主-髂动脉闭塞侧支循环形成的CTA表现

目的 探讨主-髂动脉闭塞伴侧支血管形成的多层螺旋CT血管成像(MSCTA)表现. 资料与方法 分析9例主-髂动脉闭塞伴侧支血管形成的MSCTA表现. 结果 9例主-髂动脉完全性闭塞,CTA显示侧支血管主要通过以下三条通路吻合:下位肋间后动脉与旋髂深动脉吻合、腹壁上动脉与腹壁下动脉吻合以及肠系膜下动脉(IMA)远段通过迂曲扩张的Riolan动脉弓与肠系膜上动脉(SMA)形成吻合. 结论 MSCTA可显示主-髂动脉闭塞患者的主要侧支血管情况.     

Internal Iliac Artery Embolization during an Endovascular Aneurysm Repair with Detachable Interlock Microcoils

Objective

The purpose of this study was to evaluate the effectiveness of detachable interlock microcoils for an embolization of the internal iliac artery during an endovascular aneurysm repair (EVAR).

Materials and Methods

A retrospective review was conducted on 40 patients with aortic aneurysms, who had undergone an EVAR between January 2010 and March 2012. Among them, 16 patients were referred for embolization of the internal iliac artery for the prevention of type II endoleaks. Among 16 patients, 13 patients underwent embolization using detachable interlock microcoils during an EVAR. Computed tomographic angiographies and clinical examinations were performed during the follow-up period. Technical success, clinical outcome, and complications were reviewed.

Results

Internal iliac artery embolizations using detachable interlock microcoils were technically successful in all 13 patients, with no occurrence of procedure-related complications. Follow-up imaging was accomplished in the 13 cases. In all cases, type II endoleak was not observed with computed tomographic angiography during the median follow-up of 3 months (range, 1-27 months) and the median clinical follow-up of 12 months (range, 1-27 months). Two of 13 (15%) patients had symptoms of buttock pain, and one patient died due to underlying stomach cancer. No significant clinical symptoms such as bowel ischemia were observed.

Conclusion

Internal iliac artery embolization during an EVAR using detachable interlock microcoils to prevent type II endoleaks appears safe and effective, although this should be further proven in a larger population.     

A Newly Designed Nitinol Stent: Early Clinical Experience in the Treatment of Iliac Artery Stenoses and Occlusions

Objective

To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions.

Materials and Methods

Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty.

Results

In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63±0.30 to 0.99±0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8±8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed.

Conclusion

The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.     

Celiac Axis Stenosis: Incidence and Etiologies in Asymptomatic Individuals

Objective

To determine the incidence and etiologies of celiac axis stenosis in asymptomatic individuals.

Materials and Methods

This prospective study involved 400 consecutive patients (male: 319, female: 81) referred to us for celiac arteriography between April and July 1999. When celiac axis branches were opacified by collateral circulation during superior mesenteric arteriography, the presence of celiac axis stenosis was suspected; lateral projection celiac arteriography was performed and the pressure gradient was measured. The indicators used to determine whether or not celiac axis stenosis was significant were luminal narrowing of more than 50% and a resultant pressure gradient of at least 10 mmHg. Its etiology was determined on the basis of angiographic appearances and CT findings.

Results

Twenty-nine patients (7.3%) had celiac axis stenosis. The etiology of the condition was extrinsic compression due to the median arcuate ligament in 16 patients (55%) and atherosclerosis in three (10%), while in ten (35%) it was not determined. The incidence of celiac axis stenosis did not vary significantly according to sex, age and the presence of calcified aortic plaque representing atherosclerosis.

Conclusion

The incidence of hemodynamically significant celiac axis stenosis in this asymptomatic Korean population was 7.3% and the most important etiology was extrinsic compression by the median arcuate ligament of the diaphragm. Atherosclerosis was only a minor cause of the condition.     

Transcatheter Arterial Embolization of Arterial Esophageal Bleeding with the Use of N-Butyl Cyanoacrylate

Objective

To evaluate the clinical efficacy and safety of a transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding.

Materials and Methods

Between August 2000 and April 2008, five patients diagnosed with arterial esophageal bleeding by conventional angiography, CT-angiography or endoscopy, underwent a TAE with NBCA. We mixed NBCA with iodized oil at ratios of 1:1 to 1:4 to supply radiopacity and achieve a proper polymerization time. After embolization, we evaluated the angiographic and clinical success, recurrent bleeding, and procedure-related complications.

