Asymptomatic moderate carotid artery stenosis with intraplaque hemorrhage: Progression of degree of stenosis and new ischemic stroke

Publication date: Available online 4 February 2019Source: Journal of Clinical NeuroscienceAuthor(s): Kiyofumi Yamada, Shinichi Yoshimura, Manabu Shirakawa, Kazutaka Uchida, Shigehiro Nakahara, Shuji Nishida, Yasuhiro Iwamoto, Yoshikazu Sato, Masanori KawasakiAbstractCarotid intraplaque hemorrhage (IPH) plays a critical role in the progression of carotid atherosclerotic disease. IPH was associated with high intensity signal (HIS) in the plaque on Maximum intensity projection (MIP) images from routine three dimensional magnetic resonance imaging (3D-TOF MRA). The aim of this study was to evaluate the relationships among HIS, new ipsilateral ischemic stroke and a progression rate in carotid plaques with moderate stenosis. We included 45 carotid plaques with moderate stenosis (50%–69%) in 45 patients who could be followed more than 12 months. Carotid IPH was defined as the presence of HIS on 3DTOF MRA using the criteria previously we published. We analyzed the relation between the presence of HIS and new ischemic strokes and annual progression rate of carotid stenosis. HIS was present in 21 (47%) carotid arteries. Over a follow-up period of 24 ± 9 months, six ischemic strokes occurred in ipsilateral side. New ipsilateral ischemic stroke occurred more frequently in HIS positive group (P group: 6 of 21, 29%) than negative group (N group: 0 of 24, 0%) (p = 0.017). Annual progression rate of carotid stenosis is significantly higher in P group (+3.35%/year) than N group...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research