Carotid intraplaque hemorrhage predicts recurrent symptoms in patients with high-grade carotid stenosis

Stroke. 2007 May;38(5):1633-5. doi: 10.1161/STROKEAHA.106.473066. Epub 2007 Mar 22.


Background and purpose: Carotid intraplaque hemorrhage (IPH), known to be associated with plaque instability, may convey a higher stroke risk. The aim of this study was to assess whether the identification of IPH by MRI predicts recurrent clinical cerebrovascular events.

Methods: Sixty-six patients with high-grade symptomatic carotid stenosis underwent MRI of the carotid arteries and were followed until carotid endarterectomy or 30 days.

Results: Of the 66 patients with a median follow up of 33.5 days, 44 (66.7%) were found on MRI to have ipsilateral carotid IPH. Fifteen recurrent events were associated with ipsilateral carotid IPH. Only 2 recurrent events occurred in the absence of IPH. IPH increased the risk of recurrent ischemia (hazard ratio=4.8; 95% CI=1.1 to 20.9, P<0.05).

Conclusions: IPH as detected by MRI predicts recurrent cerebrovascular events in patients with symptomatic high-grade carotid stenosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carotid Stenosis / complications*
  • Carotid Stenosis / surgery
  • Female
  • Hemorrhage / diagnosis*
  • Hemorrhage / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Recurrence
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology