Embolism, Plaque and Stenosis - Cardiovascular Update

Abstract 42: Validation of a New Plaque-RADS Classification System to a Cohort of Embolic Stroke of Undetermined Source Patients

Stroke Journal

FEBRUARY 1, 2024

Introduction:A new Plaque-RADS classification (I-IV) is proposed to categorize the degree of carotid plaque instability and risk of embolic ischemic stroke. Carotid total plaque thickness and ulceration were scored by a neuroradiologist blinded to stroke side. N=188 plaques) met criteria.

Plaque

Plaque Embolism Strokes Stroke

Link Between Clonal Hematopoiesis and Stroke in Carotid Stenosis

All About Cardiovascular System and Disorders

MAY 22, 2024

About a fifth of all ischemic strokes are attributed to embolization of ruptured atherosclerotic plaque from carotid arterial stenosis. But it has been difficult to predict which person with asymptomatic carotid artery stenosis is likely to progress to symptomatic carotid disease and stroke. J Am Coll Cardiol.

Stenosis

Stenosis Strokes Stroke Risk Factors

HonorHealth Research Institute First in Southwest to Implant New Stroke Prevention Stent

DAIC

JUNE 4, 2024

The Neuroguard Integrated Embolic Protection (IEP) system is an experimental treatment for carotid artery stenosis, also known as carotid artery disease, a condition in which fatty-waxy deposits known as plaque builds up and blocks the normal flow of blood in the large arteries on either side of the neck.

Stent

Stent Stents Research Strokes

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Abstract TP176: Radiological Reporting Frequencies of High-Risk Non-Stenosing Carotid Plaque Features: A Follow-Up Observational Study

Stroke Journal

FEBRUARY 1, 2024

Background:High-risk non-stenosing carotid plaque features are emerging as a possible source of embolism in the setting of ESUS. We utilized Fisher’s exact test to compare the frequencies of reporting each plaque characteristic.Results:We analyzed 152 CTA reports in depth.

Plaque

Plaque Stenosis Embolism Strokes

Elder Male with Syncope

EMS 12-Lead

APRIL 9, 2024

The LM has an irregular 30% distal stenosis, followed by an 80% ostial LAD stenosis, and total occlusion of the LAD proximally with TIMI grade 1 flow in the distal vessel. The LCX demonstrates an ostial 80% stenosis prior to the bifurcation of a large OM artery. This latter part has been implicated in embolic CVA.

Ischemia

Ischemia Stenosis Chest Pain Coronary Artery Disease

Epidemiology, Pathophysiology, and Imaging of Atherosclerotic Intracranial Disease

Stroke Journal

JANUARY 21, 2024

The risk of stroke recurrence among patients with ICAD-related stroke is the highest among those with confirmed stroke and stenosis ≥70%. In fact, the 1-year recurrent stroke rate of >20% among those with stenosis >70% is one of the highest rates among common causes of stroke.

Stenosis

Stenosis Thrombosis Dementia Embolism

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection; myocardial disorders, including myocarditis, takotsubo cardiomyopathy, and other cardiomyopathies. There may be a chronic tight stenosis and a non-obstructed lesion that thrombosed.

Coronary Angiogram

Coronary Angiogram Plaque Thrombosis STEMI

Concerning EKG with a Non-obstructive angiogram. What happened?

Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. Smith's comments in the May 19, 2020 post : — Non-obstructive coronary disease does not ne cessarily imply no plaque rupture with thrombus.

Plaque

Plaque Angina Blog Stents

Abstract TMP68: Proximal Balloon Occlusion With Forced Aspiration (POWER) Technique Should Be Effective in Preventing Distal Microembolization During Carotid Artery Stenting With the Filter Protection Device

Stroke Journal

FEBRUARY 1, 2024

We have developed a Proximal balloon Occlusion With forcEd aspiRation (POWER) technique to prevent distal embolization in CAS with the filter protection device. Symptomatic stenosis (63.9% The concept of this technique was to standardize the three points: (1) aspiration force, (2) timing of aspiration and (3) use of balloon guiding.

Stents

Stents Stent Stenosis Embolism

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

To prove there is no plaque rupture, you need to do intravascular ultrasound (IVUS). An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!! One of the most common is rupture of a non-obstructive plaque, with thrombus formation and OMI that spontaneously lyses and leaves a wide open artery. It can only be seen by IVUS.

Plaque

Plaque Chest Pain Thrombosis Stenosis

1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

MAY 19, 2020

If the arrest was caused by acute MI due to plaque rupture, then the diagnosis is MINOCA. Here is my comment on MINOCA: "Non-obstructive coronary disease" does not necessarily imply "no plaque rupture with thrombus." They often cannot even be recognized as culprits, as fissured or ulcerated plaque. myocarditis).

Defibrillator

Defibrillator Circulation Plaque Cardiac Arrest

American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

DAIC

FEBRUARY 29, 2024

24: Joint American College of Cardiology/Journal of the American College of Cardiology Late-Breaking Clinical Trials (Session 402) Saturday, April 6 9:30 – 10:30 a.m.

Aortic valve

Aortic valve Myocardial Infarction Aortic Blood Pressure

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Dr. Smith's ECG Blog

MAY 10, 2023

LAD plaque with 0-25 percent stenosis. The LAD has moderate 40% ostial-proximal LAD stenosis and severe 90% mid LAD stenosis involving first diagonal branch. --The If there are T-wave inversions and elevated trops in the context of persistent pain, think of other pathologies such as pulmonary embolism.

Coronary Angiogram

Coronary Angiogram Chest Pain Stenosis STEMI

Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

JANUARY 15, 2024

In addition, the top left blue arrow indicates a section in the LAD with a severe stenosis, likely the culprit for the prior L A D occlusion which has since recanalized. Then, part of the thrombus embolized into the LCx causing an inferoposterolateral OMI. (As There are also diagonal branches which are not well visualized.

Chest Pain

Chest Pain Blog Arrhythmia Critical Care

Prevalence of High-Risk CTA-Based Carotid Plaque-RADS Subtypes in Patients With Embolic Stroke of Undetermined Source

Stroke Journal

JANUARY 24, 2025

BACKGROUND:A modified computed tomography angiography (CTA)based Carotid Plaque Reporting and Data System (Plaque-RADS) classification was applied to a cohort of patients with embolic stroke of undetermined source to test whether high-risk Plaque-RADS subtypes are more prevalent on the ipsilateral side of stroke.

Plaque

Plaque Embolism Strokes Stroke

Abstract 42: Validation of a New Plaque-RADS Classification System to a Cohort of Embolic Stroke of Undetermined Source Patients

Link Between Clonal Hematopoiesis and Stroke in Carotid Stenosis

HonorHealth Research Institute First in Southwest to Implant New Stroke Prevention Stent

Webinars

Abstract TP176: Radiological Reporting Frequencies of High-Risk Non-Stenosing Carotid Plaque Features: A Follow-Up Observational Study

Elder Male with Syncope

Epidemiology, Pathophysiology, and Imaging of Atherosclerotic Intracranial Disease

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Concerning EKG with a Non-obstructive angiogram. What happened?

Abstract TMP68: Proximal Balloon Occlusion With Forced Aspiration (POWER) Technique Should Be Effective in Preventing Distal Microembolization During Carotid Artery Stenting With the Filter Protection Device

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

1 hour of CPR, then ECMO circulation, then successful defibrillation.

American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day

Noisy, low amplitude ECG in a patient with chest pain

Prevalence of High-Risk CTA-Based Carotid Plaque-RADS Subtypes in Patients With Embolic Stroke of Undetermined Source

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