Sonographic evaluation of plaque morphology in haemodynamic and non-haemodynamic symptomatic carotid artery stenoses.

Abstract

A prospective duplex ultrasound and Colour Doppler imaging studies were performed on 52 consecutive patients with 63 carotid arteries (11 patients with bilateral carotid interrogation). The cases were classified into two study groups — non-haemodynamically 50 °o) and haemodynamically ( = 50% ) significant stenoses in relation to clinical events and carotid plaque echomorphology . Of the 63 carotid arteries that were evaluated, 36 (57.1 % ) revealed non-haemodynamic and 27 (42. 9 %) haemodynamic stenoses Our study confirmed that more than half o f the cases with hemispheric symptoms (stroke and TIA ) were related to nonhaemodynamic stenosis accounting for 53.7% . While hetctogeneous and homogeneous plaques were seen in both study groups with hemispheric symptoms, no heterogeneous plaque was seen in haemodynamic stenosis with non-hemispheric symptoms No statistically significant differences were seen between heterogeneous and homogeneous plaques in non - haemodynamic and haemodynamic cases. Predominantly hypoechoic stenoses, representing thrombotic materials are more common in haemodynamic cases of stroke accounting for 64.3 % and in 769 % o f non-haemodynamic cases in TIA. Plaque surface irregularity and ulceration did not seem to be related to the severity of stenosis as there was no statistically significant difference in the frequencies. However, while irregularly surfaced plaques are of equal frequency in non-haemodynamic and haemodynamic cases.