title: Morphological changes of ulcerative plaque in patients received carotid angioplasty and stenting (CAS).
abstract: BACKGROUND
  Carotid ulceration plaque is a strong risk factor for stroke and systemic vascular events. The purpose of this study was to assess immediate and follow-up ulcer morphology after carotid angioplasty and stenting (CAS).
  
  
  RESULTS
  A total of 124 patients were included in the study. Ulcerative plaques were identified in 92 arteries from 81 patients (21% were asymptomatic and 79% symptomatic). The ulcer disappeared immediately after stenting in 36 (39%) of 92 arteries in 50 patients. Patients with initial mild degree of stenosis (50-69% stenosis) prior to stent, Type-3 and Type-4 ulcers were more prone to have residual ulcers immediate after stenting procedure. Ulcers located distal and proximal to the site of maximal stenosis, and ulcers extending outside of the imaginary line connecting the distal and proximal normal borders of the carotid artery were also more likely to have residual ulcers (P<0.001). Follow-up angiograms (mean time after CAS=10.1 months, range=3-28 months) performed in 32 arteries (29 patients) revealed that residual ulceration disappeared in 17 lesions (53%) and became smaller in 15 lesions (47%). During follow-up, ipsilateral neurological symptoms were not evident in any of the 29 patients (mean time after CAS=20.1 months, range=9-41 months).
  
  
  CONCLUSIONS
  Ulceration morphology, and stenosis severity prior to stent procedure had an impact on ulcer coverage after CAS. Our findings suggest that residual ulcers disappear or improve over time and that with appropriate medication, will not lead to embolic strokes.
authors.affiliation: Department of Radiology, Dokter Soetomo Hospital, Surabaya, Indonesia. cindysadikin@walla.com
authors.forename: Cindy
authors.initials: C
authors.lastname: Sadikin
authors.forename: Michael Mu Huo
authors.initials: MM
authors.lastname: Teng
authors.forename: Ching-Cheng
authors.initials: CC
authors.lastname: Yeh
authors.forename: Feng-Chi
authors.initials: FC
authors.lastname: Chang
authors.forename: Chao-Bao
authors.initials: CB
authors.lastname: Luo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D016896:Treatment Outcome