2018 Volume 46 Issue 6 Pages 422-428
Delineating the distal end of the plaque in the internal carotid artery (ICA) is important in carotid endarterectomy. In general, a plaque's distal edges are estimated based on the degree of carotid artery stenosis. Sometimes, the plaque's distal end cannot be detected before surgery and additional arteriotomy of the ICA distal edge is needed. We retrospectively evaluated 33 patients with carotid artery stenosis treated at the Kumamoto University Hospital between April 2013 and September 2016. Of these, 2 (6.1%) patients needed additional arteriotomy at the ICA distal edge. They had soft and maldistributed elongated plaques. Distal plaque ends in the ICAs could not be detected accurately on three-dimensional computed tomography, magnetic resonance angiography, and digital subtraction angiography, but could be detected on coronal magnetic resonance imaging (MRI). The patients who needed additional arteriotomy of the distal edge of the ICA had soft, maldistributed and elongated plaques. Plaque coronal MRI may be an easy, effective, and practical method for evaluation of the distal plaque end in the ICA.
