title: Use of Contrast-Enhanced Ultrasound in Carotid Atherosclerotic Disease: Limits and Perspectives.
abstract: Contrast-enhanced ultrasound (CEUS) has recently become one of the most versatile and powerful diagnostic tools in vascular surgery. One of the most interesting fields of application of this technique is the study of the carotid atherosclerotic plaque vascularization and its correlation with neurological symptoms (transient ischemic attack, minor stroke, and major stroke) and with the characteristics of the "vulnerable plaque" (surface ulceration, hypoechoic plaques, intraplaque hemorrhage, thinner fibrous cap, and carotid plaque neovascularization at histopathological analysis of the sample after surgical removal). The purpose of this review is to collect all the original studies available in literature (24 studies with 1356 patients enrolled) and to discuss the state of the art, limits, and future perspectives of CEUS analysis. The results of this work confirm the reliability of this imaging study for the detection of plaques with high risk of embolization; however, a shared, user-friendly protocol of imaging analysis is not available yet. The definition of this operative protocol becomes mandatory in order to compare results from different centers and to validate a cerebrovascular risk stratification of the carotid atherosclerotic lesions evaluated with CEUS.
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Varetto
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Gibello
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Castagno
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Quaglino
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ripepi
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Benintende
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gattuso
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Garneri
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zan
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Capaldi
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Bertoldo
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Molinette Corso Bramante 88, 10126 Torino, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Rispoli
mesh_terms: D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D014463:Ultrasonography