Serial CT Angiography of atherosclerotic carotid plaque:determinants and prognosis of change in volume, composition and morphology

It has been recognized that atherosclerotic plaque composition and morphology
could be much more important than luminal stenosis for the development of acute
neurovascular events: plaques consisting of a necrotic core covered by a thin
fibrous cap are prone to rupture leading to thrombo-embolic events. Despite
this concept, not much is known about the natural course of atherosclerotic
disease in the carotid arteries.
In this project we will evaluate atherosclerotic carotid plaque features
(plaque volume, plaque composition, plaque morphology, shear stress) with MDCTA

1) To assess the the natural course of atherosclerotic disease in the carotid
artery.
2) to evaluate whether a change in plaque volume, composition and morphology
can be predicted based on risk factor profiles, baseline plaque status and
shear stress and
3) To assess the predictive value of atherosclerotic plaque features (both
baseline and changes) for risk of recurrent ipsilateral stroke?

Observational prospective study

In this study an extra MDCTA of the carotid artery is performed. Participants
have to visit the hospital for this examination. An extra MDCTA requires
additional ionizing radiation, which is within the international acceptable
limits. MDCTA requires injection of contrast agents. This agents can provoke an
allergic reaction and a decrease in renal function. In persons with a higher
risk for renal insufficiency, a recent renal function has to be available.
During follow-up, the participants will be contacted once a year for a
questionnaire which will take 15 minutes.
Benefits: There is no individual benefit. In case a carotid atherosclerotic
stenosis has increased during follow-up to more than 70%, participants will be
referred to a neurologist to discuss an intervention (surgery or stent
placement).