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.

References 

  1. Chaturvedi S, Bruno A, Feasby T, Holloway R, Benavente O, Cohen SN, et al. Carotid endarterectomy-An evidence based review: report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology. 2005;65:794–801
  2. North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high grade stenosis. N Engl J Med. 1991;325:445–453
  3. European Carotid Surgery Trialists’ Colloborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351:1379–1387
  4. Osarumwense D, Pararajasingam R, Wilson P, Abraham J, Walker SR. Carotid artery imaging in the United Kingdom: a postal questionnaire of current practice. Vascular. 2005;13:173–177
  5. Rothwell PM, Gibson RJ, Slattery J, Sellar RJ, Warlow CP. Equivalence of measurements of carotid stenosis. A comparison of three methods on 1001 angiograms. Stroke. 1994;25:2435–2439
  6. Brittenden J, Murie JA, Jenkins M, Ruckley CV, Bradbury AW. Carotid endartrectomy before and after publication of randomized controlled trials. Br J Surg. 1999;86:206–210
  7. Neale ML, Chambers JL, Kelly AT, Connard S, Lawton MA, Roche J, et al. Reappraisal of duplex criteria to assess significant carotid stenosis with special reference to reports from the North American symptomatic carotid endarterectomy trial and the European carotid surgery trial. J Vasc Surg. 1994;20:642–649
  8. Staikov IN, Arnold M, Mattle HP, Remonda L, Sturzenegger M, Baumgartner RW, et al. Comparison of the ECST, CC and NASCET grading methods and ultrasound for assessing carotid stenosis. J Neurol. 2000;247:681–686
  9. Walker J, Naylor AR. Ultrasound based measurement of ‘carotid stenosis >70%’: An audit of UK practice. Eur J Vasc Endovasc Surg. 2006;31:487–490
  10. U-King-Im JM, Young V, Gillard JH. Carotid artery imaging in the diagnosis and management of patients at risk of stroke. Lancet. 2009;8:569–580
  11. Dawson DL, Roseberry CA, Fujitani RM. Preoperative testing before carotid endarterectomy: a survey of vascular surgeons’ attitudes. Ann Vasc Surg. 1997;11:264–272
  12. Long A, Lepoutre A, Corbillon E, Branchereau A, Kretz JG. Modalities of preoperative imaging of the internal carotid artery used in France. Ann Vasc Surg. 2002;16:261–265
  13. Wardlaw JM, Chappell FM, Best JJK, Wartolowska K, Berry E. Non-invasive imaging compared with intra-arterial angiography in the diagnosis of symptomatic carotid stenosis:a meta-analysis. Lancet. 2006;367:1503–1512
  14. Rothwell PM, Eliasziw M, Gutnikov SA, Fox AJ, Taylor DW, Mayberg MR, et al. Analysis of pooled data from the randomised controlled trials of endaterectomy for symptomatic carotid stenosis. Lancet. 2003;361:107–116
  15. Barnett HJM. Reflections on the carotid artery: 438 BC to 2009 AD: The Karolinska 2008 award lecture in stroke research. Stroke. 2009;40:3143–3148
  16. Xian PM, Saloner D, Reilly LM. Assessment of carotid artery stenosis by ultrasonography, conventional angiopgraphy, and magnetic resonance angiography: Correlation with ex vivo measurement of plaque stenosis. J Vasc Surg. 1995;21:82–89
  17. Imparato AM, Riles T, Mintzer R, Bauman FG. The importance of haemorrhage in the relationship between gross morphologic characteristics and cerebral symptoms in 376 carotid artery plaques. Ann Surg. 1983;197:195–203
  18. Gao P, Chen ZQ, Bao YH, Jiao LQ, Ling F. Correlation between intraplaque hemorrhage and clinical symptoms: Systematic review of observational studies. Stroke. 2007;38:2382–2390
  19. Rothwell PM, Warlow CP on behalf of ECST collaborative group. Prediction of benefit from carotid endarterectomy in individual patients: a risk modelling study. Lancet. 1999;353:2105–2110
