Ultrasound for the assessment of the embolic risk of carotid plaques
| Autor: | Ch. Kessler, H. Brückmann, M. von Maravic, D. Kömpf |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Ultrasonography Doppler Transcranial Risk Assessment Central nervous system disease medicine.artery Humans Medicine Carotid Stenosis Carotid Artery Thrombosis Prospective Studies cardiovascular diseases Risk factor Dominance Cerebral Aged Aged 80 and over business.industry Vascular disease Ultrasound Echogenicity Cerebral Infarction General Medicine Intracranial Embolism and Thrombosis Middle Aged Intracranial Arteriosclerosis medicine.disease Stenosis Neurology Middle cerebral artery cardiovascular system Female Neurology (clinical) Radiology Internal carotid artery business Carotid Artery Internal |
| Zdroj: | Acta Neurologica Scandinavica. 92:231-234 |
| ISSN: | 1600-0404 0001-6314 |
| DOI: | 10.1111/j.1600-0404.1995.tb01693.x |
| Popis: | In a prospective study we compared duplex-ultrasound characteristics of symptomatic internal carotid artery (ICA) stenoses with cranial computerized tomographic (CCT) findings in 82 patients suffering from completed or transient middle cerebral artery symptoms. The aim was to assess the pathogenic role of ICA plaque morphology and the potential embolic risk of ICA plaques. The degree of carotid stenosis was estimated by spectral analysis of the pulsed Doppler signal. The CCT findings were classified as being either normal, lacunar lesions, hemodynamically induced low-perfusion infarctions, or territorial embolic infarctions. According to their ultrasonic features we characterized the ICA plaque surface as smooth or irregular and their structure as homogeneous or heterogeneous. Plaques with an irregular surface and heterogeneous echogenicity dominated significantly in CCT-territorial infarctions (p0.01), whereas hemodynamically induced low-perfusion infarctions showed no relationship with any plaque characteristic. High degree ICA stenoses (50%) dominated in both territorial infarctions and low-perfusion infarctions, as compared to ipsilateral normal CCT or lacunes (p0.05). Normal CCT and lacunar infarctions were associated with homogeneous and smooth plaques (both p0.05). We conclude that50% ICA stenoses can cause both hemodynamically induced low-perfusion infarctions as well as thromboembolic territorial infarctions, whereas ulcerated and heterogeneous plaques constitute a high risk factor for arterio-arterial embolic stroke. Furthermore, carotid ultrasound may help to estimate the clinical significance of carotid lesions. |
| Databáze: | OpenAIRE |
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