2015 Volume 43 Issue 2 Pages 98-102
The purpose of this study is to clarify the therapeutic outcomes for symptomatic lowgrade carotid stenosis with vulnerable plaque. We investigated 43 patients with symptomatic lowgrade stenosis (<50%) and a high-signal plaque on T1-weighted imaging. Single antiplatelet therapy (APT) was started, and recurrent ischemic events were treated with dual APT. Carotid endarterectomy (CEA) was considered when recurrence occurred refractory to dual APT. During follow-up (mean, 28.1 ± 23.5 months), 23 of 43 patients (53%) experienced recurrent events. Fifteen of the 26 patients who underwent dual APT had recurrent events. Fourteen patients were treated with CEA, and the complication seen was temporary hoarseness. During postoperative follow-up (mean, 24.8 ± 17.6 months), no patients showed ipsilateral ischemic events. We concluded that symptomatic low-grade carotid stenosis with a high-signal plaque on carotid magnetic resonance imaging tends to be associated with a high risk of recurrent ischemic events, even with dual APT. CEA for symptomatic lowgrade carotid stenosis might be safe and effective.
