Sonographic and angioscopic characteristics of atherosclerotic lesions of the carotid arteries in patients with transient ischemic attacks

A cross-reference of the ultrasonography results in B-mode, color flow mapping (CFM) of the brachiocephalic arteries and intraoperative angioscopy of 46 patients with transient ischemic attacks in the middle cerebral artery circulation was performed. Atherosclerotic lesions formed as plaques of homogeneous or heterogeneous structure with reduced echolucency and luminal stenosis up to 50-70 percent, prone to degradation with formation of emboli of different sizes, or degradation of the whole plaque, was exposed. Plaque’s edge or surface roughness on ultrasound indicates continued gradual degradation with formation of the microemboli. It was revealed, that in patients with minor angiostenoses (up to 50 percent of the artery) and unstable loose plaques with the intima’s defect, the embologenic factor is one of the main reasons for emergence and relapse of the transient ischemic attacks, and it can be considered as an indication to urgent endarterectomy.