Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan.
J Neuroimaging. 2011 Oct;21(4):348-54. doi: 10.1111/j.1552-6569.2010.00552.x. Epub 2010 Dec 1.
Several prospective studies have shown that carotid endarterectomy can reduce the risk for subsequent ischemic stroke in patients with 70-99% stenosis of the internal carotid artery (ICA). However, its benefits are still controversial in less than 70% stenosis of the ICA. There is increasing evidence that carotid lumen irregularities may correlate with neurological symptoms. Recent development of computed tomography angiography (CTA) can provide adequate information on the carotid plaque morphology. In this study, therefore, we aimed to clarify whether carotid lumen morphology estimated by CTA correlates with neurological symptoms in patients with 30-69% ICA stenosis.
This study included 67 carotid stenotic lesions with 30-69% ICA stenosis in 52 consecutive patients. These 67 lesions were examined by CTA from the viewpoints of the degree of stenosis, the prevalence of ulceration, and lumen morphology. Multivariate analysis was performed to detect significant predictors for the occurrence of ipsilateral ischemic events.
Multivariate analysis showed that the irregular shape of the carotid lumen was the most powerful variable to predict symptomatic lesion in 30-69% ICA stenosis.
These findings suggest that the morphology of carotid plaque may be associated with the occurrence of ipsilateral ischemic events in 30-69% ICA stenosis.
几项前瞻性研究表明，在颈内动脉（ICA）狭窄 70%-99%的患者中，颈动脉内膜切除术可降低随后发生缺血性卒中的风险。然而，在 ICA 狭窄不足 70%的情况下，其益处仍存在争议。越来越多的证据表明，颈动脉管腔不规则可能与神经症状相关。最近计算机断层血管造影（CTA）的发展可以提供关于颈动脉斑块形态的充分信息。因此，在这项研究中，我们旨在阐明 CTA 估计的颈动脉管腔形态是否与 30%-69%ICA 狭窄患者的神经症状相关。
本研究纳入了 52 例连续患者的 67 个颈内动脉狭窄病变，狭窄程度为 30%-69%。这些 67 个病变通过 CTA 从狭窄程度、溃疡发生率和管腔形态的角度进行了检查。进行多变量分析以检测同侧缺血事件发生的显著预测因素。
多变量分析显示，颈动脉管腔的不规则形状是预测 30%-69%ICA 狭窄中症状性病变的最有力变量。
这些发现表明，颈动脉斑块的形态可能与 30%-69%ICA 狭窄中同侧缺血事件的发生有关。
