Correlation between the vulnerability of carotid plaque and ischemic stroke

Abstract

Objective To analysis the correlation between the vulnerability of carotid plaque and ischemic stroke and to explore the clinical significance of assessing vulnerable plaques accurately. Methods A total of 64 patients, who underwent carotid endarterectomy (CEA) in First Affiliated Hospital of Soochow University from October 2014 to February 2016, were classified into ischemic and non-ischemic stroke group according to whether ischemic stroke symptoms occurred during the last 6 months before surgery. To judge the stable and vulnerable plaques, the patients underwent carotid doppler ultrasonography (CDU) before surgery, and the carotid plaques were evaluated with HE staining after CEA. We also analyzed the risk factors of plaque formation and the relevance between the plaque characteristic and ischemic stroke with chi-square test. Kappa test were used to analyze the consistency of CDU and pathology. Results Of the 44 cases in ischemic stroke group, CDU identified 81.8% (36/44) vulnerable plaques and 18.2% (8/44) stable plaques, while pathology confirmed 86.4% (38/44) vulnerable plaques and 13.6% (6/44) stable plaques. Of the 20 cases in non-ischemic stroke group, CDU identified 35% (7/20) vulnerable plaques and 65% (13/20) stable plaques, while pathology confirmed 40% (8/20) vulnerable plaques and 60% (12/20) stable plaques. In both CDU and pathology, vulnerable plaques in ischemic stroke group were obviously higher than that in non-ischemia group (χ2=13.67, P<0.001; χ2=14.62, P<0.001). The results of CDU agreed well to that of pathology results (Kappa=0.669, P<0.01). Conclusions The vulnerability of plaques were closely related to the ischemic stroke. CDU is a reliable examination method to identify vulnerable plaques. The accurate assessment of vulnerability of plaques has a great significance in preventing ischemic stroke. Key words: Ultrasonography; Stroke; Endarterectomy carotid