BACKGROUND: The importance of identifying features of carotid artery disease, in addition to degree of stenosis, which predict subsequent stroke is becoming increasingly clear. This study assessed the relationship between carotid plaque characteristics and presenting symptoms. METHODS: Some 285 symptomatic (transient ischaemic attack (TIA) 127, amaurosis fugax 58, transient stroke 15, established stroke 55, progressive stroke 11, crescendo TIA 19) and 65 asymptomatic patients were studied with colour-flow duplex imaging. All patients had 60-99 per cent internal carotid stenosis. Carotid plaque morphology (classified according to Gray-Weale) and plaque surface features were assessed. RESULTS: Plaque types I and II were more common in symptomatic patients (83 per cent versus 44 per cent; P < 0.0001). Plaque surface was classified as smooth (34 per cent), irregular (44 per cent) or ulcerated (22 per cent). Ulceration was also more common in symptomatic patients (23 versus 14 per cent; P = 0.04). In symptomatic patients there was no association between presenting symptom and plaque morphology or surface features (P = 0.9 and P = 0.8 respectively). On multiple regression analysis plaque morphology did not distinguish between patients who presents with stroke without warning and other symptomatic patients (who had TIA, amaurosis fugax, crescendo TIA or stroke with warning). CONCLUSION: There was an association between echolucent type I and II carotid plaques and the presence of symptoms but not their type. Plaque morphology was not characteristic in a subgroup of patients who had stroke without warning. Further prospective study of plaque morphology in asymptomatic patients might help identify high-risk groups.
BACKGROUND: The importance of identifying features of carotid artery disease, in addition to degree of stenosis, which predict subsequent stroke is becoming increasingly clear. This study assessed the relationship between carotid plaque characteristics and presenting symptoms. METHODS: Some 285 symptomatic (transient ischaemic attack (TIA) 127, amaurosis fugax 58, transient stroke 15, established stroke 55, progressive stroke 11, crescendo TIA 19) and 65 asymptomatic patients were studied with colour-flow duplex imaging. All patients had 60-99 per cent internal carotid stenosis. Carotid plaque morphology (classified according to Gray-Weale) and plaque surface features were assessed. RESULTS: Plaque types I and II were more common in symptomatic patients (83 per cent versus 44 per cent; P < 0.0001). Plaque surface was classified as smooth (34 per cent), irregular (44 per cent) or ulcerated (22 per cent). Ulceration was also more common in symptomatic patients (23 versus 14 per cent; P = 0.04). In symptomatic patients there was no association between presenting symptom and plaque morphology or surface features (P = 0.9 and P = 0.8 respectively). On multiple regression analysis plaque morphology did not distinguish between patients who presents with stroke without warning and other symptomatic patients (who had TIA, amaurosis fugax, crescendo TIA or stroke with warning). CONCLUSION: There was an association between echolucent type I and II carotid plaques and the presence of symptoms but not their type. Plaque morphology was not characteristic in a subgroup of patients who had stroke without warning. Further prospective study of plaque morphology in asymptomatic patients might help identify high-risk groups.
Authors: Raf H M van Hoof; Floris H B M Schreuder; Patty Nelemans; Martine T B Truijman; Narender P van Orshoven; Tobien H Schreuder; Werner H Mess; Sylvia Heeneman; Robert J van Oostenbrugge; Joachim E Wildberger; M Eline Kooi Journal: Cerebrovasc Dis Date: 2017-09-26 Impact factor: 2.762
Authors: Stephen J Murphy; Soon T Lim; Justin A Kinsella; Sean Tierney; Bridget Egan; Tim M Feeley; Clare Dooley; James Kelly; Sinead M Murphy; Richard A Walsh; Ronan Collins; Tara Coughlan; Desmond O'Neill; Joseph A Harbison; Prakash Madhavan; Sean M O'Neill; Mary P Colgan; Jim F Meaney; George Hamilton; Dominick Jh McCabe Journal: J Cereb Blood Flow Metab Date: 2019-11-11 Impact factor: 6.200
Authors: Ahmed Tawakol; Raymond Q Migrino; Udo Hoffmann; Suhny Abbara; Stuart Houser; Henry Gewirtz; James E Muller; Thomas J Brady; Alan J Fischman Journal: J Nucl Cardiol Date: 2005 May-Jun Impact factor: 5.952
Authors: Amit Shankar Singh; Virendra Atam; Nirdesh Jain; Besthanahalli Errapa Yathish; Malagouda R Patil; Liza Das Journal: N Am J Med Sci Date: 2013-06