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Alfred V. Persson, MD; Wayne T. Robichaux, MD; Mark Silverman, MD

Arch Surg. 1983;118(9):1048-1052.

Abstract
• Fifty-seven carotid artery plaques in 54 patients were harvested at surgery and studied. Preoperative noninvasive findings, arteriograms, clinical symptoms, surgical findings, and light microscopic findings were compared. Thirty-four patients had symptoms, 28 with TIAs and six with a previous stroke. Thirty-three of the 34 had intraplaque hemorrhage, and 28 had a connection between the hemorrhage and the arterial lumen. Eleven of the 21 asymptomatic patients also had an intraplaque hemorrhage, and one had a connection. In eight of the 11, noninvasive studies showed progression of disease. The development of an intraplaque hemorrhage appears to be an important factor in an innocent plaque's becoming a clinically relevant one. If a connection develops between the intraplaque hemorrhage and the arterial lumen, the patient may have TIAs.

(Arch Surg 1983;118:1048-1052)

Author Affiliations
From the Lahey Clinic Medical Center, Burlington, Mass.

Footnotes
Accepted for publication March 3, 1983.

Read before the ninth annual meeting of the New England Society for Vascular Surgery, Bretton Woods, NH, Oct 14, 1982.

Reprint requests to Lahey Clinic Medical Center, 41 Mall Rd, Burlington, MA 01805 (Dr Persson).

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