{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T15:01:54Z","timestamp":1777820514749,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The presence of severely calcified plaque remains problematic in endovascular therapy, and no specific endovascular treatment strategy has been established. Estimating plaque solidity before the procedure may help operators penetrate calcified plaque with a guide wire. The aim of this study was to establish a method of measuring plaque solidity with noncontrast computed tomography (CT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective, single-center study included consecutive patients who, between October 2020 and July 2022, underwent noncontrast 5\u2009mm and 1\u2009mm CTs before endovascular therapy to penetrate calcified plaque with a wire in the common femoral, superficial femoral, and popliteal arteries. Three cross-sectional CT slices were selected. To target a calcified plaque lesion, the operator identified a region of interest, which corresponded to 24\u00d724 pixels, and Hounsfield unit (HU) values of each pixel were displayed on the CT image. The average HU values and the ratio of number of pixels of lower values (130\u2013599 HU) represented plaque solidity. We used the Mann-Whitney-Wilcoxon rank-sum test and the chi-square test to compare the solidity of plaques penetrated and not penetrated by the wire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We evaluated 108 images of 36 calcified plaque lesions (in 19 patients). The wire penetrated 28 lesions (77.8%) successfully. The average HU value was significantly lower in the lesions that the wire penetrated than in the others, in both the 5\u2009mm CT slices (434.7\u00b186.8 HU vs 554.3\u00b1112.7 HU, p=0.0174) and 1\u2009mm slices (497.8\u00b1103.1 HU vs 593.5\u00b1114.5 HU, p=0.0381). The receiver operating curve revealed that 529.9 and 533.9 HU in the 5 and 1\u2009mm slices, respectively, were the highest values at which wires could penetrate. Moreover, at the lesions that were penetrates successfully, the ratio of number of lower HU value pixels was significantly higher both in 5\u2009mm slice CTs (74.7\u00b113.4 vs 61.7\u00b113.1%, p=0.0347) and 1\u2009mm (68.7\u00b111.8 vs 57.1\u00b111.4%, p=0.0174).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The use of noncontrast CT to evaluate plaque solidity was associated with successful wire penetration of calcified lesions in peripheral arteries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This study revealed an association between the wire penetration inside calcified plaque and plaque solidity estimated using non-contrasted computed tomography. The mean Hounsfield unit values of three cross-sections in calcified plaques were associated with the successful wire penetration. This wire penetration difficulty is associated with extended procedure time, excessive radiation exposure, usage of extra contrast agents, and increased medical costs. Therefore, estimating calcified plaque solidity before procedure enables us to choose effective and lean procedures. In addition, to predict the success of dilating calcified plaque from the inside is also beneficial when the operator wants to avoid extra scaffold implantation for target lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028231170119","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T04:29:33Z","timestamp":1683001773000},"page":"139-147","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Objective Evaluation With Noncontrast Computed Tomography Can Reveal Calcified Plaque Solidity in Peripheral Artery Diseases"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3012-6248","authenticated-orcid":false,"given":"Dai","family":"Ozaki","sequence":"first","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, 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Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Yabe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Midori","family":"Kakihara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Shimai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Isogai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Ouchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuminori","family":"Odagiri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhisa","family":"Takamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Yaginuma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Tokano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Radiology, Juntendo University Urayasu Hospital, Urayasu-shi, 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IDKD Springer series noninvasive angiography of peripheral arteries. In: Hodler J, Kubik-Huch RA, von Schulthess GK, eds. Diseases of the Chest, Breast, Heart and Vessels 2019-2022: Diagnostic and Interventional Imaging. 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