European Journal of Vascular & Endovascular Surgery
Volume 40, Issue 4 , Pages 475-482 , October 2010

Carotid Endarterectomy for Symptomatic, but “Haemodynamically Insignificant” Carotid Stenosis

  • R.M. Ahmed

      Affiliations

    • Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
    • ,
  • J.P. Harris

      Affiliations

    • Department of Vascular Surgery, Royal Prince Alfred Hospital and The University of Sydney, NSW, Australia
    • ,
  • C.S. Anderson

      Affiliations

    • Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
    • George Institute of Global Health, Sydney, Australia
    • ,
  • V. Makeham

      Affiliations

    • Department of Vascular Surgery, Royal Prince Alfred Hospital and The University of Sydney, NSW, Australia
    • ,
  • G.M. Halmagyi

      Affiliations

    • Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 2 9515 7565; fax: +61 2 9515 7564.

Received 9 March 2010 ,Accepted 12 July 2010.

  • Image Result

    Case 1 CT angiogram showing 50% stenosis and soft plaque (A); Catheter angiogram (lateral projection) showing a minimal stenosis (B); Diffusion-weighted MRI showing multiple small middle cerebral arte

    Case 1 CT angiogram showing 50% stenosis and soft plaque (A); Catheter angiogram (lateral projection) showing a minimal stenosis (B); Diffusion-weighted MRI showing multiple small middle cerebral artery territory infarcts(C); Carotid duplex showing 40-60% stenosis with soft plaque (CCA= common carotid artery, ICA= internal carotid artery. small stem arrows show plaque surface, large stem arrows show vessel wall) (D); Hemorrhagic plaque found at operation (E).

  • Image Result
    Carotid duplex (Case 2) showing 50–70% stenosis with echolucent plaque (arrowed and outlined), thought to represent intra-plaque hemorrhage. (ICA = internal carotid artery, ECA = external carotid arte

    Carotid duplex (Case 2) showing 50–70% stenosis with echolucent plaque (arrowed and outlined), thought to represent intra-plaque hemorrhage. (ICA = internal carotid artery, ECA = external carotid artery).

  • Image Result
    Catheter angiogram Stenosis on lateral projection of catheter angiogram (A) appears to be less than 50%, but on MRI was estimated to be 70%. Plaque removed at CEA was ulcerated and haemorrhagic (B).

    Catheter angiogram Stenosis on lateral projection of catheter angiogram (A) appears to be less than 50%, but on MRI was estimated to be 70%. Plaque removed at CEA was ulcerated and haemorrhagic (B).

PII: S1078-5884(10)00429-6

doi: 10.1016/j.ejvs.2010.07.003

European Journal of Vascular & Endovascular Surgery
Volume 40, Issue 4 , Pages 475-482 , October 2010

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