Assessment of Carotid Plaque by Ultrasound for the Characterization of Atherosclerosis and Evaluation of Cardiovascular Risk

Publication Date: July 1, 2020
Last Updated: March 14, 2022

Recommendations

DEFINITION OF PLAQUE

We recommend that carotid arterial plaque visualized by ultrasound (with or without use of an ultrasound enhancing agent [UEA]) be defined in one of the following 2 ways:
1) any focal thickening thought to be atherosclerotic in origin and encroaching into the lumen of any segment of the carotid artery (protuberant-type plaque) or
2) in the case of diffuse vessel wall atherosclerosis, when carotid intima-media thickness (CIMT) measures ≥1.5 mm in any segment of the carotid artery (diffuse-type plaque).
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We recommend the evaluation of both protuberant and diffuse types of carotid arterial plaque for cardiovascular risk stratification and the serial assessment of atherosclerosis.
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We recommend that first, the carotid arterial wall be visually scanned for the presence of protuberant plaque, and if absent, then carotid intima-media thickness (CIMT) measurement be performed to identify the presence of diffuse plaque (defined as CIMT ≥1.5 mm). If performed, CIMT should be measured as described in the ASE Consensus Statement on the Use of Carotid Ultrasound to Identify Subclinical Vascular Disease and Evaluate Cardiovascular Risk.
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Overview

Title

Assessment of Carotid Plaque by Ultrasound for the Characterization of Atherosclerosis and Evaluation of Cardiovascular Risk

Authoring Organization

American Society of Echocardiography