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  1. Home
  3. Ulceration Location Is Associated With Clinical Course In Carotid Stenosis.
  1. Home
  3. Ulceration Location Is Associated With Clinical Course In Carotid Stenosis.

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Ulceration location is associated with clinical course in carotid stenosis.

Kokyo Sakurada1, Koji Shimonaga1, Shinya Tabata1

  • 1Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan.

Journal of Vascular Surgery
|June 9, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Distal plaque ulcers in carotid artery stenosis significantly increase the risk of cerebrovascular ischemic events. Ulcer location is a key factor in predicting stroke risk, suggesting a need for timely intervention.

Keywords:
Carotid artery stentingCarotid endarterectomyInternal carotid artery stenosisPlaque ulcerPlaque vulnerability

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Area of Science:

  • Vascular Surgery
  • Neurology
  • Cardiology

Background:

  • Carotid artery stenosis with plaque ulceration is a known risk factor for ischemic events.
  • Understanding plaque vulnerability and ulcer characteristics is crucial for predicting stroke risk.

Purpose of the Study:

  • To assess the association between the location of plaque ulcers and the occurrence of cerebrovascular ischemic events.
  • To determine if ulcer location relative to the most stenotic point influences stroke risk.

Main Methods:

  • Retrospective analysis of 60 patients with carotid artery stenosis and plaque ulcers.
  • Patients were categorized into proximal and distal ulcer groups based on location.
  • Primary endpoint was ipsilateral cerebrovascular ischemic events; follow-up was conducted for at least 1 month.

Main Results:

  • Distal plaque ulcers were more frequent and associated with significantly higher rates of ischemic events (59%) compared to proximal ulcers (18%).
  • Kaplan-Meier analysis showed shorter event-free survival in the distal group.
  • Multivariate analysis confirmed distal ulcer location as an independent predictor of ischemic events (OR 3.85-4.31).

Conclusions:

  • Carotid artery plaque ulcers located distal to the most stenotic point are independently associated with an increased risk of cerebrovascular ischemic attacks.
  • This finding suggests that distal ulcer location may serve as an indicator for surgical intervention, such as carotid endarterectomy.