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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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Relationships between recent intraplaque hemorrhage and stroke risk factors in patients with carotid stenosis: the

Guillaume Turc1, Catherine Oppenheim, Olivier Naggara

  • 1Department of Neurology; Hôpital Sainte-Anne, 1 rue Cabanis, 75014 Paris, France.

Arteriosclerosis, Thrombosis, and Vascular Biology
|November 15, 2011
PubMed

Insights

Intraplaque hemorrhage (IPH) is linked to stroke risk in symptomatic carotid stenosis. In asymptomatic cases, IPH is less influenced by traditional risk factors, suggesting different predictive values.

Area of Science:

  • Cardiovascular Imaging
  • Neurology
  • Vascular Biology

Background:

  • Intraplaque hemorrhage (IPH) is an emerging marker for carotid plaque instability.
  • The relationship between IPH and traditional stroke risk factors is not well understood, especially in symptomatic versus asymptomatic carotid stenosis.

Purpose of the Study:

  • To investigate the associations between recent intraplaque hemorrhage (IPH) and traditional risk factors in patients with symptomatic and asymptomatic carotid stenosis.
  • To determine if these associations differ between symptomatic and asymptomatic disease states.

Main Methods:

  • High-resolution plaque magnetic resonance imaging was performed on 234 patients with symptomatic (n=114) or asymptomatic (n=120) carotid stenosis.
  • The presence of recent IPH was assessed and correlated with degree of stenosis, qualifying ischemic events, and time from ischemic event.

Main Results:

  • Recent IPH was found in 33% of symptomatic and 31% of asymptomatic patients.
  • In symptomatic stenosis, IPH was independently associated with degree of stenosis, qualifying event type, and time from ischemic event (p for trend=0.03).
  • In asymptomatic stenosis, IPH was associated with stenosis severity >70% (ECST criteria) but not consistently with other risk factors.

Conclusions:

  • Findings support a link between recent IPH and ipsilateral stroke risk in symptomatic carotid stenosis.
  • Prognostic studies for symptomatic disease should adjust for known stroke risk factors.
  • In asymptomatic stenosis, the predictive value of recent IPH appears less confounded by traditional stroke risk factors.
Abstract

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