Atherosclerotic plaque rupture and intraplaque hemorrhage do not correlate with symptoms in carotid artery stenosis.
OBJECTIVE
Previously we failed to demonstrate a correlation between plaque type and symptoms in 165 carotid endarterectomy specimens. The purpose of this study was to analyze the relation between the anatomy of the carotid plaques and the presence of symptoms in 281 carotid endarterectomy specimens.


METHODS
The patients were 213 men (mean age, 68 years) and 68 women (mean age, 68.7 years), with symptomatic disease (n = 133) or asymptomatic disease (n = 148). Specimens were processed for histologic analysis and immunohistochemistry.


RESULTS
Plaques were categorized as complicated or noncomplicated, and ruptured or nonruptured. Risk factors could not be correlated with any pathologic or immunohistochemical findings or between plaque type and clinical symptoms.


CONCLUSIONS
Almost 70% of plaque specimens demonstrated thrombus, intraplaque hemorrhage, or both. Thrombosis was observed in one fourth of specimens, and intraplaque hemorrhage in almost two thirds of specimens. Sixty four percent of plaques demonstrated neovascularization. It was not possible to demonstrate that complicated plaques (plaque rupture, thrombosis, intraplaque hemorrhage) are associated with symptoms, and it appears that such plaques may occur at any time, irrespective of symptoms.
Milei
José
J
Instituto de Investigaciones Cardiológicas, Marcelo T de Alvear 2270, C1122AAJ, Buenos Aires, Argentina. ininca@fmed.uba.ar
Parodi
Juan C
JC
Ferreira
Mariano
M
Barrone
Andrea
A
Grana
Daniel R
DR
Matturri
Luigi
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D016893:Carotid Stenosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006470:Hemorrhage / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000150:complications / Q000378:metabolism / Q000473:pathology; D013927:Thrombosis / Q000150:complications / Q000378:metabolism / Q000473:pathology