Ultrasonic Characterization of Carotid Plaques and Its Clinical Implications

In recent years, it has become apparent that the severity of an asymptomatic carotid stenosis is not sufficient to assess the risk of stroke. Although the risk of stroke increases with increasing grades of stenosis, and as a result a stenosis of ≥80% is used by many surgeons as an indication for surgery, this subgroup does not contain the majority of strokes that will subsequently occur. In addition, because the severity of stenosis cannot identify subgroups with stroke risk higher than 2.5%, a very large number of operations (approximately 90) with an asymptomatic stenosis of ≥80% would need to undergo carotid endarterectomy to prevent one stroke for one year of follow-up.