The relationship between vulnerable plaque and nonlacunar infarction

Abstract

Objective To study the relationship between vulnerable plaque and nonlacunar infarction, and analyze distribution regularity of carotid atherosclerotic plaque. Methods One hundred and four patients with ischemic stroke were divided into two groups: nonlacunar infarction group (64 cases) and lacunar infarction group (40 cases) based on imaging and clinical manifestation. Location, number, type,degree of carotid atherosclerotic plaque was recorded and compared between the two groups. Results Two hundred and ninety-seven plaques shown by the imaging were distributed in different areas:9 plaques located in the initial part of the carotid artery, 51 plaques located in the carotid artery, 148 plaques located in the bifurcation of the carotid artery, 27 plaques located in the internal carotid artery and 62 plaques located in the intracalvarium part of internal carotid artery. The percentage of severe or occlusion carotid artery stenosis in nonlacunar infarction group was 29.7% (19/64), which was higher than that in lacunar infarction group [10.0% (4/40)] (P = 0.019 ). The percentage of vulnerable plaque in nonlacunar infarction group was 62.5% (40/64), which was higher than that in lacunar infarction group [47.5%( 19/40)](P=0.004). Multivariate analysis showed that the degree of carotid artery stenosis(OR = 1.740,95% CI: 1.002 -3.021 ) and vulnerable plaque (OR = 2.865,95% CI: 1.047 - 7.813 ) was related with nonlacunar infarction.Conclusions The plaque is more frequently encountered at the bifurcation of the carotid artery. The degree of carotid artery stenosis and vulnerable plaque are the independent risk factors of the nonlacunar infarction.CT angiography can clearly display carotid artery stenosis, morphology and component of plaque, so it will be used as the preferred clinical examination. Key words: Brain infarction; Carotid stenosis; Angiography; Vulnerable plaque