[Unstable carotid stenosis--an inflammatory disease?].
Arterioarterial thromboembolism from extracranial internal carotid artery (ICA) stenosis is an important pathogenic mechanism of ischemic stroke. However, even a high-grade ICA stenosis carries a greatly variable annual risk of stroke, as high as 13% following a recent occurrence of transient or minor cerebral ischemia or as low as 1-2% in clinically asymptomatic patients. There is increasing evidence that inflammatory processes play a central role in atherosclerosis and particularly in plaque destabilization converting chronic atherosclerosis into an acute neurological disorder. In thromboendarterectomy specimens from patients with high-grade ICA stenoses, the extent of inflammatory infiltration and the expression of matrixmetalloproteinase-9 correlated to clinical and ultrasonic features of plaque destabilization such as cerebral microembolism. Inflammation might become a new therapeutic target in symptomatic carotid artery disease.
Stoll
G
G
Neurologische Klinik der Heinrich-Heine-Universität, Moorenstr. 5, 40225 Düsseldorf. stollg@uni-duesseldorf.de
Jander
S
S
Sitzer
M
M
Müller
W
W
Sandmann
W
W
Siebler
M
M
D002343:Carotid Artery, Internal / Q000276:immunology / Q000473:pathology; D016893:Carotid Stenosis / Q000276:immunology* / Q000473:pathology; D006801:Humans; D020766:Intracranial Embolism / Q000276:immunology* / Q000473:pathology; D008264:Macrophages / Q000276:immunology / Q000473:pathology; D008666:Metalloendopeptidases / Q000378:metabolism*; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D013925:Thromboplastin / Q000378:metabolism
D013925:Thromboplastin; D008666:Metalloendopeptidases