2026-04-17T02:17:58Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/108372025-10-24T10:16:28Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Sakai, Yu author Cao, Quy author Rubin, Jeremy author Witsch, Jens author Cohen-Addad, Dan author de Macedo Rodrigues, Katyucia author Juega, Jesus author 2024-01-12T08:25:21Z 2024-01-12T08:25:21Z 2023-12-05 Atherosclerosis; Imaging; Stroke Aterosclerosis; Imágenes; Ictus Aterosclerosi; Imatges; Ictus Background Complex aortic plaque (CAP) is a potential embolic source in patients with cryptogenic stroke (CS). We review CAP imaging criteria for transesophageal echocardiogram (TEE), computed tomography angiography (CTA), and magnetic resonance imaging and calculate CAP prevalence in patients with acute CS. Methods and Results PubMed and EMBASE databases were searched up to December 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. Two independent reviewers extracted data on study design, imaging techniques, CAP criteria, and prevalence. The Cochrane Collaboration tool and Guideline for Reporting Reliability and Agreement Studies were used to assess risk of bias and reporting completeness, respectively. From 2293 studies, 45 were reviewed for CAP imaging biomarker criteria in patients with acute CS (N=37 TEE; N=9 CTA; N=6 magnetic resonance imaging). Most studies (74%) used ≥4 mm plaque thickness as the imaging criterion for CAP although ≥1 mm (N=1, CTA), ≥5 mm (N=5, TEE), and ≥6 mm (N=2, CTA) were also reported. Additional features included mobility, ulceration, thrombus, protrusions, and assessment of plaque composition. From 23 prospective studies, CAP was detected in 960 of 2778 patients with CS (0.32 [95% CI, 0.24–0.41], I2=94%). By modality, prevalence estimates were 0.29 (95% CI, 0.20–0.40; I2=95%) for TEE; 0.23 (95% CI, 0.15–0.34; I2=87%) for CTA and 0.22 (95% CI, 0.06–0.54; I2=92%) for magnetic resonance imaging. Conclusions TEE was commonly used to assess CAP in patients with CS. The most common CAP imaging biomarker was ≥4 mm plaque thickness. CAP was observed in one‐third of patients with acute CS. However, high study heterogeneity suggests a need for reproducible imaging methods. The work is supported by the National Heart, Lung, and Blood Institute (R01 HL147355, Z.F.), American Heart Association Career Development Awards (938082 to J.W.S.; 23CDA1053561 to J.W.), Vice Provost for University Research Foundation (J.W.S.), and Institute of Translational Medicine and Therapeutics (J.W.S.). http://hdl.handle.net/11351/10837 Placa ateroscleròtica Imatgeria per al diagnòstic Malalties cerebrovasculars DISEASES::Pathological Conditions, Signs and Symptoms::Pathological Conditions, Anatomical::Plaque, Atherosclerotic DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging ENFERMEDADES::afecciones patológicas, signos y síntomas::afecciones patológicas anatómicas::placa aterosclerótica ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen Imaging Biomarkers and Prevalence of Complex Aortic Plaque in Cryptogenic Stroke: A Systematic Review