Evolution of XXXX carotid plaque morphology: do ulcerated plaques heal? A serial multidetector CT angiography study.

@entity1 @entity63 @entity1066 @entity397 @entity1031 @entity731 @entity385
BACKGROUND: Atherosclerotic carotid @entity397 may lead to @entity1031 , causing transient @entity63 attack or @entity385 . Carotid plaque ulceration on angiography is associated with @entity397 . Although healing of @entity397 has been described in coronary arteries, little is known about the natural development of plaque ulcerations in carotid arteries. We therefore explored the evolution of carotid plaque surface morphology with serial multidetector CT angiography (MDCTA). METHODS: From a registry of @entity1 with transient @entity63 attack or minor @entity385 , we selected 83 @entity1 who had undergone serial MDCTA of the carotid arteries. Arteries subjected to revascularization procedures between the two scans were excluded (n = 11). Plaque surface morphology was classified as smooth, irregular or ulcerated on both baseline and follow-up MDCTA. Progression (i.e. development of irregularities or ulceration) and regression (i.e. disappearance of irregularities or ulceration) in morphology were evaluated. RESULTS: The mean time interval between the MDCTA scans was 21    13 months. At baseline, 28 (18%) arteries were normal, 124 (80%) contained @entity731 plaque and 3 (2%) were occluded. Plaque surface morphology was smooth in 86 arteries (55%), irregular in 23 (15%) and ulcerated in 15 (10%). At follow-up, surface morphology was unchanged in 88% of arteries, had progressed in 8% and regressed in 4%. Most importantly, plaque morphology remained unchanged in most ulcerated plaques (10/15; 67%). One @entity1066 had progressed, whereas 4 had regressed. New ulcerations had developed in 2 nonulcerated plaques. CONCLUSION: MDCTA allows evaluation of temporal changes in @entity731 carotid plaque morphology. Plaque surface morphology remained unchanged in most arteries. Carotid ulcerations persist for a long time, and may remain a potential source of @entity1031 .