Results

The bleeding esophageal artery directly originated from the aorta in four patients and from the left inferior phrenic artery in one patient. Although four patients had an underlying coagulopathy at the time of the TAE, angiographic and clinical success was achieved in all five patients. In addition, no procedure-related complications such as esophageal infarction were observed during this study.

Conclusion

NBCA can be an effective and feasible embolic agent in patients with active arterial esophageal bleeding, even with pre-existing coagulopathy.     

Post-Operative Hemorrhage after Myomectomy: Safety and Efficacy of Transcatheter Uterine Artery Embolization

Objective

To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage.

Materials and Methods

We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients'' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted.

Results

The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients.

Conclusion

Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.     

Outcome of Endovascular Treatment in Symptomatic Intracranial Vascular Stenosis

Objective

The outcome evaluation for the revascularization of intracranial vascular stenoses has not been fully described due to the highly technical nature of the procedure. We report here on the early and late clinical outcomes of angioplasty and/or stenting of symptomatic severe intracranial vascular stenoses at a single institute.

Materials and Methods

Since 1995, we have treated 35 patients with symptomatic intracranial vascular stenosis (more than 70% stenosis, mean stenosis: 78.6% ± 6.2%). Angioplasty (n = 19) was performed for the horizontal segment of the middle cerebral artery (M1) (n = 16) and the basilar artery (BA) (n = 1), the intradural vertebral artery (VA) (n = 1), and the cavernous internal carotid artery (ICA) (n = 1). Stenting (n = 16) was performed for the cavernous or petrous ICAs (n = 9), the intradural VA (n = 3), BA (n = 2), and M1 (n = 2) artery. We assessed the angiographic success (defined as residual stenosis < 50%) rate, the periprocedural complications during the 30-day periprocedural period, the symptomatic recurrence and restenosis during a mean 22-month follow-up (FU) period. The Kaplan-Meier estimate of the cumulative event-free rate of the major cerebrovascular events, i.e. death, stroke or restenosis, was also done.

Results

Angiographic success was achieved in 97% of our patients (34/35). There were four procedure-related complications (11%) including a death and a minor stroke. During the mean 22-month FU, the asymptomatic restenosis rate was 9% and the symptomatic restenosis rate was 6% in the target lesion and 9% in all the vascular territories. The Kaplan-Meier estimate was 70.6% (95% confidence interval = 46.5-94.7) after 33 months of FU.

Conclusion

In addition to a high angiographic success rate and an acceptable periprocedural complication rate, intracranial angioplasty and/or stenting revealed a relatively low symptomatic recurrence rate. Hemorrhage is a rare, but the physician must aware that potentially fatal periprocedural complications can occur.     

Stent Placement for Chronic Iliac Arterial Occlusive Disease: the Results of 10 Years Experience in a Single Institution

Objective

We wanted to retrospectively evaluate the long-term therapeutic results of iliac arterial stent placement that was done in a single institution for 10 years.

Materials and Methods

From May 1994 to April 2004, 206 patients who underwent iliac arterial stent placement (mean age; 64±8.8) were followed up for evaluating the long term stent patency. Combined or subsequent bypass surgery was performed in 72 patients. The follow up period ranged from one month to 120 months (mean; 31±25.2 months). The factors that were analyzed for their effect on the patency of stents were age, the stent type and diameter, the lesion site, lesion shape, lesion length, the Society of Cardiovascular and Interventinal Radiology criteria, the total run off scores, the Fontaine stage and the cardiovascular risk factors (diabetes mellitus, hypertension and smoking). Follow-up included angiography and/or CT angiography, color Doppler sonography and clinical evaluation with the ankle-brachial index.

Results

Two hundred and eighty-four stents were placed in 249 limbs of 203 patients. The technical success rate was 98% (203/206). The primary patency rates of the stents at 3, 5, 7 and 10 year were 87%, 83%, 61% and 49%, respectively. One hundred seventy-seven patients maintained the primary stent patency until the final follow up and 26 patients showed stenosis or obstruction during the follow up. Secondary intervention was performed in thirteen patients. Lesions in the external iliac artery (EIA) or lesions in both the common iliac artery (CIA) and EIA were a poor prognostic factor for stent patency. The run off score and stent diameter also showed statistically significant influence on stent patency. The overall complication rate was 6%.

