Cor Vasa 2021, 63(4):459-465 | DOI: 10.33678/cor.2021.027

Carotid artery plaque structure in the context of symptomatic/asymptomatic nature of carotid artery stenosis

Didem Melis Oztas^a, Bukem Tanoren Bilen^b, Leyla Turker Sener^c, Metin Onur Beyaz^d, Mustafa Ozer Ulukan^e, Orcun Unal^f, Mehmet Burcin Unlu^g, Paulo Eduardo Ocke Reis^h, Murat Ugurlucan^e

^a Cardiovascular Surgery Clinic, Istanbul Education and Research Hospital, Istanbul, Turkey

^b Faculty of Engineering, Department of Medical Engineering, Acibadem University, Istanbul, Turkey

^c Department of Biophysics, Istanbul, University Istanbul Medical Faculty, Istanbul, Turkey

^d Department of Cardiovascular Surgery, Hatay Mustafa Kemal University Medical Faculty, Hatay, Turkey

^e Department of Cardiovascular Surgery, Istanbul Medipol University Medical Faculty, Istanbul, Turkey

^f Cardiovascular Surgery Clinic, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey

^g Department of Physics, Bogazici University, Istanbul, Turkey

^h Department of Vascular & Endovascular Surgery, Federal Fluminense University, Rio de Janeiro, Brazil

Objective: In this paper, we examined the relationship between atherosclerotic plaque characteristics and symptomatic carotid artery disease.

Material and methods: Twenty-two patients who underwent carotid endarterectomy were enrolled into the study. Thirteen patients were male and remaining 9 patients were female. The mean age was 60.2±9.6 years.The carotid artery stenosis ranged between 75% and 99%. Eight patients were asymptomatic and remaining 14 patients were symptomatic. Ten patients suffered stroke. One of them had recurrent transient ischemic attacks, 4 patients had dizziness, and one of them had amaurosis fugax. The extracted plaques were evaluated by scanning acoustic microscopy (SAM) and micro-computerized tomography (micro-CT).

Results: Smaller acoustic impedance values that reveal collagen-rich plaque formation were detected in patients who had stroke, while higher acoustic impedance values that reveal calcium-rich plaque formation were detected in the asymptomatic patients' plaques.

Conclusions: Determination of plaque characteristics with modern radiographic techniques, rather than relying on the degree of stenosis in patients with carotid artery disease, may be helpful to discriminate patients requiring intervention.

Keywords: Atherosclerotic plaque characteristics, Carotid artery stenosis, Symptomatic disease

Received: February 5, 2021; Revised: February 5, 2021; Accepted: February 11, 2021; Published: August 25, 2021  Show citation