Relationship Between Characteristics of Stenotic Plaque in Carotid Artery and Ischemic Stroke Recurrence

Abstract

OBJECTIVE: Quantification of stenosis, plaque morphology and surface characteristics by doppler sonography and prediction of plaque rupture risk are important for treatment options in ischemic stroke. OBJECTIVE: We evaluated the association of carotid plaque characteristics and the risk of recurrent ischemic stroke. METHODS: Carotid plaques were ultrasonographically evaluated within ten days in 79 acute anterior circulation ischemic stroke patients without source of cardiac emboli. The subsequent incidence of transient ischemic attack, minor and major stroke was investigated wtihin six months period. During follow-up, 20 strokes occurred. Logistic regression analysis was used to determine the relation between plaque morphology and recurrent stroke risk. RESULTS: Patients with an ulcerated plaque had an 8.7-fold higher risk of recurrent stroke than those without ulceration (p<0.001). Patients with a hypoechogenic plaque had a 1.78-fold higher risk of recurrent stroke than those with hyperechogenic plaque (p<0.001). Patients with a functional stenosis greater than 70% had a 5.25-fold higher risk of recurrent stroke than those with a functional stenosis lesser than 70% (p<0.001). CONCLUSION: Plaque ulceration, hypoechogenicity and increased stenosis are independently associated with a higher risk of stroke recurrenc