THE CLINICAL-SIGNIFICANCE OF CAROTID PLAQUE HEMORRHAGE

The clinical picture with the pathology findings of 89 atheromatic pla ques which were removed following endarterectomy of the internal carot id artery, for the purpose of determining the clinical significance of the haemorrhagic atheromatic plaque were correlated. Intraplaque haem orrhage was determined in 44 of the 57 plaques (72.2%) of symptomatic patients while in the asymptomatic patients haemorrhage was noted in 1 2 of the 32 plaques (37.5%) p < 0.001. The extent of haemorrhage was > 25% of the plaque thickness in 21 of 44 symptomatic plaques (47.72%) and in the asymptomatic plaques in 3 out of 12 (25%) p > 0.05. The inc idence of ulceration of the intima, with or without the presence of th rombus, was more frequent in the haemorrhagic plaques (68.42%) as comp ared with the nonhaemorrhagic (31.57%), without any significant differ ence between the symptomatic and asymptomatic plaques. Communication o f haemorrhage with the lumen was observed in 8 of 24 plaques (33.33%), 7 of which (29.16%) were symptomatic. The presence of haemorrhage in the atheromatic plaque of the internal carotid artery does not seem to play any direct role in the pathogenesis of the symptoms but, neverth eless, it constitutes a significant indication of instability of the a theromatic plaque.