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A Four Year Clinical and Echographic Follow-up of Asymptomatic Carotid Plaque

Department of Geriatric Medicine, University of Turin, Turin, Italy

L. Poli

Department of Geriatric Medicine, University of Turin, Turin, Italy

M. Zanocchi

Department of Geriatric Medicine, University of Turin, Turin, Italy

M. Bo

Department of Geriatric Medicine, University of Turin, Turin, Italy

U. Fiandra

Department of Geriatric Medicine, University of Turin, Turin, Italy

G. Fonte

Department of Geriatric Medicine, University of Turin, Turin, Italy

Eighty-five patients with asymptomatic carotid plaque—a diagnosis revealed by B-mode high-resolution echotomography—were followed up for four years; the echoplaque changes were compared with the clinical history. Eight patients died (2 from stroke, 4 from myocardial infarction, and 2 from lung tumor) and were excluded from the follow-up. Three patients underwent carotid thromboen darterectomy (TEA) (1 bilateral), and these 4 carotids were not considered in the total series.

At the first echo Doppler evaluation of 150 carotids, plaques were observed in 112; 38 vessels were free of lesions.

Of the 150 carotids, 8 revealed a new plaques. In regard to the echogenic pattern, 95 of the 112 plaques (84.8%) remained unchanged, 16 (14.3%) progressed, and regression of a small homogeneous plaque was observed in 1 patient (0.9%). An increase of the degree of vascular stenosis, was observed in 23 of the 150 carotids (15.3%).

Cerebral ischemic symptoms occurred in 5 patients. In 1 patient who suffered from stroke, a new, soft, dyshomogeneous plaque in the carotid of the side of the lesion was observed. In 3 patients (2 with strokes, 1 with transient ischemic attack) the occlusion of a previous severe stenosis was observed. The fifth pa tient had a stroke on the side of an unchanged, ulcerated hemodynamic lesion.

A valid criterion for identifying a risky plaque should be the joint evaluation of the echostructural characteristics and the degree of stenosis.

Angiology, Vol. 43, No. 7, 590-598 (1992)
DOI: 10.1177/000331979204300708


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