The structure of atherosclerotic plaques of the arteries estimated at ultrasonography in patients with acute ischemic stroke

Aim. Evaluation of histological structure of an atherosclerotic plaque of the carotids received during carotid endarterectomy and its comparison to the data obtained at ultrasonography of carotids.

Methods. 36 patients with the history of cerebral circulatory disorders aged from 50 to 75 years (24 males and 12 females) were examined. 22 patients (14 males and 8 females) had ischemic focus at CAT scan, 7 patients had recurrent ischemic stroke and the rest had transient ischemic attacks. We performed color duplex scanning of extracranial vessels. In addition to ultrasonography contrast intensifying was performed. Sulfur hexafluoride stabilized by phospholipid shell was used as a contrast. Transcranial Doppler with functional assays was carried out as well. Pathomorphological study of the plaques removed at carotid endarterectomy was conducted.

Results. According to the results of ultrasonography conducted before the surgery and histological results, 28 plaques received during carotid endarterectomy were unstable. 60 to 90% stenoses of carotid bifurcation and internal carotids were revealed. Heterogeneous structure, disturbance of fibrous cap and ulcerations, presence of hypoechoic zones of various sizes were observed.

Conclusions. The results of ultrasonography are in accordance with histological conclusion; this method is a reliable tool that provides new opportunities for prediction of embolic complications risk and proves the necessity for carotid endarterectomy.