Routine assessment of carotid plaques on Doppler USG and associated presenting symptoms at a Tertiary Care Centre, Lahore

https://doi.org/10.53730/ijhs.v6nS9.13996

Authors

  • Madiha Naseer BSc, MBBS, MD, SR Radiology Department, Shaikh Zayed PGMI, Lahore
  • Mahwish Farzana MBBS, MD Radiology, Assistant Professor Radiology Department, Farooq hospital, DHA branch Lahore
  • Muhammad Awais Ahmad Khan Surgery department, University Hospital Wishaw Lanarkshire Trust Scotland
  • Amna Nasir MBBS, Cardiology department, Shaikh zayed Hospital Lahore
  • Alia Ahmad Associate professor, Hematology/Oncology department, University of Child Health Sciences and children's Hospital, Lahore
  • Sidra Javed Mphill Histopathology, Pathology department, Shaikh Zayed Hospital Lahore
  • Saulat Sarfraz MBBS, FCPS, MCPS, Professor and head radiology department, Shaikh Zayed PGMI, Lahore
  • Shafiq Ahmad MBBS DMRD, EX HOD Radiology department, Shaikh Zayed PGMI, Lahore

Keywords:

Carotid artery Plaques, Doppler ultrasound, Atherosclerosis

Abstract

Objective: To determine the frequency of carotid plaques on Doppler USG and associated presenting symptoms at Tertiary Care Centre, Lahore. Methods: A cross-sectional study of 366 individuals was conducted from January 2020 to November 2020 at the Radiology Department of Shiekh Zayed Hospital, Lahore, Pakistan. A consultant radiologist scanned both sides of the extra-cranial carotid artery tree. The DUS of carotid arteries was done with a GE Voluson Expert 730 Doppler ultrasound machine, using a linear probe with a transducer frequency of 6-12.5MHz. Results: A total of 366 patients underwent bilateral carotid Doppler ultrasound examinations. Our findings showed carotid plaques in 156 (42.62%) patients; the majority were males 105(67.53). The mean age recorded was 61.17 ±9.54 years and the mean body mass index was 25.43±3.40 Kg/m2. The highest number of plaques were noted in the left carotid artery 64 (41.03%), the main location was the common carotid artery 88 (56.41%) and, the majority were homogenous plagues 88 (56.41%).The majority of patients presented with headaches 177 (48.36%). Associated comorbidities were diabetes mellitus, hypertension, and dyslipidemia. Conclusion: The accuracy of diagnosing Carotid artery plaques has greatly increased over time payable to radiological innovation.

Downloads

Download data is not yet available.

References

Björkegren Jl, Lusis Aj. Atherosclerosis: recent developments. Cell. 2022 may 2. Https://doi.org/10.1016/j.cell.2022.04.004

Effoe VS, McClendon EE, Rodriguez CJ, Wagenknecht LE, Evans GW, Chang PP, et al. Diabetes status modifies the association between carotid intima-media thickness and incident heart failure: The Atherosclerosis Risk in Communities study. Diabetes research and clinical practice. 2017 Jun 1;128:58-66. Https://doi.org/10.1016/j.diabres.2017.04.009

Yamashita A, Asada Y. Pathology of coronary atherosclerotic plaques and mechanisms of plaque disruption. Annals of Nuclear Cardiology. 2017;3(1):66-72. Https://doi.org/10.17996/anc.17-00011

Wang Y, Meng R, Liu G, Cao C, Chen F, Jin K, et al. Intracranial atherosclerotic disease. Neurobiology of disease. 2019 Apr 1;124:118-32. Https://doi.org/10.1016/j.nbd.2018.11.008

Wang C, Lv G, Zang D. Risk factors of carotid plaque and carotid common artery intima‐media thickening in a high‐stroke‐risk population. Brain and behavior. 2017 Nov;7(11):e00847. Https://doi.org/10.1002/brb3.847

