Abstract

Worldwide, about 17 million people die from cardiovascular disease (CVD) each year, chiefly from ischemic heart disease and stroke.(1) Amongst those, stroke, the most common manifestation of cerebrovascular disease, has been the leading cause of serious, long-term disability in adults worldwide (1990-2010) (2) There are two main types of stroke — ischemic and hemorrhagic. Ischemic stroke is more common and caused by an obstruction in the cerebral vasculature. The causes of ischemic strokes are heterogeneous, including atherosclerosis in the large arteries such as the carotid arteries (see fig 1.), lacunar infarctions and cardiogenic embolism. In this thesis, I will focus on carotid atherosclerosis as it is the most prominent to identify patients with a high risk of ischemic stroke. Atherosclerotic plaques can rupture which will lead to thrombo-embolization into the intracranial circulation or to acute occlusion of the carotid artery. Despite major advances in treatment strategies, ischemic stroke due to carotid atherosclerotic remains a serious public health problem. Current screening and diagnostic methods are insufficient to identify the plaques that have a high rupture risk and thus to select the individual before he is confronted with an ischemic stroke. One of the strategies to better face the challenges of cerebrovascular disease and improve well being of the population and of the individual includes early recognition of the vulnerable high-risk atherosclerotic plaque.

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Keywords Carotid Atherosclerosis, cardiovascular dieseases, imaging, cardiology
Promotor A. van der Lugt (Aad) , O.H. Franco (Oscar)
Publisher The work in this thesis was conducted at the Departments of Radiology, Epidemiology and Cardiology (Biomedical Engineering) of the Erasmus MC, University Medical Center, Rotterdam, the Netherlands. The research described in this thesis was performed within the framework of The Rotterdam Study. The contribution of all of the participants and staff of the Rotterdam Study, as well as the general practitioners and pharmacists of the Ommoord district for help with data collection and validation, is gratefully acknowledged. The Rotterdam Study is supported by the Erasmus Medical Center and Erasmus University Rotterdam; The Netherlands Organization for Scientific Research (NWO); The Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); The Netherlands Heart Foundation; the Ministry of Education, Culture and Science; the Ministry of Health Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. The carotid MRI study was supported by the Dutch Heart Foundation (2009B044) and the Netherlands Organization for Scientific Research (NWO/ZonMwVici,918-76-619). This work was carried out in the Netherlands Institute for Health Sciences (NIHES) and Cardiovascular Research school Erasmus MC Rotterdam (COEUR) graduate schools. Financial support by the Dutch Heart Foundation for the publication of this thesis is gratefully acknowledged. Additional financial support for printing of this thesis was kindly provided by the department of Radiology, Epidemiology and Biomedical Engineering, Erasmus MC.
ISBN 978-94-6259-332-9
Persistent URL hdl.handle.net/1765/77775
Citation
Selwaness, M. (2014, February 21). Magnetic Resonance Imaging of Carotid Atherosclerosis. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/77775