  20. Geroulakos G, Hobson W, Nicolaides A. Ultrasonographic carotid plaque morphology in predicting stroke risk. Br J Surg. 1996;83:582–587
  21. Snow M, Ben- Sassi A, Winter RK, Verghese A, Hibberd R, Saad RA, et al. Can carotid ultrasound predict plaque histopathology?. J Cardiovasc Surg. 2007;48:299–303
  22. Bock RW, Gray-Weal AC, Mock PA, App Stats M, Robinson DA, Irwig L, et al. The natural history of asymptomatic carotid artery disease. J Vasc Surg. 1993;17:160–169
  23. Grogan J, Shaalan WE, Cheng H, Gewertz B, Desai T, Schwarze G, et al. B mode ultrasonographic characterization of carotid atherosclerotic plaques in symptomatic and asymptomatic patients. J Vasc Surg. 2005;42:435–441
  24. AbuRahma AF, Wulu JT, Crotty B. Carotid plaque ultrasonic heterogeneity and severity of stenosis. Stroke. 2002;33:1772–1775
  25. Rothwell PM, Warlow CP. Interrelation between plaque surface morphology and degree of stenosis on carotid angiograms and the risk of ischaemic stroke in patients with symptomatic carotid stenosis. Stroke. 2000;31:615–621
  26. Eikelboom BC, Riles TR, Mintzer R, Baumann FG, DeFillip G, Lin J, et al. Inaccuracy of angiography in the diagnosis of carotid ulceration. Stroke. 1983;14:882–885
  27. De Weert TT, Cretier S, Groen HC. Atherosclerotic plaque surface morphology in the carotid bifurcation assessed with multidetector computed tomography angiography. Stroke. 2009;40:1334–1340
  28. Hermus L, Van Dam GM, Zeebregts CJ. Advanced carotid plaque imaging. Eur J Vasc Endovasc Surg. 2010;39:125–133
  29. Ballotta E, Da Glau G, Renon L. Carotid plaque gross morphologyand clinical presentation. A prospective studyof 457 carotid specimens. J Surg Res. 2000;89:78–84
  30. Park AE, McCarthy WJ, Pearce WH, Matsumura S, Yao JST. Carotid morphology correlates with presenting symptomology. J Vasc Surg. 1998;27:872–879
  31. Pressin MS, Hinton RC, Davis KR, Duncan GW, Roberson GH, Ackerman RH, et al. Mechanism of acute carotid stroke. Ann Neurol. 1979;6:245–252
  32. Shi ZS, Feng L, He X, Ishii A, Goldstine J, Vinters HV, et al. Vulnerable plaque in a swine model of carotid atherosclerosis. Am J Neuroradiol. 2009;30:469–472
  33. Kolodgie FD, Gold HK, Burke AP, Fowler DR, Kruth HS, Weber DK, et al. Intraplaque hemorrhage and progression of coronary atheroma. N Engl J Med. 2003;349:2316–2325
  34. Derdeyn CP. Mechanism of ischaemic stroke secondary to large artery atherosclerotic disease. Neuroimaging Clin N Am. 2007;17:303–311
  35. Kang DW, Chu K, Ko SB. Lesion patterns and mechanism of ischaemia in internal carotid artery disease. A diffusion weighted imaging study. Arch Neurol. 2002;59:1577–1582
  36. Rothwell PM, Warlow CP. Low risk of ischaemic stroke in patients with reduced internal carotid artery lumen diameter distal to severe symptomatic carotid stenosis. Cerebral protection due to low poststenotic flow. Stroke. 2000;31:622–630
  37. Countee RW, Vijayanathan T. External carotid artery in internal carotid artery occlusion. Angiographic, therapeutic, and prognostic considerations. Stroke. 1979;10:450–460
  38. Golledge J, Siew DA. Identifying the ‘high risk’ plaque: Is it a riddle still wrapped up in a enigma?. Eur J Vasc Endovasc Surg. 2008;35:2–8
  39. Hackman DG, Spence D. Combining multiple approaches for the secondary prevention of vascular events after stroke. A quantitative modelling study. Stroke. 2007;38:1881–1885
  40. Donnan G, Fisher M, Macleod M, Davis SM. Stroke. Lancet. 2008;371:1612–1623
  41. Krupinski J, Turu MM, Slevin M, Martinez-Gonzalez J. Carotid plaque, stroke pathogenesis, and crp: treatment of ischemic stroke. Curr Treat Options Cardiovasc Med. 2007;9:229–235

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