ParisK: Validation of Imaging Techniques

Conditions

Atherosclerosis, Stroke

Keywords

Plaque, Imaging

Brief summary

The possibility of the identification of the risk of rupture of a carotid plaque will have tremendous impact in clinical decision making. Firstly, in symptomatic patients with a 30-69% stenosis, who are currently not operated upon according to the current guidelines, identification of the risk of rupture plaque could identify patients who have a high risk of recurrent stroke, and would benefit of carotid intervention, such as endarterectomy or stent placement. This could potentially prevent a substantial number of strokes. Secondly, in all symptomatic patients with a 70-99% stenosis carotid intervention should be considered, according to the guidelines. However, only one out of six patients with a 70-99% stenosis benefits from a carotid intervention. Identification of patients with a high risk of a recurrent stroke would reduce the number of unnecessary interventions substantially. The main objective is to show whether imaging characteristics assessed at baseline can predict clinical events in patients with a 30-69 % symptomatic carotid stenosis.

Aikaterini Tziotziou, Yanjing Liu, Federica Fontana, Juul Bierens, Paul J. Nederkoorn et al. (13 authors)

Atherosclerosis2025-06-262 citations

10.1016/j.atherosclerosis.2025.120415

The relationship between fibrous cap status or plaque surface morphology and intraplaque hemorrhage volume over time: The PARISK Study.

Kassem M, Gorissen T, Albenwan M, Bierens J, van Dam-Nolen DHK, Liem MI, Hofman PAM, Wildberger JE, Hendrikse J, Mess W, Nederkoorn PJ, Bos D, Nelemans P, van Oostenbrugge RJ, Kooi ME.

2025-03-121 citations

10.1016/j.jstrokecerebrovasdis.2025.108283

Signal intensity and volume of carotid intraplaque hemorrhage on magnetic resonance imaging and the risk of ipsilateral cerebrovascular events: The Plaque At RISK (PARISK) study

Kelly Nies, Mueez Aizaz, Dianne H.K. van Dam-Nolen, Timothy Goring, Tobien H.C.M.L. Schreuder et al. (14 authors)

Journal of Cardiovascular Magnetic Resonance2024-01-019 citations

10.1016/j.jocmr.2024.101049

Carotid Plaque Characteristics Predict Recurrent Ischemic Stroke and TIA: The PARISK (Plaque At RISK) Study.

van Dam-Nolen DHK, Truijman MTB, van der Kolk AG, Liem MI, Schreuder FHBM, Boersma E, Daemen MJAP, Mess WH, van Oostenbrugge RJ, van der Steen AFW, Bos D, Koudstaal PJ, Nederkoorn PJ, Hendrikse J, van der Lugt A, Kooi ME, PARISK Study Group.

2022-06-15105 citations

10.1016/j.jcmg.2022.04.003

Sex Differences in Plaque Composition and Morphology Among Symptomatic Patients With Mild-to-Moderate Carotid Artery Stenosis

Dianne H.K. van Dam-Nolen, Nina C.M. van Egmond, Kristine Dilba, Kelly Nies, Anja G. van der Kolk et al. (12 authors)

Stroke2022-01-0539 citations

10.1161/strokeaha.121.036564

Microvasculature and intraplaque hemorrhage in atherosclerotic carotid lesions: a cardiovascular magnetic resonance imaging study.

Crombag GAJC, Schreuder FHBM, van Hoof RHM, Truijman MTB, Wijnen NJA, Vöö SA, Nelemans PJ, Heeneman S, Nederkoorn PJ, Daemen JH, Daemen MJAP, Mess WH, Wildberger JE, van Oostenbrugge RJ, Kooi ME.

2019-03-0416 citations

10.1186/s12968-019-0524-9

Association between fibrinogen and fibrinogen γ' and atherosclerotic plaque morphology and composition in symptomatic carotid artery stenosis: Plaque-At-RISK study.

van Dijk AC, Donkel SJ, Zadi T, Sonneveld MAH, Schreuder FHBM, Chohan MF, Koudstaal PJ, Leebeek FWG, Saxena R, Hendrikse J, Kooi ME, van der Lugt A, de Maat MPM.

2019-02-2713 citations

10.1016/j.thromres.2019.02.030

Definition of common carotid wall thickness affects risk classification in relation to degree of internal carotid artery stenosis: the Plaque At RISK (PARISK) study.

Steinbuch J, van Dijk AC, Schreuder F, Truijman M, Hendrikse J, Nederkoorn PJ, van der Lugt A, Hermeling E, Hoeks A, Mess WH.

2017-04-043 citations

10.1186/s12947-017-0097-4

Plaque Components in Symptomatic Moderately Stenosed Carotid Arteries Related to Cerebral Infarcts

Alexandra A.J. de Rotte, Martine T.B. Truijman, Anouk C. van Dijk, Madieke I. Liem, Floris H.B.M. Schreuder et al. (30 authors)

Stroke2015-01-0715 citations

10.1161/strokeaha.114.008121

Interventions

OTHERMagnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT), Ultrasonography (US), Transcranial Doppler (TCD)

3 Tesla Magnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT), Ultrasonography (US), Transcranial Doppler (TCD)

Study design

Observational model

OTHER

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* neurological symptoms due to ischemia in the carotid artery territory as diagnosed by their neurologist based on anamneses, physical examination and brain imaging (CT or MRI) * carotid artery stenosis \< 70% (upper cut-off value is based on the NASCET criteria, the lower cut-off value is an atherosclerotic plaque with a thickness of at least 2-3 mm, which corresponds to an ECST stenosis of 30% * written informed consent

Exclusion criteria

* patients with probable cardiac source of embolism (rhythm disorders, mitral valve stenosis, prolapse or calcification, mechanical cardiac valves, recent myocardial infarction, left ventricular thrombus, atrial myxoma, endocarditis, dilated cardiomyopathy, patent foramen ovale) or a clotting disorder * patients with evident other cause of neurological symptoms than carotid stenosis due to atherosclerotic disease (like demyelinating diseases, epilepsy, congenital brain disorders, aneurysms, fibromuscular dysplasia etc) * patients already scheduled for carotid endarterectomy or stenting. * severe co-morbidity, dementia or pregnancy * standard contra-indications for MRI * patients who have a documented allergy to MRI or CT contrast media * patients with renal clearance \< 30 ml/minute are not eligible to undergo contrast-enhanced MRI * patients with renal clearance \< 60 ml/minute are not eligible to undergo MDCT * patients who had a TIA or minor stroke more than 3 months before inclusion

Design outcomes

Primary

Measure	Time frame	Description
stroke	within 5 years of follow-up	Ipsilateral recurrent ischemic stroke, transient ischaemic attack (TIA) or new ischemic brain lesions on follow-up brain MRI.

Countries

Netherlands

Outcome results

None listed