Carotid intraplaque hemorrhage predicts recurrent symptoms in patients with high-grade carotid stenosis.
OBJECTIVE
Carotid intraplaque hemorrhage (IPH), known to be associated with plaque instability, may convey a higher stroke risk. The aim of this study was to assess whether the identification of IPH by MRI predicts recurrent clinical cerebrovascular events.


METHODS
Sixty-six patients with high-grade symptomatic carotid stenosis underwent MRI of the carotid arteries and were followed until carotid endarterectomy or 30 days.


RESULTS
Of the 66 patients with a median follow up of 33.5 days, 44 (66.7%) were found on MRI to have ipsilateral carotid IPH. Fifteen recurrent events were associated with ipsilateral carotid IPH. Only 2 recurrent events occurred in the absence of IPH. IPH increased the risk of recurrent ischemia (hazard ratio=4.8; 95% CI=1.1 to 20.9, P<0.05).


CONCLUSIONS
IPH as detected by MRI predicts recurrent cerebrovascular events in patients with symptomatic high-grade carotid stenosis.
Altaf
Nishath
N
Department of Academic Radiology, University of Nottingham, Queen's Medical Centre, Nottingham, UK. nish.altaf@nottingham.ac.uk
MacSweeney
Shane T
ST
Gladman
John
J
Auer
Dorothee P
DP
D000368:Aged; D016893:Carotid Stenosis / Q000150:complications* / Q000601:surgery; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology