Stroke : Highlights of Selected Articles

Carotid artery stenosis is a risk factor for stroke. The benefit of carotid endarterectomy for severe (≥70%), symptomatic internal carotid stenosis has been shown to be significant in major trials compared with medical therapy. The benefit of carotid endarterectomy for 50% to 70% symptomatic and asymptomatic carotid stenosis is less clear. Thus, the identification of specific carotid plaque features that allow further risk stratification of patients at risk of stroke is extremely important. A vulnerable plaque has high-risk features thought to have increased risk of stroke. Plaque neovascularization and adventitial vasa vasorum (VV) have been shown to have important role in the pathogenesis of the vulnerable plaque. Dr Romero and colleagues have previously demonstrated that enhancement of the VV on computed tomography angiography (CTA) in patients with ≥70% carotid stenosis is associated with increased risk of vascular events. This study sought to determine whether a similar relationship exists in patients with moderate 50% to 70% internal carotid stenosis stenosis. …