Abstract:
BACKGROUND AND PURPOSE:The management of carotid atherosclerosis is well-established for symptomatic stenosis above 69%, but the optimal approach for managing lower degrees of narrowing remains uncertain. Because the risk of stroke increases with higher grades of stenosis, we are inclined to consider low-grade disease to be low risk. This approach, however, does not take into account other factors such as plaque size or composition. Plaque may progress to a substantial size before it demonstrates significant stenosis by angiography. We know that low-grade disease can result in cerebrovascular ischemic events, but predicting vulnerable lesions has not been possible by relying on stenosis alone. SUMMARY OF REVIEW:An understanding of the clinical behavior of plaque causing little to no narrowing is now possible with the advent of high-resolution black blood MRI, a modality that does not rely on luminal narrowing for detection. CONCLUSIONS:We present the current understanding of the clinical implications of low-grade carotid stenosis with an example of the MRI assessment of high-risk carotid plaque causing minimal narrowing that highlights the importance of looking beyond the lumen.
journal_name
Strokejournal_title
Strokeauthors
Wasserman BA,Wityk RJ,Trout HH 3rd,Virmani Rdoi
10.1161/01.STR.0000185726.83152.00subject
Has Abstractpub_date
2005-11-01 00:00:00pages
2504-13issue
11eissn
0039-2499issn
1524-4628pii
01.STR.0000185726.83152.00journal_volume
36pub_type
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