Conclusion

Iliac arterial stent placement is a safe treatment with favorable long term patency. Lesions in the EIA or lesions in both the EIA and CIA, poor run off vessels and a stent having the same or a larger diameter than 10 mm were the poor prognostic factors for long term stent patency.     

Coronary Artery Disease in Asymptomatic Young Adults: Its Prevalence According to Coronary Artery Disease Risk Stratification and the CT Characteristics

Objective

We aimed at evaluating the prevalence and CT characteristics of occult coronary artery disease (CAD) in young Korean adults under 40 years of age by performing coronary CT angiography (CCTA).

Materials and Methods

We retrospectively enrolled 112 consecutive asymptomatic subjects (90 men, mean age: 35.6 ± 3.7 years) who underwent CCTA as part of a general health evaluation. We classified the subjects into three National Cholesterol Education Program risk categories and we assessed the plaque characteristics on CCTA according to the number of involved vessels, the location and type of plaques and vascular remodeling.

Results

Twelve individuals had CAD (11%, 11 men). The prevalence of CAD was significantly higher in the subgroups with moderate (22%) or high (25%) risk than that in the low risk subgroup (5%) (p < 0.05). Nine patients had single-vessel disease and three patients had two-vessel disease. The most common location for plaque was the proximal left anterior descending coronary artery (60%). All the patients had non-significant stenosis and plaque, including the non-calcified (27%), mixed (47%) and calcified (27%) types. Positive vascular remodeling was identified in all the patients with non-calcified or mixed plaques.

Conclusion

The prevalence of occult CAD was not negligible in the asymptomatic young adults with moderate to high risk, and this suggests the importance of management and risk factor modification in this population. All the patients had non-significant stenosis, and one fourth of the plaques did not show calcification.     

Use of Self-Expanding Stents for the Treatment of Vertebral Artery Ostial Stenosis: a Single Center Experience

Objective

To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results.

Materials and Methods

A total of 20 lesions in 20 patients underwent stenting of the VAOS using a self-expanding stent (Precise RX; Cordis Neurovascular, Miami Lakes, FL). Two patients were asymptomatic. We analyzed the technical success rate, causes of technical failure, occurrence of any vascular or neurological event, and the occurrence of any neurological abnormality or in-stent restenosis (ISR) seen on follow-up. The imaging follow-up was performed with Doppler ultrasound (DUS) as a primary screening modality.

Results

One instance of technical failure was caused by failure of the guidewire passage. The stent diameter was 5 mm, and post-stenting balloon dilatations were necessary in all cases. Stent misplacement requiring placement of an additional stent occurred in four cases. Following a 14.8 month average clinical follow-up time, two patients showed anterior circulation ischemia, which was not attributed to the VAOS we treated. Following a 13.7 month average DUS follow-up, five patients showed a mild degree of diffuse or focal intimal thickening in the stent lumen; however, none of the stenosis showed luminal loss of more than 50% and no stent fracture was noted.

Conclusion

The use of self-expanding stents for treating VAOS was technically feasible and helped to improve artery patency during our limited follow-up interval.     

Cryptogenic Hemoptysis: Effectiveness of Bronchial Artery Embolization Using N-Butyl Cyanoacrylate

Purpose

To describe angiographic findings and assess safety and effectiveness of bronchial artery embolization (BAE) with N-butyl cyanoacrylate (NBCA) in patients with cryptogenic hemoptysis (CH).

Unruptured Aneurysms with Cranial Nerve Symptoms: Efficacy of Endosaccular Guglielmi Detachable Coil Treatment

Objective

To evaluate the efficacy of endosaccular Guglielmi detachable coil (GDC) treatment of unruptured aneurysms causing cranial nerve (CN) symptoms.

Materials and Methods

Among a database of 218 patients whose aneurysms were treated using GDC, seven patients met the criteria for unruptured aneurysms presenting with symptoms and signs of CN palsy. Changes in CN symptoms before and after GDC treatment were reviewed.

Results

Aneurysms were located in the internal carotid-posterior communicating artery (n=3), the basilar bifurcation (n=1) and the cavernous internal carotid artery (n=3). CN symptoms included ptosis (n=6), mydriasis (n=2), and extraocular muscle (EOM) disorder (CN III: n=4; CN VI: n=3). Overall, improvement or resolution of CN symptoms after treatment was noted in five patients. CN symptoms in cases involving small (≤ 10 mm) and intradural aneurysms tended to respond better to GDC treatment. Ptosis was the initial symptom to show improvement, while EOM dysfunction responded least favourably.

