NEW YORK (Reuters Health), Sep 15 - Patients with symptomatic carotid stenoses show evidence of considerable occult inflammation in contralateral carotid plaque, UK researchers report in the September issue of Stroke.
This paper, senior investigator Dr. Jonathan Gillard told Reuters Health, "has clinical implications regarding the management of carotid stenosis in that inflammatory burden assessment could be performed for improved risk stratification of individual patients."
Dr. Gillard of Cambridge University Hospitals NHS Foundation Trust and colleagues note that vulnerable atheromatous plaque is associated with inflammation, which can be detected by MRI using a contrast medium.
The team used ultrasmall superparamagnetic iron oxide (USPIO)-enhanced MRI to explore signs of inflammation in 20 symptomatic patients.
Conventional angiography showed mean symptomatic stenosis of 77% compared with 46% on the asymptomatic side.
Inflammatory activity was seen in all symptomatic stenoses and inflammation was also seen in the contralateral side in all but one of the patients (95%).
Signal loss after USPIO, an indicator of inflammatory activity, was noted in 71% of the 217 image quadrants on the symptomatic side versus 57% of 163 on the contralateral side, suggesting a bilateral inflammatory burden within the carotid atheromas.
This result, say the investigators, "adds weight to the argument that atherosclerosis is a truly systemic disease."
Dr. Gillard concluded, "Contralateral carotid stenosis should be followed up more closely as this sub-population of asymptomatic disease has a higher occult inflammatory burden."
By David Douglas
Last Updated: 2006-09-14 15:33:14 -0400 (Reuters Health)
Stroke 2006;37:2266-2270.
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