque ulceration in asymptomatic patients with DM. Methods and results: A total of 51 asymptomatic patients with DM underwent standard carotid ultrasound in conjunction with contrast-enhanced ultrasound (CEUS) to assess the prevalence of subclinical atherosclerosis, IPN, and plaque ulceration. Subclinical atherosclerosis was defined as the presence of atherosclerotic plaque, according to the Mannheim consensus. Semi-automated quantification software was used to assess IPN in suitable plaques. Plaque ulceration was defined as a disruption of the plaque-lumen border of ≥ 1 × 1 mm. A total of 408 carotid segments in 102 carotid arteries were investigated. Forty-six (90%) patients had subclinical atherosclerotic plaques, with a median plaque thickness of 2.4 mm (inter-quartile range 1.9-3.0). CEUS revealed IPN in 88% of the patients. In 10 carotid segments (8%), the plaque had an ulcerated surface. The presence of IPN could not be predicted by the presence of clinical characteristics including complications of DM (P > 0.05). Conclusion: Patients with DM have a high prevalence (90%) of subclinical carotid atherosclerosis. Severe IPN and plaque ulceration, which are markers of the vulnerable plaque type, were detected in, respectively, 13 and 9% of these patients.
MeSH term(s)	Biomarkers/analysis ; Carotid Artery Diseases/diagnostic imaging ; Carotid Artery Diseases/pathology ; Diabetes Mellitus/diagnostic imaging ; Diabetes Mellitus/pathology ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Middle Aged ; Neovascularization, Pathologic/diagnostic imaging ; Neovascularization, Pathologic/pathology ; Plaque, Atherosclerotic/diagnostic imaging ; Plaque, Atherosclerotic/pathology ; Prospective Studies ; Risk Factors ; Software ; Ultrasonography
Chemical Substances	Biomarkers
Language	English
Publishing date	2014-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jeu127
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Zs.A 5614: Show issues

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Article ; Online: New quantification methods for carotid intra-plaque neovascularization using contrast-enhanced ultrasound.

Akkus, Zeynettin / Hoogi, Assaf / Renaud, Guillaume / van den Oord, Stijn C H / Ten Kate, Gerrit L / Schinkel, Arend F L / Adam, Dan / de Jong, Nico / van der Steen, Antonius F W / Bosch, Johan G

Ultrasound in medicine & biology

2014 Volume 40, Issue 1, Page(s) 25–36

Abstract: As carotid intra-plaque neovascularization (IPN) is linked to progressive atherosclerotic disease and plaque vulnerability, its accurate quantification might allow early detection of plaque vulnerability. We therefore developed several new quantitative ... ...

Abstract	As carotid intra-plaque neovascularization (IPN) is linked to progressive atherosclerotic disease and plaque vulnerability, its accurate quantification might allow early detection of plaque vulnerability. We therefore developed several new quantitative methods for analyzing IPN perfusion and structure. From our analyses, we derived six quantitative parameters-IPN surface area (IPNSA), IPN surface ratio (IPNSR), plaque mean intensity, plaque-to-lumen enhancement ratio, mean plaque contrast percentage and number of micro-vessels (MVN)-and compared these with visual grading of IPN by two independent physicians. A total of 45 carotid arteries with symptomatic stenosis in 23 patients were analyzed. IPNSA (correlation r = 0.719), IPNSR (r = 0.538) and MVN (r = 0.484) were found to be significantly correlated with visual scoring (p < 0.01). IPNSA was the best match to visual scoring. These results indicate that IPNSA, IPNSR and MVN may have the potential to replace qualitative visual scoring and to measure the degree of carotid IPN.
MeSH term(s)	Algorithms ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Contrast Media ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods ; Neovascularization, Pathologic/diagnostic imaging ; Neovascularization, Pathologic/etiology ; Observer Variation ; Pattern Recognition, Automated/methods ; Phospholipids ; Reproducibility of Results ; Sensitivity and Specificity ; Sulfur Hexafluoride ; Ultrasonography
Chemical Substances	Contrast Media ; Phospholipids ; contrast agent BR1 ; Sulfur Hexafluoride (WS7LR3I1D6)
Language	English
Publishing date	2014-01
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2013.09.010
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Zs.A 963: Show issues

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Article ; Online: High-definition imaging of carotid artery wall dynamics.

Kruizinga, Pieter / Mastik, Frits / van den Oord, Stijn C H / Schinkel, Arend F L / Bosch, Johannes G / de Jong, Nico / van Soest, Gijs / van der Steen, Anton F W

Ultrasound in medicine & biology

2014 Volume 40, Issue 10, Page(s) 2392–2403

Abstract: The carotid artery (CA) is central to cardiovascular research, because of the clinical relevance of CA plaques as culprits of stroke and the accessibility of the CA for cardiovascular screening. The viscoelastic state of this artery, essential for ... ...

Abstract	The carotid artery (CA) is central to cardiovascular research, because of the clinical relevance of CA plaques as culprits of stroke and the accessibility of the CA for cardiovascular screening. The viscoelastic state of this artery, essential for clinical evaluation, can be assessed by observing arterial deformation in response to the pressure changes throughout the cardiac cycle. Ultrasound imaging has proven to be an excellent tool to monitor these dynamic deformation processes. We describe how a new technique called high-frame-rate ultrasound imaging captures the tissue deformation dynamics throughout the cardiac cycle in unprecedented detail. Local tissue motion exhibits distinct features of sub-micrometer displacements on a sub-millisecond time scale. We present a high-definition motion analysis technique based on plane wave ultrasound imaging able to capture these features. We validated this method by screening a group of healthy volunteers and compared the results with those for two patients known to have atherosclerosis to illustrate the potential utility of this technique.
MeSH term(s)	Adult ; Atherosclerosis/diagnostic imaging ; Atherosclerosis/physiopathology ; Blood Flow Velocity/physiology ; Carotid Arteries/diagnostic imaging ; Carotid Arteries/physiology ; Carotid Arteries/physiopathology ; Female ; Healthy Volunteers ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Ultrasonography ; Vascular Stiffness/physiology
Language	English
Publishing date	2014-10
Publishing country	England
Document type	Journal Article
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2014.03.009
Database	MEDical Literature Analysis and Retrieval System OnLINE

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