Interventions aimed to prevent cardiovascular diseases (CVD) are more effective if administered to subjects carefully selected
according to their CVD risk. Usually, this risk is evaluated on the basis of the presence and severity of conventional vascular risk factors
(VRFs); however, atherosclerosis, the main pathologic substrate of CVD, is not directly revealed by VRFs. The measurement of the arterial
wall, using imaging techniques, has increased the early identification of individuals prone to develop atherosclerosis and to quantify
its changes over time.
B-mode ultrasound is a technique which allows a non-invasive assessment of the arterial wall of peripheral arteries (e.g. extracranial carotid
arteries), and provides measures of the intima-media thickness complex (C-IMT) and additional data on the occurrence, localization
and morphology of plaques.
Being an independent predictor of vascular events, C-IMT has been considered as a tool to optimize the estimation of CVD risk but this
application is still a matter of debate. Though the technique is innocuous, relatively inexpensive and repeatable, its use in the clinical
practice is limited by the lack of standardized protocols and clear guidelines.
This review outlines the rationale for the potential use of C-IMT in the stratification of cardio- and cerebro-vascular risk and discusses
several topics related to the measurement of this variable, which are still controversial among experts of the field.