The natural history of carotid plaque development.
Fifty-seven carotid artery plaques in 54 patients were harvested at surgery and studied. Preoperative noninvasive findings, arteriograms, clinical symptoms, surgical findings, and light microscopic findings were compared. Thirty-four patients had symptoms, 28 with TIAs and six with a previous stroke. Thirty-three of the 34 had intraplaque hemorrhage, and 28 had a connection between the hemorrhage and the arterial lumen. Eleven of the 21 asymptomatic patients also had an intraplaque hemorrhage, and one had a connection. In eight of the 11, noninvasive studies showed progression of disease. The development of an intraplaque hemorrhage appears to be an important factor in an innocent plaque's becoming a clinically relevant one. If a connection develops between the intraplaque hemorrhage and the arterial lumen, the patient may have TIAs.
D000368:Aged; D001161:Arteriosclerosis / Q000150:complications* / Q000473:pathology; D002545:Brain Ischemia / Q000601:surgery; D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications* / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000601:surgery; D004691:Endarterectomy; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male