Carotid Arteries Ultrasonography

ABCIC

Review Article

Artificial Intelligence in Carotid Ultrasonography: Current Status and Future Directions

Gustavo Paglioli Dannenhauer et al. Simone Nascimento dos Santos Ana Claudia Gomes Pereira Petisco Claudia Maria Vilas Freire … Ana Cristina Lopes Albricker Fanilda Souto Barros

Abstract

To review the current applications of artificial intelligence (AI) in carotid ultrasonography and its future perspectives. This narrative review was based on recent studies addressing machine learning, deep learning, radiomics, and integration with advanced ultrasound modalities, including contrast-enhanced ultrasound (CEUS), elastography, three-dimensional ultrasound, microvascular flow imaging (MFI), and ultrafast ultrasound. Carotid assessment has evolved from an approach focused primarily on the degree of luminal stenosis to a more comprehensive evaluation encompassing plaque burden, morphology, composition, and vulnerability. AI algorithms have been applied to automated plaque detection, image segmentation, plaque stability classification, radiomic feature extraction, and prediction of ischemic events. When combined with advanced imaging techniques, these models may improve reproducibility, reduce operator dependence, and reveal quantitative patterns that conventional visual assessment may not detect. Despite promising results, important challenges remain regarding image standardization, external validation, model explainability, and prospective clinical impacts. AI has the potential to transform carotid ultrasonography into a multiparametric tool for personalized medicine. Its clinical implementation will depend on robust validation, integration into clinical workflows, and demonstration of incremental value over conventional ultrasonography.

Read Full Article

ABC

Original Article

Association between Cardiovascular Risk Factors and Carotid Plaques in a Population-Based Study – The SHIP-Brazil Study

Fernanda Burger Zimmermann et al. Sérgio Luiz Zimmermann Marcelo Burger Zimmermann Enrico Klug Beraldi … Mateus Campanelli Franco da Rocha Bruno Pereira de Oliveira Zabot Siegmar Starke Ernani Tiaraju de Santa Helena Marcello Ricardo Paulista Markus

Abstract

Background

Atherosclerotic disease is a relevant cause of morbidity and mortality in the general population, and it is important to detect factors that can influence its prevention.

Objective

To evaluate the association of cardiovascular risk factors with carotid plaques in participants of the Study of Health in Pomerania (SHIP) – Brazil.

Methods

A total of 1,953 participants were assessed for the presence of cardiovascular risk factors (hypertension, dyslipidemia, type 2 diabetes, obesity, smoking and physical inactivity) and sociodemographic variables (gender, age group, Germanic culture, color/race self-declared, and alcohol consumption), waist circumference measurement, waist-to-hip ratio and waist-to-height ratio. The presence of carotid plaques was analyzed by ultrasound. The association between the study variables and carotid plaques was assessed using the Chi-square test. A p-value < 0.05 was considered significant.

Results

Plaques were present in 56.5% of hypertensive patients (p<0.001), 49.8% of dyslipidemic patients (p<0.001), 62% of diabetic patients (p<0.001), 52% of smokers, 29% of those who had never smoked (p<0.001), 39.5% of sedentary people and 33.1% of non-sedentary people (p=0.014), 43.7% of obese people and 26.1% of eutrophic people (p<0.001).

Conclusion

Carotid plaques were prevalent in men, aged between 60 and 79, white, hypertensive, dyslipidemic, diabetic, smokers, sedentary and obese, illiterate, in economic class A1/A2, and of Germanic culture, and low alcohol consumption.

Read Full Article

ABCIC

Case Report

Ultrasound in the Diagnosis of Carotid Web: Report of Two Cases and Review

Ana Claudia Gomes Pereira Petisco et al. Paulo Magno Martins Dourado Larissa Almeida Dourado João Paulo Almeida Dourado Ricardo Thomaz Tebaldi

Introduction

Carotid web (CW) is a nonatherosclerotic disease of the extracranial carotid artery, described as an atypical, still little known, and poorly diagnosed focal fibromuscular dysplasia (FMD). CW has been associated with the occurrence of cerebral vascular accidents (CVAs) and transient ischemic attacks (TIAs), affecting young patients, with no other known causes.