Conclusion

GDC coil packing appears to be an appropriate treatment method for the relief of CN symptoms associated with intracranial aneurysms.     

Looking a bit superficial to the pleura

Background

The internal thoracic artery (ITA) is a descendant branch of the subclavian artery. The former is located bilaterally in both internal sides of the thorax near the sternum and is accompanied by two internal thoracic veins (ITV). From a practical point of view, the ITA (and the ITV) identification is important because these vessels can be injured when pericardiocentesis with the parasternal approach is used. Other advantage of the ITA recognition is to check the patency of the ITA grafts in coronary artery revascularizated patients with new onset chest pain. The purpose of this article is to introduce a simple ultrasonographic technique for recognition of the aforementioned vessels and to highlight the utility of this finding in clinical practice.

Findings

With linear probe and along paraesternal line, the internal thoracic vessels are recognized on grayscale imaging as an anechoic tubular structure immediately anterior to pleural line. Color Doppler identifies a pulsatile (ITA) and a non-pulsatile (ITV) flow. Spectral Doppler normally shows a high resistance velocity profile in non-grafted ITA and a phasic flow in ITV. A biphasic low resistance velocity profile is normally expected in the grafted and permeable ITA.

Conclusions

The ITA (non-grafted) and ITV are recognized routinely along the parasternal line. The operators should identify these vessels when the parasternal approach pericardiocentesis is required and should also consider obtaining spectral Doppler images to check permeability of grafted ITA in coronary artery bypass graft patients with chest pain.     

Renal Artery Embolization Using a New Liquid Embolic Material Obtained by Partial Hydrolysis of Polyvinyl Acetate (Embol): Initial Experience in Six Patients

Objective

To evaluate the therapeutic efficacy of a new liquid embolic material, Embol, in embolization of the renal artery.

Materials and Methods

Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed.

Results

The six patients showed immediate total occlusion of their renal vascular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hypertension.

Conclusion

Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.     

Transcatheter Arterial Embolization of Nonvariceal Upper Gastrointestinal Bleeding with N-Butyl Cyanoacrylate

Objective

To evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-Butyl Cyanoacrylate (NBCA) for nonvariceal upper gastrointestinal bleeding.

Materials and Methods

Between March 1999 and December 2002, TAE for nonvariceal upper gastrointestinal bleeding was performed in 93 patients. The endoscopic approach had failed or was discarded as an approach for control of bleeding in all study patients. Among the 93 patients NBCA was used as the primary embolic material for TAE in 32 patients (28 men, four women; mean age, 59.1 years). The indications for choosing NBCA as the embolic material were: inability to advance the microcatheter to the bleeding site and effective wedging of the microcatheter into the bleeding artery. TAE was performed using 1:1-1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure related complications and clinical outcomes were evaluated.

Results

The angiographic and clinical success rates were 100% and 91% (29/32), respectively. There were no serious ischemic complications. Recurrent bleeding occurred in three patients (9%) and they were managed with emergency surgery (n = 1) and with a successful second TAE (n = 2). Eighteen patients (56%) had a coagulopathy at the time of TAE and the clinical success rate in this group of patients was 83% (15/18).

Conclusion

TAE with NBCA is a highly effective and safe treatment modality for nonvariceal upper gastrointestinal bleeding, especially when it is not possible to advance the microcatheter to the bleeding site and when the patient has a coagulopathy.     

The Benefits of Internal Thoracic Artery Catheterization in Patients With Chronic Abdominal Aortic Occlusion

Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor technical equipment. This study was designed to show the benefit of the selective internal thoracic angiography in cases with complete aortic occlusion. We present 30 patients with chronic aortic abdominal occlusion who were submitted to the transaxillary aortography and selective ITA angiography with purpose of distal run off evaluation. Angiographic evaluation was performed by two independent radiologists according to previously defined classification. Good angiographic score via internal thoracic angiography by first observer was achieved in 19 (63.3%) patients and in 18 (60%) by a second observer. Transaxillary aortography showed inferior results: good angiographic score by the first observer in six (20%) patients and by the second observer in three (3%) patients. Low extremity run-off is better visualized during internal thoracic angiography than during transaxillary aortography.     

