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• W2219413526 abstract "Complexities in carotid artery plaque morphology, including surface irregularities/ulcerations, calcification, lipid-laden/hemorrhagic core, and hemodynamically significant stenoses, are potential predictors of thromboembolic risk leading to ipsilateral neurologic symptoms. This study analyzed the correlation between helical computed tomography angiography (CTA) images of plaque morphology to neurologic symptoms in patients undergoing carotid endarterectomy. Eighty-nine consecutive patients (78 men, 11 women), aged 50 to 84 years, underwent 94 primary carotid endarterectomies, of which 39 of 94 (41%]) were for symptomatic (transient ischemic attack, amaurosis fugax, or stroke) and 55 of 94 (59%]) for asymptomatic disease. All patients had preoperative duplex ultrasonography and adjunctive thin-slice axial CTA to image the characteristic and severity of stenosis at the carotid bifurcation. Serial axial and maximal intensity projection CTA images were evaluated for severity and location of stenoses, luminal shape, presence of surface irregularities/ulceration, and plaque characteristics. Associated clinical symptoms were correlated to these CTA images of plaque morphology. Surface irregularities/ulcerations were seen in 25 of 39 (64%) of the symptomatic and in six of 55 (11%) of the asymptomatic patients. Twenty-eight of 31 (90%) of the ulcerations were identified at locations remote from the area of maximal stenosis, particularly overlying mixed plaque composition of calcification and lipid-laden or hemorrhagic core. Average maximal carotid stenosis was 68.5% in symptomatic and 81.7% in asymptomatic patients. The greatest luminal stenosis was located in the common carotid artery (n = 5), carotid bifurcation (n = 24), and internal carotid artery (n = 65). The residual carotid artery lumen was circular (28 of 94 [30%]), elliptical (39 of 94 [41%]), crescentic (19 of 94 [20%]), and irregular (8 of 94 [9%]) in shape. The bulk of the plaque was located opposite the flow divider (87%). The presence of surface irregularities and ulcerations in hemodynamically significant stenotic plaques, regardless of location, correlated best with the occurrence of ipsilateral neurologic symptoms. There was an inverse correlation between diameter reduction and symptomatology, reinforcing the importance of plaque characteristic and surface morphology in the etiology of thromboembolic events" @default.
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• W2219413526 date "2015-08-01" @default.
• W2219413526 modified "2023-09-28" @default.
• W2219413526 title "Correlation of Preoperative CTA Carotid Artery Plaque Morphology With Symptoms in Patients Undergoing Carotid Endarterectomy" @default.
• W2219413526 doi "https://doi.org/10.1016/j.jvs.2015.06.005" @default.
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