Major carotid plaque surface irregularities correlate with neurologic symptoms

Journal of Vascular Surgery
Aaron TroyerAssessment of Carotid Stenosis by Comparison with Endarterectomy Plaque Trial Investigators

Abstract

Many studies have linked carotid plaque surface irregularities with stroke risk, but this relationship has been obscured by the limited ability of available imaging modalities to resolve plaque surface morphology. To address this issue, we performed a prospective study correlating the presenting neurologic symptoms of patients with high-resolution magnetic resonance imaging (MRI; 200 microm) studies of ipsilateral plaque surface invaginations and ledges, lumen shape, and the location of the plaque bulk creating the stenosis. One hundred patients, 17 women and 83 men, 45 to 81 years old (mean, 68 years) underwent surgery. Forty-five patients had a transient ischemic attack (TIA) or stroke as the indication for surgery, and 55 patients had no symptoms. Angiograms were obtained in 50 patients. Carotid plaques were removed "en bloc" and placed in gadolinium doped saline for imaging in a Siemens Symphony, 1.5T scanner with a custom-built transmit-receive radiofrequency coil. The resulting slice thickness was 200 microm, with 200 microm by 200 microm in plane resolution. The MRI data and angiograms were reviewed by using National Institutes of Health Image software and read by consensus. A surface irregularity was categorized as a le...Continue Reading

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Citations

Aug 20, 2009·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Wei YuBaocheng Chu
Mar 28, 2013·Computational and Mathematical Methods in Medicine·Xin YangMingyue Ding
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May 24, 2003·Journal of Vascular Surgery·Bo YuUNKNOWN ACSCEPT Trialists
Aug 7, 2004·Journal of Vascular Surgery·Wael E ShaalanHisham S Bassiouny
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