title: Plaque Imaging to Decide on Optimal Treatment: Medical Versus Carotid Endarterectomy Versus Carotid Artery Stenting.
abstract: Many of the current guidelines for the management of carotid atherosclerosis are based on clinical trial findings published more than 2 decades ago. The lack of plaque information in clinical decision making represents a major shortcoming and highlights the need for contemporary trials based on characteristics of the atherosclerotic lesion itself, rather than luminal stenosis alone. This article summarizes the major dilemmas clinicians face in current practice, and discusses the rationale and evidence that plaque imaging may help to address these challenges and optimize the clinical management of carotid artery disease in the future.
authors.affiliation: Department of Radiology, University of Washington, 850 Republican Street, Seattle, WA 98109, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Surgery, University of Washington, 850 Republican Street, Seattle, WA 98109, USA. Electronic address: tomhat@u.washington.edu.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Hatsukami
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods*; D016894:Endarterectomy, Carotid / Q000379:methods*; D019317:Evidence-Based Medicine; D018810:Magnetic Resonance Angiography / Q000379:methods*; D011300:Preoperative Care; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Carotid artery disease; Carotid artery stenting; Carotid endarterectomy; MR imaging; Optimal medical therapy