Extracranial carotid atherosclerosis evaluation and stroke occurrence: role of the echotomographic analysis.

High-resolution real-time echotomography was used in a longitudinal study on 118 atherosclerotic plaques of the extracranial carotid tract with the aim of identifying those most likely to cause a cerebrovascular event. Seventy patients (average age 61 +/- 7 years), referred to our Clinical Vascular Laboratory because suffering from transient cerebral ischemic attacks (TIA), coronary heart disease (CHD, peripheral artery disease (PAD), or cervical bruits (CB), were followed up for two years. Medical treatment remained that of the referring physician. Ten patients suffered from clinical events caused by stroke, TIA, and/or carotid occlusion during the follow-up. The echostructural profile of the lesions most often correlated with the clinical event was characterized by a mixed or hard echogenic pattern, and irregular surface, and an initial vascular stenosis of more than 50%.