MDCT angiography can potentially help determine which patients with narrowed carotid arteries are at greater risk of having a stroke, a new study shows. This information could help identify which patients need surgery and which can be treated with less invasive procedures.

The study reviewed 31 patients who had greater than 60% carotid artery stenosis18 had symptoms of carotid artery disease, including transient or permanent episodes of neurologic dysfunction, while 13 had no history of stroke-related symptoms. All patients underwent MDCT angiography, and the density of the plaque in the carotid artery was determined. We found that patients with calcified (more dense) plaques were 21 times less likely to have had symptoms than those with noncalcified plaques, said Kiran R. Nandalur, MD, at the University of Virginia Health System.

Currently the American Heart Association recommends surgery for patients with carotid artery stenosis greater than 60%, provided that the surgery is associated with low complications at the respective institution, Dr. Nandalur said. However, our study suggests that patients who have no symptoms and calcified plaques could potentially be treated less aggressively, possibly with just medicine, although larger prospective studies need to be done to confirm these results.

Dr. Nandalur noted that the study supports the emerging evidence that the risk of stroke is dependent on the plaque type as well as the plaque amount.

This study appears in the January 2005 issue of the American Journal of Roentgenology.

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27-Dec-2004