Comparison of the Effectiveness of Embolic Agents for Bronchial Artery Embolization: Gelfoam versus Polyvinyl Alcohol

Objective

The purpose of this study was to compare the results of different agents for bronchial artery embolization of hemoptysis.

Materials and Methods

From March 1992 to December 2006, a bronchial artery embolization was performed on 430 patients with hemoptysis. The patients were divided into three groups. Group 1 included 74 patients treated with a gelfoam particle (1×1×1 mm), while group 2 comprised of 205 patients treated with polyvinyl alcohol (PVA) at 355-500 µm, and group 3 included 151 patients treated with PVA at 500-710 µm. We categorized the results as technical and clinical successes, and also included the mid-term results. Retrospectively, the technical success was compared immediately after the procedure. The clinical success and mid-term results (percentage of patients who were free of hemoptysis) were compared at 1 and 12 months after the procedure, respectively.

Results

Neither the technical successes (group 1; 85%, 2; 85%, 3; 90%) nor the clinical successes (group 1; 72%, 2; 74%, 3; 71%) showed a significant difference among the 3 groups (p > 0.05). However, the mid-term results (group 1; 45%, 2; 63%, 3; 62%) and mid-term results excluding the recurrence from collateral vessels in each of the groups (group 1; 1 patient, 2; 4 patients, 3; 2 patients) showed that group 1 was lower than the other two groups (p < 0.05). No significant difference was discovered for the mid-term results between groups 2 and 3. Moreover, the same results not including incidences of recurrence from collateral vessels also showed no statistical significance between the two groups (p > 0.05).

Conclusion

Polyvinyl alcohol appears to be the more optimal modality compared to gelfoam particle for bronchial artery embolization in order to improve the mid-term results. The material size of PVA needs to be selected to match with the vascular diameter.     

Superficial Endobronchial Lung Cancer: Radiologic-Pathologic Correlation

Objective

To analyze the plain chest radiographic and CT findings of superficial endobronchial lung cancer and to correlate these with the findings of histopathology.

Materials and Methods

This study involved 19 consecutive patients with pathologically proven lung cancer confined to the bronchial wall. Chest radiographs and CT scans were reviewed for the presence of parenchymal abnormalities, endobronchial nodules, bronchial obstruction, and bronchial wall thickening and stenosis. The CT and histopathologic findings were compared.

Results

Sixteen of the 19 patients had abnormal chest radiographic findings, while in 15 (79%), CT revealed bronchial abnormalities: an endobronchial nodule in seven, bronchial obstruction in five, and bronchial wall thickening and stenosis in three. Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one.

Conclusion

CT helps detect superficial endobronchial lung cancer in 79% of these patients, though there is some disagreement between the CT findings and the pathologic pattern of bronchial lesions. Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.     

Carotid Artery FDG Uptake May Serve as a Biomarker for Cardiovascular Risk Stratification in Asymptomatic Adults

Purpose

We investigated the relation between carotid artery FDG uptake and cardiovascular risk based on the Framingham risk score (FRS) and evaluated the possible role of FDG uptake in terms of risk stratification of asymptomatic adults.

Methods

We evaluated 290 adults who underwent FDG PET/CT as part of general health screens. We calculated target-to-background ratios, corrected for pre-scan blood glucose levels, and obtained “TBRglu” values for both common carotid arteries. The FRS and the presence/absence of metabolic syndrome were recorded for each subject. Relationships among TBRglu values, metabolic syndrome status, and clinical parameters were assessed.

Results

Carotid artery FDG uptake was significantly associated with clinical risk factors. Stepwise multiple regression analysis revealed that triglyceride levels, diabetes, and metabolic syndrome were independent determinants of high TBRglu. Of subjects with metabolic syndrome, those exhibiting high carotid artery FDG uptake had significantly higher levels of high sensitivity C-reactive protein (hsCRP). In subjects who did not have metabolic syndrome, FRSs were significantly elevated in those exhibiting high carotid artery FDG uptake compared to those with low uptake (13.1 ± 7.0 vs. 8.2 ± 7.4), as was also true of subjects with the syndrome (21.8 ± 16.0 vs. 13.5 ± 11.9).

Conclusion

High carotid FDG uptake is significantly associated with clinical risk factors and a greater FRS. Of subjects with metabolic syndrome, those with high carotid uptake had significantly higher hsCRP concentrations and FRSs. Therefore, carotid artery FDG activity may serve as a possible biomarker allowing cardiovascular risk stratification of asymptomatic populations.