Beyond established criteria for carotid endarterectomy (CEA), additional plaque histologic features such as a large lipid core, fibrous cap rupture, surface ulceration, and intraplaque hemorrhage have been associated with atheroembolic stroke.(1,2) It has become of great interest to identify which plaques are "vulnerable," even though not yet ruptured (ie, at risk of becoming symptomatic or at a vulnerable stage).(3) The 2-year risk of ipsilateral stroke for medically treated patients with ulcerated plaques was 73% for higher degrees of stenosis compared with 21% for all degrees.(4) We report the imaging findings of high-grade symptomatic carotid stenosis. On admission, the ultrasound study did not show any feature suggestive of a vulnerable plaque except for the degree of stenosis. However, an ultrasound examination performed 24 hours later revealed acute changes in the plaque surface, leading to urgent CEA.

Sallustio, F., Di Legge, S., Koch, G., Ippoliti, A., Mauriello, A., & Stanzione, P. (2009). Urgent carotid endarterectomy: The role of serial ultrasound studies in early detection of plaque rupture. JOURNAL OF ULTRASOUND IN MEDICINE, 28(2), 239-243.

Urgent carotid endarterectomy: The role of serial ultrasound studies in early detection of plaque rupture

IPPOLITI, ARNALDO;MAURIELLO, ALESSANDRO;STANZIONE, PAOLO
2009-02

Abstract

Beyond established criteria for carotid endarterectomy (CEA), additional plaque histologic features such as a large lipid core, fibrous cap rupture, surface ulceration, and intraplaque hemorrhage have been associated with atheroembolic stroke.(1,2) It has become of great interest to identify which plaques are "vulnerable," even though not yet ruptured (ie, at risk of becoming symptomatic or at a vulnerable stage).(3) The 2-year risk of ipsilateral stroke for medically treated patients with ulcerated plaques was 73% for higher degrees of stenosis compared with 21% for all degrees.(4) We report the imaging findings of high-grade symptomatic carotid stenosis. On admission, the ultrasound study did not show any feature suggestive of a vulnerable plaque except for the degree of stenosis. However, an ultrasound examination performed 24 hours later revealed acute changes in the plaque surface, leading to urgent CEA.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/22 - Chirurgia Vascolare
Settore MED/08 - Anatomia Patologica
English
Con Impact Factor ISI
acetylsalicylic acid; atorvastatin; clopidogrel; aged; article; atheroma; atherosclerosis; atherosclerotic plaque; carotid endarterectomy; case report; color ultrasound flowmetry; computed tomographic angiography; early diagnosis; emergency surgery; human; internal carotid artery occlusion; magnetic resonance angiography; male; treatment outcome; vascular patency; acute disease; carotid artery obstruction; echocardiography; echography; intensive care; methodology; rupture; Acute Disease; Aged; Carotid Stenosis; Critical Care; Echocardiography; Endarterectomy, Carotid; Humans; Male; Rupture; Treatment Outcome
http://www.jultrasoundmed.org/
Sallustio, F., Di Legge, S., Koch, G., Ippoliti, A., Mauriello, A., & Stanzione, P. (2009). Urgent carotid endarterectomy: The role of serial ultrasound studies in early detection of plaque rupture. JOURNAL OF ULTRASOUND IN MEDICINE, 28(2), 239-243.
Sallustio, F; Di Legge, S; Koch, G; Ippoliti, A; Mauriello, A; Stanzione, P
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/39002
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