The risk of cerebral microembolism depends on the type of atherosclerotic plaques of the carotid arteries according to the RADS classification
https://doi.org/10.33667/2078-5631-2025-24-36-41
Abstract
Introduction. The aim of the study is to assess the risk of arterio-arterial embolism in patients with cerebral circulatory disorders with stenosis of the internal carotid arteries (ICA) of various degrees, depending on the characteristics of atherosclerotic plaque (ASB), its risk level according to the Plaque-RADS classification.
Materials and methods. The study included 47 patients with symptomatic ICA stenosis (39 men and 8 women aged 61±11 years). All patients underwent duplex scanning of the brachiocephalic arteries, magnetic resonance or computed tomography of the brain and transcranial Doppler monitoring in the mode of embolodetection. Based on the ultrasound data, ASB was classified according to the Plaque-RADS classification.
Results. The relationship between the registration of microembolism and the ASB category according to the Plaque-RADS classification was revealed. The greatest embologenicity was shown by ASBS belonging to categories IV a, IV b, IV c. A smaller number of microemboli were isolated by plaques of the RADS category II.
Conclusions. Plaque embologicity depends not only on the degree of plaque-induced stenosis, but also, to a large extent, on the structure of the ASB.
About the Author
A. V. Vasylyeva
KSMA – Branch Campus of the FSBEI FPE RMACPE MOH Russia;
Republican Clinical Hospital Ministry of health Republic of Tatarsta
Russian Federation
Russian Federation
Anna V. Vasylyeva – Assistant Lecturer of the Department of Functional Diagnostics, Doctor of Functional Diagnostics
Kazan
References
1. Gebreyohhannes, E.A. In-hospital mortality among ischemic stroke patients in Gondar University Hospital: A retrospective cohort study. / Gebreyohhannes E.A., Bhagavathula A.S., Abebe T.B. // Stroke Res Treat. 2019; 2019: 7275063. https://dx.doi.org/10.1155/2019/727506.
2. Global Stroke Statistics 2019./Kim J, Thayabaranathan T, Donnan GA, Howard G, Howard VJ, et al.// Int J Stroke. 2020 Oct; 15(8):pp 819–838.
3. Bokarev, I.N. Atherosclerosis — the problem of modernity // Thrombosis, hemostasis and rheology, 2000. – Vol. 1. – pp. 6–7.
4. Clinical recommendations. Ischemic stroke and transient ischemic attack in adults. All-Russian Society of Neurologists, National Association for Stroke Control, Association of Neurosurgeons of Russia, interregional public organization «Association of Neuroanesthesiologists and Neuro-resuscitators», All-Russian public organization «Union of Rehabilitologists of Russia»// Rubricator of clinical recommendations of the Ministry of Health of Russia. 2021. ID: 171. Access: https://cr.minzdrav.gov.ru/schema/171_2.
5. Fernandez-Alvarez ea. Novel imaging-Based Biomarkers for identifying Carotid Plaque Vulnerability.// Biomolecules 2023, 13, P. 12–36.
6. Johry A.M. et al Recommendation for the assessment of Carotid Arterial Plaque by Ultrasound for the Characterization of Aterosclerosis and Evaluation of Cardiovascular Risk: From the American Society of Echocardiography. – 2020.
7. Chernyavsky M.A., Irtyuga O.B., Yanishevsky S.N. [et al.]. Russian consensus on the diagnosis and treatment of patients with carotid artery stenosis // Russian Journal of Cardiology, 2022. – 27 (11). – Pp. 76–86.
8. Luca Saba, Riccardo Cau, Alessandro Murgia, Andrew N Nicolaides et al. Carotid Plaque-RADS: A Novel Stroke Risk Classification System // JACC Cardiovasc Imaging, 2024 Jan. – 17 (1). – Р. 62–75.
9. Kuznetsov A.N. Cardiogenic and arterio-arterial cerebral embolism, etiology, pathogenesis, clinic, diagnosis, treatment and prevention:// abstract of the dissertation of the Doctor of Medical Sciences. – St. Petersburg: VMA, 2001. – 32.
10. Tegos T.J ea. Carotid plaque echogenicity and types of silent CT-brain infarcts. Is there an association in patients with asymptomatic carotid stenosis. // Int Angiol. 2001 Mar, 20(1):51–7.
11. Shlyk E.V. Microembolism in the cerebral arteries in the acute period of ischemic stroke:// abstract of the dissertation of the Candidate of Medical Sciences. — Moscow, Research Institute of Cerebrovascular Pathology, 2012.
12. Consensus Committee of the Ninth International Cerebral Hemodynamics Symposium. Basic identification criteria of Doppler microembolic signal // Stroke.– 1995 – Vol. 26 – P. 1123.
13. Vasilyeva A.V., Teregulov Yu.E. Mangusheva M.M. et al. Biophysical characteristics of microemboles in patients with acute cerebral circulatory disorders//. Practical Medicine 03 (14), July 2014.
14. Levy C.R., Malley H.M., Fell G. et al. Transcranial Doppler detected cerebral mikroembolism following carotid endarterectomy. High microembolic signal loads predict postoperative cerebral ischemia // Brain. 1997. V. 120. P. 621–629.
15. Abbott A., Chambers B.R, Stork L. et al. Embolic signals and prediction of ipsilateral stroke of transient ischemic attact in asymptomatic carotid stenosis. A mulicenter prospective cohort study // Stroke. 2005. V. 36. P. 1128–1133.
16. Dubrov E.Y., Akhmetov V.V., Alekseechkina O.A. et al. Ultrasound criteria for the embologicity of atherosclerotic plaque of the carotid arteries// Ultrasound and functional diagnostics .2006. (1) pp. 97–104.
17. Delcker A., Diener H.C., Wilhelm H. Cource oh cerebral microembolic signals in occlusion of the internal carotid artery // J.Neurol. 1997. V. 244. (5) P. 312–317.
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For citations:
Vasylyeva A.V. The risk of cerebral microembolism depends on the type of atherosclerotic plaques of the carotid arteries according to the RADS classification. Medical alphabet. 2025;(24):36-41. (In Russ.) https://doi.org/10.33667/2078-5631-2025-24-36-41
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