The purpose of this study is to determine the frequency, characteristics, and consequences of vulnerable carotid artery plaques ipsilateral to an acute ischemic stroke or TIA in the territory of the internal carotid artery.
Even with extensive diagnostic workup the underlying etiology remains unidentified in about 25% of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). Non-invasive high-resolution magnetic resonance imaging (HR-MRI) of the carotid artery allows detecting vulnerable plaques (VP) and quantifying single plaque components. The hypotheses behind this study are that i) a substantial proportion of cases of AIS and TIA within the anterior circulation and no identified cause (cryptogenic AIS or TIA) are caused by VP in the carotid artery; ii) that these patients are at a high risk of developing a recurrent stroke, TIA, or clinically silent lesions detectable by brain MRI; and iii) that VP in the carotid artery are associated with specific infarct patterns as detected by diffusion-weighted MR imaging. Finally, the investigators will search for biomarkers associated with vulnerable carotid artery plaques. Motivating this study are the following considerations: i) data on the frequency and characteristics of VP in patients with cryptogenic AIS or TIA will provide valuable insights into stroke mechanisms; ii) depending on the results this study may have implications for diagnostic decision making and provide the basis for the planning of targeted interventional studies.
- Observation: Cohort
- Perspective: Prospective
- Sampling: Probability Sample
Patients admitted to a specialized stroke service because of an acute stroke or TIA
|Type||Measure||Time Frame||Safety Issue|
|Primary||Frequency and characteristics of vulnerable plaques (VP) in the carotid artery ipsilateral to an acute ischemic stroke (AIS) or TIA in the territory of the carotid artery in patients with a cryptogenic stroke||Baseline||No|
|Secondary||Pattern of acute ischemic lesions on brain MRI associated with VP in the carotid artery||Baseline||No|
|Secondary||Recurrence rates of AIS or TIA in patients with VP in the carotid artery||12 Months||No|
|Secondary||Rate of new ischemic lesions on FLAIR MRI at 12 month follow-up in patients with VP in the carotid artery||12 Months||No|
|Secondary||Association between VP in the carotid artery and atherosclerotic plaques in the aortic arch as determined by transoesophageal ultrasound||Baseline||No|
|Secondary||Biomarkers associated with vulnerable carotid artery plaques||Baseline||No|
Biospecimen Retention:Samples With DNA - whole blood, serum, plasma, RNA