The natural history of carotid plaque development

• Published in: Archives of surgery (Chicago. 1960) Vol. 118; no. 9; p. 1048
• Main Authors: Persson, A V, Robichaux, W T, Silverman, M
• Format: Journal Article
• Language: English
• Published: United States 01-09-1983
• Subjects: Aged; Arteriosclerosis - complications; Arteriosclerosis - pathology; Brain Ischemia - surgery; Carotid Arteries - pathology; Carotid Arteries - surgery; Carotid Artery Diseases - complications; Carotid Artery Diseases - pathology; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - surgery; Endarterectomy; Female; Humans; Ischemic Attack, Transient - etiology; Male
• ISSN: 0004-0010
• DOI: 10.1001/archsurg.1983.01390090038008

Fifty-seven carotid artery plaques in 54 patients were harvested at surgery and studied. Preoperative noninvasive findings, arteriograms, clinical symptoms, surgical findings, and light microscopic findings were compared. Thirty-four patients had symptoms, 28 with TIAs and six with a previous stroke. Thirty-three of the 34 had intraplaque hemorrhage, and 28 had a connection between the hemorrhage and the arterial lumen. Eleven of the 21 asymptomatic patients also had an intraplaque hemorrhage, and one had a connection. In eight of the 11, noninvasive studies showed progression of disease. The development of an intraplaque hemorrhage appears to be an important factor in an innocent plaque's becoming a clinically relevant one. If a connection develops between the intraplaque hemorrhage and the arterial lumen, the patient may have TIAs.