Case of the month - May
Carotid Plaque Volume (CPV) as an indicator of high-risk plaque.
Miss Alison Phair, Vascular Specialist Registrar and Clinical Research Fellow. BSc (Hons), MBBS (Hons), MRCS. Department of Academic Surgery, University of Manchester.
The degree of stenosis has been the method of defining the necessity of surgery in symptomatic carotid stenosis since the NASCET and ECST randomized trials of the 1990’s. But a greater degree of stenosis does not correlate to a greater risk of stroke. Atherosclerotic plaque burden in the coronary and carotid arteries is reported to be a more important risk factor for future event than severity of stenosis. Measuring carotid plaque volume (CPV), as a measure of atherosclerotic burden, may be of more importance in predicting likelihood of further event than degree of stenosis alone. The case presented highlights the added benefit of assessing CPV prior to surgery to appreciate the risk of stroke.