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Carotid plaque morphology and clinical events
T S Hatsukami1, M S Ferguson, K W Beach
1Seattle Veterans Affairs Medical Center, WA 98108, USA. tomhat@u.washington.edu
Stroke
|January 1, 1997
Summary
Carotid plaque composition, including hemorrhage and lipid core, did not differ between symptomatic and asymptomatic patients undergoing endarterectomy. These findings suggest plaque composition alone may not explain embolic events in patients with severe carotid stenosis.
Area of Science:
- Vascular Surgery
- Neurology
- Pathology
Background:
- B-mode ultrasonography shows potential for carotid plaque characterization.
- Carotid plaque characteristics are linked to clinical outcomes, but histological data is conflicting.
- Quantifiable plaque morphology data is limited.
Purpose of the Study:
- To investigate the association between carotid plaque constituent volumes and preoperative ischemic neurological symptoms.
- To analyze plaque constituents identifiable by imaging modalities like ultrasound and MRI.
Main Methods:
- Histological examination of atherosclerotic plaques from 43 carotid endarterectomy patients.
- Quantification of fibrous intimal tissue, intraplaque hemorrhage, lipid core, necrotic core, and calcification.
- Comparison of plaque constituents between symptomatic and asymptomatic patient groups using Kolmogorov-Smirnov statistic.
Main Results:
- No significant differences in the presence or volume of fibrous intimal tissue, intraplaque hemorrhage, lipid core, necrotic core, or calcification were found between symptomatic and asymptomatic patients.
- Plaque composition was similar regardless of preoperative symptom status in patients with highly stenotic carotid lesions.
Conclusions:
- Gross plaque composition is similar in patients undergoing carotid endarterectomy, irrespective of symptom status.
- Differences in plaque constituents like hemorrhage, lipid core, or necrotic core are unlikely to explain the embolic history of atherosclerotic carotid plaques.