Song P, Fang Z, Wang H, Cai Y, Rahimi K, Zhu Y, Fowkes FG, Fowkes FJ, Rudan I. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modeling study. The Lancet Global Health. 2020 May 1;8(5):e721-9. Https://doi.org/10.1016/s2214-109x(20)30117-0

Pelisek J, Wendorff H, Wendorff C, Kuehnl A, Eckstein HH. Age-associated changes in human carotid atherosclerotic plaques. Annals of Medicine. 2016 Oct 2;48(7):541-51..https://doi.org/10.1080/07853890.2016.1204468

Lu J, Ma X, Shen Y, Wu Q, Wang R, Zhang L, Mo Y, Lu W, Zhu W, Bao Y, Vigersky RA. Time in the range is associated with carotid intima-media thickness in type 2 diabetes. Diabetes technology & therapeutics. 2020 Feb 1;22(2):72-8. Https://doi.org/10.1089/dia.2019.0251

Hoke M, Schillinger M, Minar E, Goliasch G, Binder CJ, Mayer FJ. Carotid ultrasound investigation as a prognostic tool for patients with diabetes mellitus. Cardiovascular diabetology. 2019 Dec;18(1):1-8.

Castelblanco E, Betriu À, Hernández M, Granado-Casas M, Ortega E, Soldevila B, Ramírez-Morros A, Franch-Nadal J, Puig-Domingo M, Fernández E, Avogaro A. Ultrasound tissue characterization of carotid plaques differs between patients with type 1 diabetes and subjects without diabetes. Journal of clinical medicine. 2019 Mar 28;8(4):424. Https://doi.org/10.3390/jcm8040424

Katakami N, Kaneto H, Shimomura I. Carotid ultrasonography: a potent tool for better clinical practice in the diagnosis of atherosclerosis in diabetic patients. Journal of diabetes investigation. 2014 Jan;5(1):3-13. Https://doi.org/10.1111/jdi.12106

Katsiki N, Banach M, Mikhailidis DP. Is type 2 diabetes mellitus a coronary heart disease equivalent or not? Do not just enjoy the debate and forget the patient! Arch Med Sci. 2019; 15 (6): 1357–64. https://doi.org/10.5114/aoms.2019.89449

Ishaque M, de Havenon A, McNally JS, Kalani MY, Park MS. Introduction to Management of Carotid Disease. InCarotid Artery Disease 2020 (pp. 1-5). Springer, Cham.

Ji X, Leng XY, Dong Y, Ma YH, Xu W, Cao XP, et al. Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review. Annals of Translational Medicine. 2019 Nov;7(22). Doi: 10.21037/atm.2019.10.115

Amor AJ, Catalan M, Pérez A, Herreras Z, Pinyol M, Sala-Vila A, Cofán M, Gilabert R, Ros E, Ortega E. Nuclear magnetic resonance lipoprotein abnormalities in newly-diagnosed type 2 diabetes and their association with preclinical carotid atherosclerosis. Atherosclerosis. 2016 Apr 1;247:161-9. Https://doi.org/10.1016/j.atherosclerosis.2016.02.014

Zhan c, Shi M, Yang Y, Pang H, Fei S, Bai l, et al. Prevalence and risk factors of carotid plaque among middle-aged and elderly adults in rural Tianjin, china. Scientific reports. 2016 mar 31;6(1):1-6. Doi: 10.1038/srep23870

De weerd M, Greving Jp, Hedblad B, Lorenz Mw, Mathiesen Eb, O’leary Dh, et al. Prediction of asymptomatic carotid artery stenosis in the general population: identification of high-risk groups. Stroke. 2014 aug;45(8):2366-71. Https://doi.org/10.1161/strokeaha.114.005145

Yang D, Iyer S, Gardener H, Della-Morte D, Crisby M, Dong C, Cheung K, Mora-McLaughlin C, Wright CB, Elkind MS, Sacco RL. Cigarette smoking and carotid plaque echo density in the Northern Manhattan Study. Cerebrovascular Diseases. 2015;40(3-4):136-43.

