The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths

A group of 72 patients with 111 asymptomatic carotid stenoses (ACS), mean age 65.42 ± 9.21, and a group of 36 patients with 58 symptomatic carotid stenoses (SCS), mean age 67.63 ± 8.79, were analyzed prospectively during a 3-year follow-up period. All patients underwent color duplex scan sonography...

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Main Authors: Milan D. Brajovic, Nataša Markovic, Goran Loncar, Nikola Šekularac, Dejan Kordic, Nebojša Despotovic, Predrag Erceg, Branislav Donfrid, Zvezdan Stefanovic, Milica Bajcetic, Ljiljana Brajovic, Živorad Savic
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/tsw.2009.74
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author Milan D. Brajovic
Nataša Markovic
Goran Loncar
Nikola Šekularac
Dejan Kordic
Nebojša Despotovic
Predrag Erceg
Branislav Donfrid
Zvezdan Stefanovic
Milica Bajcetic
Ljiljana Brajovic
Živorad Savic
author_facet Milan D. Brajovic
Nataša Markovic
Goran Loncar
Nikola Šekularac
Dejan Kordic
Nebojša Despotovic
Predrag Erceg
Branislav Donfrid
Zvezdan Stefanovic
Milica Bajcetic
Ljiljana Brajovic
Živorad Savic
author_sort Milan D. Brajovic
collection DOAJ
description A group of 72 patients with 111 asymptomatic carotid stenoses (ACS), mean age 65.42 ± 9.21, and a group of 36 patients with 58 symptomatic carotid stenoses (SCS), mean age 67.63 ± 8.79, were analyzed prospectively during a 3-year follow-up period. All patients underwent color duplex scan sonography (CDS), carotid arteriography, computed tomography (CT) scan, and neurological examination. The aim of the study was to analyze the correlation between echo plaque morphology (degree and plaque quality), local hemodynamic plaque characteristics, ischemic CT findings, and onset of new neurological events and deaths. The results analysis showed significantly more ACS in the group of 30–49% stenosis (p < 0.001), but significantly more SCS in the group of 70–89% (p < 0.0001) and ≥90% stenosis (p < 0.05). Fibrous plaque was more frequent in the ACS group (p < 0.001), while ulcerated and mixed plaques were more frequent in the SCS group (both p < 0.0001). In the SCS group, a significantly higher frequency of increased peak systolic and end diastolic velocities was noted at the beginning and end of the study (both p < 0.01), as well as for contralateral common (CCA) or internal carotid artery (ICA) occlusion (p < 0.05 and p < 0.01, respectively), but reduced carotid blood flow volume (p < 0.05) only at the end of the study. In the ACS group, the best correlation with new neurological events and deaths was shown with positive CT findings, peak systolic flow velocity over 210 cm/sec, end diastolic flow velocity over 110 cm/sec, plaque stenosis ≥70%, plaque ulceration, mixed plaque (all p < 0.0001); stenosis ≥50% (p < 0.001); and reduced carotid blood flow volume (p < 0.05).
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spelling doaj-art-4bef4450f74e4c6db7732bc73789176a2025-02-03T05:53:01ZengWileyThe Scientific World Journal1537-744X2009-01-01950952110.1100/tsw.2009.74The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and DeathsMilan D. Brajovic0Nataša Markovic1Goran Loncar2Nikola Šekularac3Dejan Kordic4Nebojša Despotovic5Predrag Erceg6Branislav Donfrid7Zvezdan Stefanovic8Milica Bajcetic9Ljiljana Brajovic10Živorad Savic11Cardiology Department, Zvezdara University Hospital, Belgrade, SerbiaCardiology Department, Zvezdara University Hospital, Belgrade, SerbiaCardiology Department, Zvezdara University Hospital, Belgrade, SerbiaCardiology Department, Zvezdara University Hospital, Belgrade, SerbiaCardiology Department, Zvezdara University Hospital, Belgrade, SerbiaClinical Department for Geriatrics, Zvezdara University Hospital, Belgrade, SerbiaClinical Department for Geriatrics, Zvezdara University Hospital, Belgrade, SerbiaVascular Surgery Department, Zvezdara University Hospital, Belgrade, SerbiaVascular Surgery Department, Zvezdara University Hospital, Belgrade, SerbiaDepartment of Pharmacology, School of Medicine, University of Belgrade, SerbiaCivil Engineering Faculty, Department of Technical Physics, Belgrade, SerbiaInstitute of Radiology, Clinical Centre of Serbia, Belgrade, SerbiaA group of 72 patients with 111 asymptomatic carotid stenoses (ACS), mean age 65.42 ± 9.21, and a group of 36 patients with 58 symptomatic carotid stenoses (SCS), mean age 67.63 ± 8.79, were analyzed prospectively during a 3-year follow-up period. All patients underwent color duplex scan sonography (CDS), carotid arteriography, computed tomography (CT) scan, and neurological examination. The aim of the study was to analyze the correlation between echo plaque morphology (degree and plaque quality), local hemodynamic plaque characteristics, ischemic CT findings, and onset of new neurological events and deaths. The results analysis showed significantly more ACS in the group of 30–49% stenosis (p < 0.001), but significantly more SCS in the group of 70–89% (p < 0.0001) and ≥90% stenosis (p < 0.05). Fibrous plaque was more frequent in the ACS group (p < 0.001), while ulcerated and mixed plaques were more frequent in the SCS group (both p < 0.0001). In the SCS group, a significantly higher frequency of increased peak systolic and end diastolic velocities was noted at the beginning and end of the study (both p < 0.01), as well as for contralateral common (CCA) or internal carotid artery (ICA) occlusion (p < 0.05 and p < 0.01, respectively), but reduced carotid blood flow volume (p < 0.05) only at the end of the study. In the ACS group, the best correlation with new neurological events and deaths was shown with positive CT findings, peak systolic flow velocity over 210 cm/sec, end diastolic flow velocity over 110 cm/sec, plaque stenosis ≥70%, plaque ulceration, mixed plaque (all p < 0.0001); stenosis ≥50% (p < 0.001); and reduced carotid blood flow volume (p < 0.05).http://dx.doi.org/10.1100/tsw.2009.74
spellingShingle Milan D. Brajovic
Nataša Markovic
Goran Loncar
Nikola Šekularac
Dejan Kordic
Nebojša Despotovic
Predrag Erceg
Branislav Donfrid
Zvezdan Stefanovic
Milica Bajcetic
Ljiljana Brajovic
Živorad Savic
The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths
The Scientific World Journal
title The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths
title_full The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths
title_fullStr The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths
title_full_unstemmed The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths
title_short The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths
title_sort influence of various morphologic and hemodynamic carotid plaque characteristics on neurological events onset and deaths
url http://dx.doi.org/10.1100/tsw.2009.74
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