Predicting Stroke Risk in Patients with Carotid Artery Stenosis Using Contrast Enhanced Carotid Duplex Ultrasound to Quantify Plaque Vasa-Vasorum Volume: Results of a Pilot Study

Introduction: In selecting patients for carotid revascularization, relying solely on symptoms and/or degree of stenosis is not sufficient. Patients with severe stenosis often remain asymptomatic, while other patients with moderate stenosis experience stroke. In contemporary practice, surgery or intervention is carried out much more often in asymptomatic patients. With the advent of improved medical management, the indications for surgery or intervention in the asymptomatic have become unclear. We utilized a technique for measuring Plaque Vasavasorum Volume (PVV) using Contrast Enhanced Carotid Duplex Ultrasound (CECDU) as a novel method for identifying asymptomatic patients with carotid artery stenosis who are at highest risk for stroke and thus more likely to benefit from early revascularization.