MDCT angiography can potentially help determine which patients are at greater risk of stroke

MDCT angiography can potentially help determine which patients with narrowed carotid arteries are at greater risk of having a stroke, a new study shows. This information could help identify which patients need surgery and which can be treated with less invasive procedures.

The study reviewed 31 patients who had greater than 60% carotid artery stenosis—18 had symptoms of carotid artery disease, including a transient or permanent brief episode s of neurologic dysfunction, while 13 had no history of stroke-related symptoms. All patients underwent MDCT angiography, to determine and the density of the plaque in the carotid artery was determined. “We found that patients with calcified (more dense) plaques were 21 times less likely to have had symptoms of stroke th a en those with noncalcified plaques,” said Kiran R. Nandalur, MD, at the University of Virginia Health System.

Currently the American Heart Association recommends surgery for any patient patients with carotid artery stenosis greater than 60% , provided that the patient is well enough to have the surgery, surgery is associated with low complications at the respective institution, Dr. Nandalur said. However, “our study suggests that patients who have no symptoms and calcified plaques could potentially be treated less aggressively , possibl y with just medicine instead , although larger prospective studies need to be done to confirm these results.”

Dr. Nandalur noted that the study supports the emerging evidence other studies have indicated that the risk of stroke is dependent on the plaque type as well as the plaque amount. He said that larger studies need to be done to confirm these results.