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Extracranial carotid atherosclerosis evaluation and stroke occurrence: role of the echotomographic analysis
L Parnetti1, M Mercuri, A Susta
1Geronotology and Geriatric Department, University of Perugia, Italy.
Insights
Echostructural patterns of carotid artery plaques can predict cerebrovascular events. Mixed or hard echogenic plaques with irregular surfaces and over 50% stenosis are most likely to cause stroke or TIA.
Area of Science:
- Vascular Medicine and Neurology
- Medical Imaging and Diagnostics
Background:
- Atherosclerotic plaques in the extracranial carotid artery are a significant risk factor for cerebrovascular events.
- Accurate identification of high-risk plaques is crucial for timely intervention and stroke prevention.
Purpose of the Study:
- To evaluate the predictive value of high-resolution real-time echotomography in identifying carotid plaques likely to cause cerebrovascular events.
- To correlate plaque echostructural characteristics with clinical outcomes in patients at risk for stroke.
Main Methods:
- A longitudinal study involving 118 atherosclerotic plaques in 70 patients with risk factors for cerebrovascular disease.
- High-resolution real-time echotomography was used to assess plaque echostructure, surface regularity, and degree of stenosis.
- Patients were followed for two years to monitor for clinical events such as stroke, transient ischemic attack (TIA), and carotid occlusion.
Main Results:
- Ten patients experienced clinical events (stroke, TIA, or carotid occlusion) during the follow-up period.
- Plaques associated with clinical events most frequently exhibited a mixed or hard echogenic pattern.
- Irregular plaque surface and initial vascular stenosis exceeding 50% were also strongly correlated with adverse clinical outcomes.
Conclusions:
- Echostructural characteristics of carotid artery plaques, including echogenicity, surface morphology, and stenosis degree, are valuable predictors of cerebrovascular events.
- Real-time echotomography can effectively identify high-risk atherosclerotic plaques, aiding in stroke risk stratification and management.
Abstract:
High-resolution real-time echotomography was used in a longitudinal study on 118 atherosclerotic plaques of the extracranial carotid tract with the aim of identifying those most likely to cause a cerebrovascular event. Seventy patients (average age 61 +/- 7 years), referred to our Clinical Vascular Laboratory because suffering from transient cerebral ischemic attacks (TIA), coronary heart disease (CHD, peripheral artery disease (PAD), or cervical bruits (CB), were followed up for two years. Medical treatment remained that of the referring physician. Ten patients suffered from clinical events caused by stroke, TIA, and/or carotid occlusion during the follow-up. The echostructural profile of the lesions most often correlated with the clinical event was characterized by a mixed or hard echogenic pattern, and irregular surface, and an initial vascular stenosis of more than 50%.