Embolic potential and ultrasonic characteristics of plaques in patients with severe unilateral carotid restenosis more than one year after surgery

Abstract Purpose The purpose of the study is to investigate the embolic potential as well as ultrasonic characteristics of plaques in patients presenting with severe unilateral restenosis at least 1 year after carotid endarterectomy (CEA), compared with patients with severe unilateral primary carotid stenosis. Methods We used transcranial Doppler (TCD) to monitor microembolic signals (MES) and Doppler ultrasound to classify types and density of plaques in 27 patients with restenosis after CEA and in 97 patients with primary stenosis. Results Mean period between surgery and examination in patients with restenosis was 36.7 ± 30.5 months (range 12–96). The groups were similar in distribution of main vascular risk factors. There were 36 (37.1%) patients with MES on TCD in primary stenosis versus 11 (40.7%) in restenosis group (NS). An average number of MES in primary stenosis group was 2.9 ± 3.5/30 min and in restenosis group − 3.4 ± 2.9 (NS). There was no difference in distribution of plaques by echogenicity as well as by density. After adjustment by age, sex, and main risk factors, no influence was found for the effect of stenosis or restenosis on either the presence or the amount of emboli, as well as on the ultrasonic character of plaques. Conclusion Carotid plaques in patients with severe unilateral carotid restenosis at least 1 year after surgery and in patients with primary lesions are similar in their embolic potential and ultrasonic characteristics.