Significance of neovascularization of carotid plaque as a new preventive factor for ischemic stroke

• Project/Area Number: 18K15568
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Hyogo Medical University
• Principal Investigator: Yamada Kiyofumi 兵庫医科大学, 医学部, 非常勤講師 (40402200)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000); Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: 頚動脈狭窄症 / 新生血管 / 脳梗塞 / プラークイメージング / 内頚動脈狭窄 / プラーク / 内頚動脈狭窄症 / 頚動脈プラーク / 光干渉断層画像 / MRI / 光干渉断層法 / プラーク内新生血管 / MRIプラークイメージング / 狭窄度進行

Outline of Final Research Achievements

The purpose of this study was to compare the presence of intraplaque neovascularization (NV) and ischemic symptom or plaque progression in the patients with carotid artery stenosis and clarify the clinical role of NV using optical frequency domain imaging (OFDI).
We performed quantitative analysis of NV using OFDI in the patients with carotid artery stenosis who were treated by carotid artery stenting. The number of NV and smoking habit were significantly larger in the patients with progression of stenosis. In multivariate logistic regression analysis, the number of NV was the independent predictor of progression of stroke. We also reported the case that NV might correlate with plaque progression and in-stent restenosis in carotid artery plaque.

Academic Significance and Societal Importance of the Research Achievements

本研究の結果から、プラーク内新生血管は狭窄進行やステント再狭窄に影響を及ぼす因子であることが示唆された。これによりプラーク内新生血管は、頚動脈狭窄症における脳虚血生イベント発症予測や頚動脈ステント留置術後の再狭窄予測に有用な因子であることが予想され、新たな診断マーカーとして脳梗塞予防もしくは外科的治療の成績向上に貢献できるものと考えられた。

Research Products

• [Journal Article] Carotid Artery Stenting Using a Double-layer Micromesh Stent (2020)
  • Author(s): Yamada K, Yoshimura S, Yoshida K, Uchida K, Shirakawa M, Kawasaki M, Miura M, Ishii A, Kataoka H, Miyamoto S.
  • Journal Title: Journal of Neuroendovascular Therapy Volume: 14 Issue: 10 Pages: 407-412
  • DOI: 10.5797/jnet.ra.2020-0066
  • NAID: 130007928377
  • ISSN: 1882-4072, 2186-2494
  • Peer Reviewed
• [Journal Article] A Patient with Carotid Mobile Plaques Treated by Carotid Artery Stenting Using a Double-layer Micromesh Stent (2020)
  • Author(s): Kuwahara S, Matsukawa H, Yamada K, Uchida K, Shirakawa M, Yoshimura S.
  • Journal Title: Journal of Neuroendovascular Therapy Volume: 14 Issue: 11 Pages: 495-500
  • DOI: 10.5797/jnet.cr.2019-0045
  • NAID: 130007941517
  • ISSN: 1882-4072, 2186-2494
  • Peer Reviewed
• [Journal Article] Presence of plaque neovascularization on optical frequency domain imaging predicts progression of carotid artery stenosis. (2019)
  • Author(s): Miura M, Yoshimura S, Yamada K, Kanamaru T, Matsumoto K, Shindo S, Uchida K, Shirakawa M, Kawasaki M, Ando Y.
  • Journal Title: World Neurosurgery Volume: 127 Pages: 330-336
  • DOI: 10.1016/j.wneu.2019.02.249
  • Peer Reviewed
• [Journal Article] Asymptomatic moderate carotid artery stenosis with intraplaque hemorrhage ~ Progression of degree of stenosis and new ischemic stroke ~. (2019)
  • Author(s): Yamada K, Yoshimura S, Shirakawa M, Uchida K, Nakahara S, Nishida S, Iwamoto Y, Sato Y, Kawasaki M
  • Journal Title: Journal of Clinical Neuroscience Volume: 63 Pages: 95-99
  • DOI: 10.1016/j.jocn.2019.01.033
  • Peer Reviewed
• [Journal Article] Magnetic Resonance Carotid Plaque Imaging (2018)
  • Author(s): Yamada K, Yoshimura S.
  • Journal Title: Journal of Neuroendovascular Therapy Volume: 12 Issue: 12 Pages: 597-602
  • DOI: 10.5797/jnet.ra.2018-0063
  • NAID: 130007536245
  • ISSN: 1882-4072, 2186-2494
  • Peer Reviewed / Open Access
• [Journal Article] Optical Coherence Tomography/Optical Frequency Domain Imaging: Imaging Application for Assessment of Human Carotid Plaque (2018)
  • Author(s): Miura M, Yamada K, Yoshimura S.
  • Journal Title: Journal of Neuroendovascular Therapy Volume: 12 Issue: 12 Pages: 609-616
  • DOI: 10.5797/jnet.ra.2018-0062
  • NAID: 130007536248
  • ISSN: 1882-4072, 2186-2494
  • Peer Reviewed / Open Access
• [Journal Article] Optical frequency domain imaging evaluation of progressive carotid plaque and in-stent restenosis lesion with multiple neovascularizations. (2018)
  • Author(s): Miura M, Yamada K, Shindo S, Matsumoto K, Uchida K, Shirakawa M, Kuramoto Y, Yoshimura S.
  • Journal Title: World Neurosurgery Volume: 119 Pages: 54-57
  • DOI: 10.1016/j.wneu.2018.07.005
  • Peer Reviewed
• [Presentation] 新規Double layer micromesh stentを使用したCAS (2020)
  • Author(s): 山田 清文、吉村 紳一、三浦 正智、金丸 拓也、白川 学、内田 和孝、石井 暁、吉田 和道、宮本 享
  • Organizer: 第７回日本心血管脳卒中学会
• [Presentation] 不安定プラークにおけるマイクロメッシュステントの有用性 (2020)
  • Author(s): 山田 清文、三浦 正智、金丸 拓也、白川 学、内田 和孝、吉村 紳一
  • Organizer: 第36回日本脳神経血管内治療学会
• [Presentation] 頚動脈ステント留置術前MRIプラークイメージングに関する前向き他施設登録研究 (2020)
  • Author(s): 山田清文、吉村紳一、白川学、榎本由貴子、小島隆生、若林和樹、Chun Yuan、吉田和道、宮本享
  • Organizer: 第35回日本脳神経血管内治療学会学術総会
• [Presentation] CAS後plaque protrusionの検出に関する研究 ～光干渉断層診断法と血管内超音波との比較～ (2018)
  • Author(s): 山田清文、三浦正智、白川学、内田和孝、松本一真、ラファエル・サヤゴ、吉村紳一
  • Organizer: 第34回日本脳神経血管内治療学会学術総会