The relationship between the angiographic findings and the clinical features of carotid artery plaque

The purpose of this study was to investigate the histological characteristi cs of atheromatous carotid plaque, and to analyze the relationship between the angiographic findings and the clinical features. We retrospectively rev iewed 55 cases of carotid endarterectomy for extracranial internal carotid artery stenosis, who were treated at our institute from January 1995 to Dec ember 1997, The histological examination included hematoxylin-eosin stainin g, Masson-trichrome staining, and immunostaining for antismooth muscle anti body and anti-CD68 antibody, The main compositions of the carotid plaque in cluded synthetic type vascular smooth muscle cells and extracellular matrix . The histological findings showed ulceration in 49 (89.1%) cases, calcium deposits in 42 (76.4%) cases, and an inflammatory reaction in 44 (80.0%) ca ses. Neurological abnormalities were strongly associated with plaque ulcera tion (P = 0.045) and an inflammatory reaction (P = 0.013), whereas no corre lation existed regarding calcium deposits (P = 0.173). The angiographic fin dings showed ulceration in 46 (83.6%) cases, Plaque ulceration in the angio graphy findings showed no statistically significant correlation with the hi stologic findings (P = 0.410) and preoperative neurologic abnormalities (P = 0.059). All of the atherosclerotic risk factors such as hypertension, smo king, diabetes mellitus, hyperlipidemia, and myocardial infarction had no s tatistically significant correlation with the histological features of the carotid plaque. In conclusion, the main compositions of carotid plaque were synthetic-type vascular smooth muscle cells and extracellular matrix. The histological ulceration and inflammatory reaction of the plaque showed a st atistically significant correlation with the preoperative neurologic sympto ms, whereas no correlation was seen in the calcium deposits, Angiographic u lceration showed no correlation with the histological findings or preoperat ive neurologic abnormalities. In addition, the histological findings showed no correlation with the atherosclerotic risk factors.