Unstable atherosclerotic plaque in the common carotid artery: Diagnosis and treatment strategy.

The indication for carotid artery stenosis treatment is based primarily on the severity of internal carotid stenosis. There is increasing evidence that unstable plaques in the extracranial carotid artery can be responsible for ischemic stroke or transient ischemic attacks as the source of emboli, even if in the presence of a moderate stenosis. Physicians should be aware that morphological characteristics of the carotid plaques that indicate recent intra-plaque hemorrhage might require intervention in the absence of severe stenosis. This report details a patient with an unstable plaque in the common carotid artery who met clinical criteria for intervention because of the risk for future stroke.