Kwon Tg, Kim Kw, Park Hw, Jeong Jh, Kim Ky, Bae Jh. Prevalence and significance of carotid plaques in patients with coronary atherosclerosis. Korean circulation journal. 2009 Aug 1;39(8):317-21. Doi 10.4070 / kcj.2009.39.8.317

Gul z, Tazeen A, Farooq Sm, Shabbir I, Asif M, Gilani Sa, Kamran M, Rehman Ku, Ullah I. Sonographic comparison of atherosclerotic changes in carotid arteries of diabetic and non-diabetic individuals. Pakistan journal of medical & health sciences. 2022 Aug 22;16(06):779-. https://doi.org/10.53350/pjmhs22166779

Nizami ma, Yousaf Ma, Liaqat J, Nawaz Kh, Hashmat A. Association of carotid artery disease with various risk factors among patients presenting with ischemic stroke. Pakistan armed forces medical journal. 2022 May 2;72.

Nan h, Feng r, Zhang g, Liu j. Correlation between ultrasonographic findings of lower extremity vascular disease and plaque formation and carotid atherosclerosis in type 2 diabetes mellitus https://dx.doi.org/10.17582/journal.pjz/20201114151119.

Rehana k, shuaib i, khan j, gul h, khattak n, nawab k. Validity of carotid doppler ultrasound for detection of carotid artery plaque keeping computed tomography sensitivity as the reference standard. Pakistan journal of medical & health sciences. 2022 oct 9;16(07):971-. https://doi.org/10.53350/pjmhs22167971

Ahmad s, wahid k, ayub g, khan pj, khan ms, ali o. Validity of carotid doppler ultrasound for detection of carotid stenosis keeping computed tomography sensitivity as the gold standard. Journal of saidu medical college, swat. 2022 Jun 14;12(2):62-5.

Wasay m, Azeemuddin M, Masroor I, Sajjad Z, Ahmed R, Khealani Ba, Malik Ma, Afridi Mb, kamal a. Frequency and outcome of carotid atheromatous disease in patients with stroke in Pakistan. Stroke. 2009 Mar 1;40(3):708-12. Doi.org/10.1161/strokeaha.108.532960

Khattak, m. I., khan, f., fida, z.and zar, et al. 2017. Carotid artery stenosis. The professional medical journal, 24(08): 1126-1131.

Thatipamula MK. Colour doppler evaluation of extracranial carotid vessels in patients of coronary artery disease. European journal of molecular & clinical medicine. 2022 jun 7;9(3):10013-21.

Wang W, Wu Yf, Zhao D, Yang Y, Lang Lr, Wang M, et al. Distribution characteristics and risk factors of carotid atherosclerosis in middle-aged and elderly Chinesese. Zhonghua xin xue guan bing za zhi. 2010 jun 1;38(6):553-7. Pmid: 21033140

Hong Ym. Atherosclerotic cardiovascular disease beginnin-g in childhood. Korean circulation journal. 2010 jan 1;40(1):1-9 https://doi.org/10.4070/kcj.2010.40.1.1

Nolan cj, prentki m. Insulin resistance and insulin hypersecretion in the metabolic syndrome and type 2 diabetes: time for a conceptual framework shift. Diabetes and vascular disease research. 2019 mar;16(2):118-27. 127. Https://doi.org/10.1177/1479164119827611

Gallo A, Mszar R, Miname Mh. Updates on the use of subclinical atherosclerosis to predict the risk of cardiovascular events in heterozygous familial hypercholesterolemia. Current atherosclerosis reports. 2022 Apr 7:1-2. Https://doi.org/10.1007/s11883-022-01017-7

Published

22-02-2023

How to Cite

Naseer, M., Farzana, M., Khan, M. A. A., Nasir, A., Ahmad, A., Javed, S., Sarfraz, S., & Ahmad, S. (2023). Routine assessment of carotid plaques on Doppler USG and associated presenting symptoms at a Tertiary Care Centre, Lahore. International Journal of Health Sciences, 6(S9), 4720–4728. https://doi.org/10.53730/ijhs.v6nS9.13996

Issue

Section

Peer Review Articles

Most read articles by the same author(s)