The size of juxtaluminal hypoechoic area in ultrasound images of asymptomatic carotid plaques predicts the occurrence of stroke

Stavros K. Kakkos, Maura B. Griffin, Andrew N. Nicolaides, Efthyvoulos Kyriacou, Michael M. Sabetai, Thomas Tegos, Gregory C. Makris, Dafydd J. Thomas, George Geroulakos, R. Adovasio, B. Ziani, F. P. Alò, C. G. Cicilioni, G. Ambrosio, A. Andreev, G. M. Andreozzi, F. Verlato, G. Camporese, E. Arosio, E. BarkauskasA. A B Barros D'Sa, P. Brannigan, V. Batchvarova, A. Dramov, P. Belardi, G. P. Novelli, G. Simoni, P. Bell, G. M. Biasi, P. Mingazzini, N. M. Bornstein, D. Bouchier-Hayes, P. Fitzgerald, M. A. Cairols, P. G. Cao, P. DeRango, G. P. Carboni, C. Geoffredo, M. Catalano, B. Chambers, M. Goetzmann, A. Dickinson, D. Clement, M. Bobelyn, S. Coccheri, E. Conti, E. Diamantopoulos, E. A. Andreadis, P. B. Dimakakos, T. Kotsis, B. Eikelboom, L. Entz, A. Ferrari-Bardile, T. Aloi, M. Salerno, J. Fernandes E Fernandes, L. Pedro, D. E. Fitzgerald, A. M. O'Shaughnessy, J. Fletcher, S. Forconi, R. Cappeli, M. Bicchi, S. Arrigucci, V. Gallai, G. Cardaiolli, G. Geroulakos, S. Kakkos, L. F. Gomez-Isaza, G. Gorgoyannis, N. Liasis, M. Graf, P. Guarini, S. Hardy, P. Harris, S. Aston, G. Iosa, A. Katsamouris, A. Giannoukas, M. Krzanowski, G. Ladurner, J. Leal-Monedero, B. B. Lee, C. Liapis, P. Galanis, W. Liboni, E. Pavanelli, E. Mannarino, G. Vaudo, P. McCollum, R. Levison, G. Micieli, D. Bosone, L. Middleton, M. Pantziaris, T. Tyllis, E. Minar, A. Willfort, L. Moggi, P. DeRango, G. Nenci, S. Radicchia, A. Nicolaides, S. Kakkos, D. Thomas, L. Norgren, E. Ribbe, S. Novo, R. Tantillo, D. Olinic, W. Paaske, A. Pagnan, P. Pauletto, V. Pagliara, G. Pettina, C. Pratesi, S. Matticari, J. Polivka, P. Sevcik, P. Poredos, A. Blinc, V. Videcnik, A. Pujia, A. Raso, P. Rispoli, M. Conforti, T. Robinson, M. S J Dennis, S. Rosfors, G. Rudofsky, T. Schroeder, M. L. Gronholdt, G. Simoni, C. Finocchi, G. Rodriguez, C. Spartera, M. Ventura, P. Scarpelli, M. Sprynger, B. Sadzot, C. Hottermans, M. Moonen, P. R. Taylor, A. Tovar-Pardo, J. Negreira, M. Vayssairat, J. M. Faintuch, J. Valaikiené, M. G. Walker, A. R. Wilkinson

Research output: Contribution to journalArticlepeer-review


Objective: To test the hypothesis that the size of a juxtaluminal black (hypoechoic) area (JBA) in ultrasound images of asymptomatic carotid artery plaques predicts future ipsilateral ischemic stroke. Methods: A JBA was defined as an area of pixels with a grayscale value 2, 1.4% in 171 patients with a JBA 4 to 8 mm2, 3.2% in 46 patients with a JBA 8 to 10 mm2, and 5% in 198 patients with a JBA >10 mm2 (P 2, 4-8 mm2, >8 mm2) was still significant after adjusting for other plaque features known to be associated with increased risk, including stenosis, grayscale median, presence of discrete white areas without acoustic shadowing indicating neovascularization, plaque area, and history of contralateral TIA or stroke. Plaque area and grayscale median were not significant. Using the significant variables (stenosis, discrete white areas without acoustic shadowing, JBA, and history of contralateral TIA or stroke), this model predicted the annual risk of stroke for each patient (range, 0.1%-10.0%). The average annual stroke risk was

Original languageEnglish
JournalJournal of Vascular Surgery
Issue number3
Publication statusPublished - Mar 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery


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