Histologic characteristics of carotid artery plaque.
Carotid plaque characteristics associated with the production of symptoms were identified with quantification of carotid plaque constituents in high-grade stenotic asymptomatic (n = 8) and symptomatic (n = 44) plaques. Asymptomatic plaques contained significantly more fibrous/collagen material (88%) than symptomatic plaques (66%) (p less than 0.05). Hemorrhage constituted 2% and 1% of asymptomatic and symptomatic plaques, respectively. The predominant nonfibrous material was a pink amorphous material mixed with cholesterol, which composed 7% of asymptomatic and 27% of symptomatic plaques (p less than 0.05). No relationship was found between plaque composition and the number of ipsilateral ischemic neurologic events, nor was there evidence of a healing process. B-mode ultrasound scanning had a sensitivity of 94% in identifying plaque with greater than 80% fibrous content. We believe that plaque composition may be a useful discriminating factor in selecting asymptomatic patients for carotid endarterectomy.
Feeley
T M
TM
Department of Vascular Surgery, St. James' Hospital, Dublin, Ireland.
Leen
E J
EJ
Colgan
M P
MP
Moore
D J
DJ
Hourihane
D O
DO
Shanik
G D
GD
D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography