Carotid atherosclerosis in relation to symptoms from the territory supplied by the carotid artery

Objectives: to investigate the relationship between intima-media thickness in the common carotid artery, plaque morphology in the carotid bifurcation and symptoms of cerebral embolism. Design: prospective study of consecutive patients referred for carotid dupl ex examination. Methods: One hundred and eighty-eight patients were classified by one of tw o neurologists into four categories (symptomatic, asymptomatic, undefined, uncertain). Carotid atherosclerosis was measured by means of high-resolutio n ultrasound technique. Carotid plaques were classified based on visual eva luation of plaque echogenicity. Results: intima-media thickness (IMT) was correlated to presence of plaques , age and gender, but not to symptoms referable to the carotid circulation. Carotid plaques were more common in symptomatic than in asymptomatic vesse ls (p<0.05). There was no difference in plaque occurrence between the ipsi- and contralateral sides in the symptomatic patients, neither in frequency of echolucent plaques between the sides or between symptomatic and asymptom atic patients. Echogenic plaques were more common and generally smaller tha n echolucent plaques. Conclusions: IMT correlates with presence of plaques, but not with symptoms from the territory supplied by the carotid artery. Echolucent plaques in t he carotid bifurcation are not more frequently symptomatic than echogenic p laques are, in patients with low-to-moderate degree of carotid stenosis.