Carotid artery plaque structure in the context of symptomatic/asymptomatic nature of carotid artery stenosis

Abstract

Objective: In this paper, we examined the relationship between atherosclerotic plaque characteristics and symptomatic carotid artery disease. Material and methods: Twenty-two patients who underwent carotid endarterectomy were enrolled into the study. Thirteen patients were male and remaining 9 patients were female. The mean age was 60.2 +/- 9.6 years. The carotid artery stenosis ranged between 75% and 99%. Eight patients were asymptomatic and remaining 14 patients were symptomatic. Ten patients suffered stroke. One of them had recurrent transient ischemic attacks, 4 patients had dizziness, and one of them had amaurosis fugax. The extracted plaques were evaluated by scanning acoustic microscopy (SAM) and micro-computerized tomography (micro-CT). Results: Smaller acoustic impedance values that reveal collagen-rich plaque formation were detected in patients who had stroke, while higher acoustic impedance values that reveal calcium-rich plaque formation were detected in the asymptomatic patients' plaques. Conclusions: Determination of plaque characteristics with modern radiographic techniques, rather than relying on the degree of stenosis in patients with carotid artery disease, may be helpful to discriminate patients requiring intervention.Cíl: V této studii jsme zkoumali vztah mezi charakteristikami aterosklerotického plátu a symptomatick?m posti?ením karotick?ch tepen. Materiál a metody: Do studie bylo za?azeno 22 pacient? (13 mu?? a 9 ?en pr?m?rného v?ku 60,2 ± 9,6 roku) po endarterektomii karotick?ch tepen. Záva?nost stenózy karotické tepny se pohybovala v rozmezí 75 % a? 99 %. Osm pacient? bylo asymptomatick?ch a zb?vajících 14 symptomatick?ch. Deset pacient? prod?lalo cévní mozkovou p?íhodu. V anamnéze m?l jeden pacient recidivující tranzitorní ischemické p?íhody, ?ty?i pacienti uvád?li presynkopální stav a u jednoho byla stanovena diagnóza amaurosis fugax. Odstran?né pláty byly vyšet?eny skenující akustickou mikroskopií (scanning acoustic microscopy, SAM) a mikrov?po?etní tomografi í (micro-computerized tomography, micro-CT). V?sledky: U pacient? po cévní mozkové p?íhod? byly nalezeny ni?ší hodnoty akustické impedance ukazující na tvorbu plát? s vysok?m obsahem kolagenu, zatímco u asymptomatick?ch pacient? byly vyšší hodnoty akustické impedance spojeny s tvorbou plát? bohat?ch na vápník. Záv?ry: Spíše ne? spoléhání se na záva?nost stenózy u pacient? s posti?ením karotick?ch tepen m??e p?i vyhledávání pacient? vy?adujících intervenci napomáhat ur?ení charakteristik plát? moderními radiografi ck?mi metodami.