Utility of Superb micro-vascular imaging ultrasound for the diagnosis of stenotic lesion in carotid artery. An observational study

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K17048
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52020:Neurology-related
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Hagiwara Yuta 聖マリアンナ医科大学, 医学部, 講師 (90811802)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: カラードプラ法 / 頸動脈狭窄性病変 / 頸動脈超音波 / 経口腔頸動脈超音波

Outline of Final Research Achievements

Cerebrovascular disease is the fourth leading cause of death in Japan (2021), and about 10% of all medical expenses are spent on this medical care. Therefore, it is important to suppress the development of stroke. Carotid artery stenosis caused by carotid plaque is one of the causes of cerebral infarction. Carotid artery stenting (CAS) is common treatment for carotid artery stenosis. This study aimed to reduce perioperative complications in CAS and establish safer strategy of the surgery. Recent ultrasounds have a new color Doppler imaging technique for assessing low velocity blood flow such as intra-plaque neovascularization (IPN). IPN might act as nutrient vessels for plaque growth. The present study indicated a significant association between IPN in SMI performed before CAS and development of in-stent restenosis at 6 months after CAS. This study indicated that carotid artery ultrasonography was useful for accurately evaluation for carotid lesions on perioperative CAS procedure.

Free Research Field

脳神経内科学

Academic Significance and Societal Importance of the Research Achievements

頸動脈にプラークが付着し引き起こされる頸動脈狭窄症は、脳梗塞の重大な原因の一つである。頸動脈狭窄を有する患者に対して、ステントで狭窄部を拡張するCASは頸動脈内膜剥離術と並び一般的な治療であるが、しばしば合併症が問題となる。その合併症を減らすために、低侵襲かつ腎毒性がない頸動脈超音波検査による周術期評価が有用と考え、本研究を立案した。本研究によって、術前の超音波所見で新生血管をみとめた症例では、術後のステント内再狭窄を示す可能性が高いことが示された。また術後においても、ステント内の評価に超音波が有用であることが示唆された。本研究の成果は、より安全なCAS手術戦略の立案に寄与するものと考える。