Plaque echolucency is not associated with the risk of stroke in carotid stenting.
OBJECTIVE
Plaque characteristics are suggested to play a potentially important role as risk factors for poor outcome after carotid artery stenting (CAS). We therefore correlated objectively and subjectively determined carotid plaque morphology with neurological complications after CAS.


METHODS
We enrolled 698 consecutive patients undergoing elective CAS from a prospective single-center registry database and classified the preinterventional plaque status according to gray-scale median levels and the standardized Beletsky and Gray-Weale plaque scores. Patients were followed for 30-day neurological complications.


RESULTS
Neurological complications including transient ischemic attack, minor and major stroke occurred in 5.9% (41/698) of the patients. Median gray-scale median, Beletsky and Gray-Weale scores were 45 (interquartile range [IQR] 25 to 70), 3.0 (IQR 2.0 to 3.0) and 2.0 (IQR 2.0 to 3.0), respectively. None of the scores was significantly associated with adverse outcome adjusting for traditional risk factors, medication, preinterventional symptoms, degree of stenosis, contralateral occlusion and use of cerebral protection, neither with respect to all neurological complications nor with respect to stroke and death (all P>0.05).


CONCLUSIONS
Plaque echolucency measured by objective and subjective grading did not identify patients with an increased risk of peri-interventional neurological events. Evaluation of plaque echolucency therefore cannot be recommended for risk stratification in CAS patients.
Reiter
Markus
M
Clinic for Internal Medicine II, Department of Angiology, University of Vienna, Austria. markus.reiter@meduniwien.ac.at
Bucek
Robert A
RA
Effenberger
Isabella
I
Boltuch
Johanna
J
Lang
Wilfried
W
Ahmadi
Ramazanali
R
Minar
Erich
E
Schillinger
Martin
M
D000368:Aged; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000209:etiology*; D014463:Ultrasonography