[…]

Read Full Article

ABC

Original Article

The Effect of Atorvastatin + Aspirin on the Endothelial Function Differs with Age in Patients with HIV: A Case-Control Study

Gerson Gomes dos Santos Junior et al. Paulo Sérgio Ramos Araújo Kaliene Maria Estevão Leite Emmanuelle Tenório Godoi … Adriana Ferraz Vasconcelos Heloisa Ramos Lacerda

Abstract

Background

Patients with HIV are more likely to present with cardiovascular disease when compared to the general population.

Objective

This was a case-control study that aimed to assess which factors were associated with a reduction in the carotid intima-media thickness (IMT) and an increase in the brachial artery flow-mediated dilation (FMD) in HIV patients who received atorvastatin + aspirin during a period of 6 months.

Methods

A secondary analysis of a clinical trial was conducted, which included people living with HIV infection and low cardiovascular risk. A total of 38 patients allocated to the intervention arm and treated for 6 months with a combination of atorvastatin + aspirin were included. All participants underwent a carotid and brachial artery ultrasound, both at the beginning and the end of the study. Cases that responded with an increase of >10% of the brachial dilatation (FMD) and reduction of the carotid intima-media thickness (IMT) were considered cases, and those who did not respond were considered controls. We assessed the factors associated with the positive responses obtained through IMT and FMD.

Results

A reduction in the IMT was not significantly associated with any of the evaluated risk factors: age (p=0.211), gender (p=0.260), smoking (p=0.131) or time since HIV diagnosis (p=0.836). An increase in the FMD was significantly associated with age amongst those in the 40-59 age group, p = 0.015 (OR = 4.37; 95% CI: 1.07-17.79).

Conclusions

Older individuals were more likely to present with an increased FMD after 6 months of treatment with atorvastatin + aspirin.

Read Full Article

ABC

Original Article

Carotid Artery Atherosclerotic Profile as Risk Predictor for Restenosis After Coronary Stenting

Cássia da Silva Antico Rodrigues et al. Rodrigo Bazan Fabrício Moreira Reis Caroline F. S. Mazeto Pupo da Silveira … Lívia Maria Severino Hueb Fábio Cardoso de Carvalho Hélio Rubens de Carvalho Nunes Katashi Okoshi João Carlos Hueb Silméia Garcia Zanati Bazan

Abstract

Background:

The incidence of restenosis of the coronary artery after a bare-metal stent implant has been lower than in simple balloon angioplasty; however, it still shows relatively high rates.

Objective:

The aim of this study was to find new risk indicators for in-stent restenosis using carotid ultrasonography, that, in addition to the already existing indicators, would help in decision-making for stent selection.

Methods:

We carried out a cross-sectional prospective study including 121 consecutive patients with chronic coronary artery disease who had undergone percutaneous coronary intervention with repeat angiography in the previous 12 months. After all cases of in-stent restenosis were identified, patients underwent carotid ultrasonography to evaluate carotid intima-media thickness and atherosclerosis plaques. The data were analyzed by Cox multiple regression. The significance level was set a p<0.05.

Results:

Median age of patients was 60 years (1^st quartile = 55, 3^rd quartile = 68), and 64.5% of patients were male. Coronary angiography showed that 57 patients (47.1%) presented in-stent restenosis. Fifty-five patients (45.5%) had echolucent atherosclerotic plaques in carotid arteries and 54.5% had echogenic plaques or no plaques. Of patients with who had echolucent plaques, 90.9% presented coronary in-stent restenosis. Of those who had echogenic plaques or no plaques, 10.6% presented in-stent restenosis. The presence of echolucent plaques in carotid arteries increased the risk of coronary in-stent restenosis by 8.21 times (RR=8.21; 95%CI: 3.58-18.82; p<0.001).

Conclusions:

The presence of echolucent atherosclerotic plaques in carotid artery constitutes a risk predictor of coronary instent restenosis and should be considered in the selection of the type of stent to be used in coronary angioplasty.

Read Full Article