Optimization Strategy of Carotid Artery Stenosis

Study Overview
=================
Brief Summary
-----------------
The goal of this observational study is to learn about how to utilize multiple evaluation techniques in carotid artery stenosis patients for optimizing assessment of diagnosis and treatment strategy. The main questions it aims to answer are: Identify best strategy that use multi-modal MRI and CT to assess patients' cerebral lesions and perfusion. Identify best strategy that use multi-modal MRI, PET-MRI ultrasound and CT to assess components and characters of patients' carotid plaques. Participants will accept imaging examination before and after surgery. And doctors will collect basic characteristics, imaging results and biological samples of patients for analysis.

Official Title
-----------------
Cohort of Optimized Assessment Strategy of Carotid Artery Stenosis

Conditions
-----------------
Carotid Artery Stenosis

Intervention / Treatment
-----------------
* Procedure: Carotid revascularization
* Diagnostic Test: MRI-PWI
* Diagnostic Test: CTA
* Diagnostic Test: PET/MRI
* Diagnostic Test: Ultrasound


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patients with severe stenosis (≥50%) or near-occlusion diagnosed by computed tomographic angiogram; patients received carotid endarterectomy at Peking Union Medical College Hospital Exclusion Criteria: (1) Any contraindication to image examination; (3) refuse to sign the Informed consent.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Carotid artery stenosis<br>patient with carotid artery stenosis | Procedure: Carotid revascularization<br>* All patients received carotid revascularization surgery at Peking Union Medical College Hospital.<br>* Other names: carotid endarterectomy and carotid artery stent;Diagnostic Test: MRI-PWI<br>* Multi-modal MRI before and after surgery.<br>Diagnostic Test: CTA<br>* CTA before and after surgery.<br>Diagnostic Test: PET/MRI<br>* PET/MRI before surgery.<br>Diagnostic Test: Ultrasound<br>* Ultrasound before and after surgery.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| stroke | perioperative stroke | During hospital stay, usually 7-30 days post operation | 
| cardiac infarction | perioperative cardiac infarction | During hospital stay, usually 7-30 days post operation | 
| transient ischemic attack | perioperative transient ischemic attack | During hospital stay, usually 7-30 days post operation | 
| cerebral hyperperfusion syndrome | perioperative cerebral hyperperfusion syndrome | During hospital stay, usually 7-30 days post operation | 
| death | perioperative death | During hospital stay, usually 7-30 days post operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Image characters of MRI | Arterial transit times, cerebral blood flow, plaque characters, etc. | half year after operation | 
| Image characters of PET/MRI | Diagnostic performance of 68Ga-FAPI PET/MR for intracranial or carotid atherosclerosis | half year after operation | 
| Image characters of ultrasound | Diagnostic performance of carotid artery ultrasound for intracranial or carotid atherosclerosis | half year after operation | 
| Carotid plaque characters | pathology characters of carotid plaque | half year after operation | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
carotid artery stenosis, Perfusion, plaque, MRI, CT, PET/MRI, Ultrasound