Carotid artery plaque structure in the context of symptomatic/asymptomatic nature of carotid artery stenosis

Objective: In this paper, we examined the relationship between atherosclerotic plaque characteristics and symptomatic carotid artery disease. Material and methods: Twenty-two patients who underwent carotid endarterectomy were enrolled into the study. Thirteen patients were male and remaining 9 patients were female. The mean age was 60.2 +/- 9.6 years. The carotid artery stenosis ranged between 75% and 99%. Eight patients were asymptomatic and remaining 14 patients were symptomatic. Ten patients suffered stroke. One of them had recurrent transient ischemic attacks, 4 patients had dizziness, and one of them had amaurosis fugax. The extracted plaques were evaluated by scanning acoustic microscopy (SAM) and micro-computerized tomography (micro-CT). Results: Smaller acoustic impedance values that reveal collagen-rich plaque formation were detected in patients who had stroke, while higher acoustic impedance values that reveal calcium-rich plaque formation were detected in the asymptomatic patients' plaques. Conclusions: Determination of plaque characteristics with modern radiographic techniques, rather than relying on the degree of stenosis in patients with carotid artery disease, may be helpful to discriminate patients requiring intervention.

Cíl: V této studii jsme zkoumali vztah mezi charakteristikami aterosklerotického plátu a symptomatick?m posti?ením karotick?ch tepen. Materiál a metody: Do studie bylo za?azeno 22 pacient? (13 mu?? a 9 ?en pr?m?rného v?ku 60,2 ± 9,6 roku) po endarterektomii karotick?ch tepen. Záva?nost stenózy karotické tepny se pohybovala v rozmezí 75 % a? 99 %. Osm pacient? bylo asymptomatick?ch a zb?vajících 14 symptomatick?ch. Deset pacient? prod?lalo cévní mozkovou p?íhodu. V anamnéze m?l jeden pacient recidivující tranzitorní ischemické p?íhody, ?ty?i pacienti uvád?li presynkopální stav a u jednoho byla stanovena diagnóza amaurosis fugax. Odstran?né pláty byly vyšet?eny skenující akustickou mikroskopií (scanning acoustic microscopy, SAM) a mikrov?po?etní tomografi í (micro-computerized tomography, micro-CT). V?sledky: U pacient? po cévní mozkové p?íhod? byly nalezeny ni?ší hodnoty akustické impedance ukazující na tvorbu plát? s vysok?m obsahem kolagenu, zatímco u asymptomatick?ch pacient? byly vyšší hodnoty akustické impedance spojeny s tvorbou plát? bohat?ch na vápník. Záv?ry: Spíše ne? spoléhání se na záva?nost stenózy u pacient? s posti?ením karotick?ch tepen m??e p?i vyhledávání pacient? vy?adujících intervenci napomáhat ur?ení charakteristik plát? moderními radiografi ck?mi metodami.