Atherosclerotic lesions are responsible for about 10% of ischemic strokes. However, the evolving thrombotic and embolic potential of these lesions remains difficult to evaluate. Pathology studies and ultrasonography have contributed to the study of the complications of atherosclerotic plaques at the origin of the internal carotid artery (hemorrhage, ulceration, necrosis, and the degree of stenosis). Moreover, improvement of ultrasound examination of intracranial arteries allows the detection of emboli which could be markers of ulceration. Considering pathologic, angiographic, ultrasonographic and clinical studies, only tight stenoses have been shown to have a high thromboembolic potential. The risk is further increased when the stenosis is ulcerated, progressive, has an intraluminal thrombus, or when it is the source of emboli detected by transcranial Doppler. Apart from this stroke risk, an increased general risk of vascular mortality and heart morbidity is present in this population. Increased intima plus media thickness of the common carotid artery, quantified by B-mode sonography, has been shown to be a good predictor of ischemic events. Further improvements in noninvasive methods will more precisely define the evolution of atherosclerotic plaques and their link with the risk of stroke, especially for low-degree stenosis.

Keywords:
Ultrasonography, Atherosclerosis, Intraplaque hemorrhage, Ulceration, Wall thickness, Emboli, Remodeling
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© 1994 S. Karger AG, Basel
1994
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