Carotid atherosclerosis in relation to symptoms from the territory supplied by the carotid artery.
OBJECTIVE
To investigate the relationship between intima-media thickness in the common carotid artery, plaque morphology in the carotid bifurcation and symptoms of cerebral embolism. Design prospective study of consecutive patients referred for carotid duplex examination.


METHODS
One hundred and eighty-eight patients were classified by one of two neurologists into four categories (symptomatic, asymptomatic, undefined, uncertain). Carotid atherosclerosis was measured by means of high-resolution ultrasound technique. Carotid plaques were classified based on visual evaluation of plaque echogenicity.


RESULTS
Intima-media thickness (IMT) was correlated to presence of plaques, age and gender, but not to symptoms referable to the carotid circulation. Carotid plaques were more common in symptomatic than in asymptomatic vessels (p<0.05). There was no difference in plaque occurrence between the ipsi- and contralateral sides in the symptomatic patients, neither in frequency of echolucent plaques between the sides or between symptomatic and asymptomatic patients. Echogenic plaques were more common and generally smaller than echolucent plaques.


CONCLUSIONS
IMT correlates with presence of plaques, but not with symptoms from the territory supplied by the carotid artery. Echolucent plaques in the carotid bifurcation are not more frequently symptomatic than echogenic plaques are, in patients with low-to-moderate degree of carotid stenosis.
Hallerstam
S
S
Department of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden.
Carlström
C
C
Zetterling
M
M
Konrad
P
P
Rosfors
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D018616:Ultrasonography, Doppler, Duplex / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data