Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis

Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence in comparison to other stroke subtypes such as cardioembolism or small artery occlusion (1–3). There is a large body of literature showing that the risk of ICAS-related stroke recurrence correlates with the degree of stenosis; ICAS≥70% bears a higher risk compared to ICAS<70% (4). However, there is growing evidence that also low-grade ICAS may lead to ischemic cerebrovascular events (ICVEs) (5, 6). This observation raises the hypothesis that atherosclerotic plaques become unstable because of other characteristics (e.g., plaque composition) and may be finally prone to rupture (“vulnerable carotid plaque concept”) (7). This—in turn–may result in microemboli originating from the surface of plaque. Imaging or pathological biomarkers of plaque, such as fibrous caps, lipid-rich core, and intraplaque hemorrha...
Source: Frontiers in Neurology - Category: Neurology Source Type: research