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What is Carotid Intima Media (CIMT) Testing?

Many patients suffering the early and intermediate stages of atherosclerosis show no outward signs or symptoms of the disease.

As many as 50% of those who died from CAD had no prior signs or symptoms.

As many as 50% of those who died from CAD had cholesterol levels that met current guidelines.

What if . . .

You can!

Measuring the thickness of the intima and media layers of the carotid artery wall (carotid intima-media thickness, or CIMT) is one way to assess the cardiovascular health of your patients. This non-invasive procedure gives you another tool in your toolbox to further solve the diagnostic puzzle and help you you accurately assess disease presence, risk of events, and progression of the disease before your patient presents with acute symptoms.

IMT Solves a Very Real Problem

The Framingham algorithm is a great tool for assessing patients at high and low risk for CAD. Establishing a treatment protocol for these patients is also relatively straightforward. However, what do we do for those patients who are at intermediate risk for CAD and who are asymptomatic? The standard of care says we should treat the symptoms of disease. Unfortunately, this may be grossly inadequate because many of these patients are already full of soft plaque (i.e. significant atherosclerosis), and have IMT measurements that place them at very high risk for an ischemic event. Though many physicians will be uneasy with the uncertainty of the Framingham risk assessment in this medium risk group of patients, they will follow the standard of care and avoid aggressive pharmacological treatment in favor of maintaining a vigilant eye on these patients instead. Others will send these patients on for additional testing such as MRA, Stress Echo, or EBCT. Because very few of these patients will have more than 60% stenosis, they will pass the Stress Echo and MRA. EBCT is a great tool for assessing calcified plaque, but is inadequate at identifying the soft and more vulnerable plaque. Many of these patients still have significant amounts of soft plaque lining their arteries. Soft plaque (or echoluscent plaque) of any size has been shown to increase the odds ratio of an ischemic event nearly 2.5 times higher than a person who has an old MI. (Honda, et al J AM Coll Cardiol 2004; 43:1177-84)

Measuring CIMT by Ultrasound

CIMT measurements using B-mode (brightness mode) ultrasound have been performed since the mid-1980s. Using structural B-mode ultrasound, a trained sonographer can easily and non-invasively acquire images of the carotid artery wall for analysis, typically the region immediately proximal to the bifurcation. Upon examination via ultrasound, the adventitia shows up as a bright, white layer and the blood-filled lumen shows up as a black area, allowing the clinician to isolate the area of interest in between . . . the IMT. CardioRisk's sonographers are all trained to use our patented protocol using patented software. A CardioRisk trained and experienced sonographer can complete the procedure in just under ten minutes of your patient's time.

How It Works:

CardioRisk is a service company. No investment is required to offer this test to your patients. There is no need to purchase additional equipment or train additional staff.

CardioRisk provides the following services to your office:

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