Analysis of calcium in carotid plaques with agatston scores for appropriate selection of surgical intervention

• Published in: Stroke (1970) 2007-11, Vol.38 (11), p.3040-3044
• Main Authors: KATANO, Hiroyuki, YAMADA, Kazuo
• Format: Article
• Language: English
• Subjects: Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Calcinosis - diagnostic imaging; Calcinosis - pathology; Calcinosis - surgery; Cardiology. Vascular system; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Arteries - surgery; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - pathology; Carotid Artery Diseases - surgery; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - pathology; Carotid Stenosis - surgery; Disability Evaluation; Endarterectomy, Carotid - standards; Female; Humans; Male; Medical sciences; Middle Aged; Neurology; Neurosurgery; Patient Selection; Predictive Value of Tests; Preoperative Care - methods; Sensitivity and Specificity; Skull, brain, vascular surgery; Stents - standards; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed - methods; Vascular diseases and vascular malformations of the nervous system; Vascular Surgical Procedures - standards
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.107.490581

The aim of the study was to determine whether the Agatston calcium score might be applied as a useful tool for evaluation of carotid stenosis. A total of 124 carotid bifurcations were examined with multidetector row CT. Calcium scores were determined according to the method described by Agatston et al. Agatston scores generally appear appropriate for evaluation of calcified plaques. Calcified lesions with bigger differences between mean and peak Hounsfield unit (HU) in single cases accounted for only 34.3% of those with volume scores under 500 mm(3), whereas 81.3% (P500 mm(3). The Agatston calcium score is useful in evaluating carotid plaques with calcium. We recommend, however, individual analyses for quality (hardness) and quantity (volume) of each large calcified focus (>500 mm(3)) by multidetector row CT lesions in order to provide indications for surgical treatment of carotid stenosis, carotid endarterectomy or carotid artery stenting.