Vaskulárna medicína 1/2016

Markers of vulnerable plaque in atherosclerotic internal carotid artery affected

Stroke is the third leading cause of death and also the most common cause of premature permanent disability of patients in developed countries. Diagnosis of stroke requires multidisciplinary representation of several experts. 80% of stroke acute cerebral infarcts formed, resulting from the involvement of atherosclerotic internal carotid artery. Atherosclerosis is basically a chronic inflammatory reaction due to which the vessel wall is an accumulation of lipids. Inflammatory mediators and pro-inflammatory cytokines are involved in the progression of atherosclerotic plaque, promoting its instability and the risk of plaque rupture. Currently, the surgical therapy indicated for asymptomatic patients with stenosis of the lumen of internal carotid arteries of 70%. In these asymptomatic patients it is not certain that the benefit of surgical endarterectomy is so obvious as initially anticipated. In the future, possibly operated on only selected patients with a high risk of transient ischemic attacks or stroke. The selection of these patients will likely depend on a number of biochemical markers of vulnerable atherosclerotic plaque with a high embolic potential and also by non-invasive imaging, ultrasonography, using the identified quality of atherosclerotic plaque.

Keywords: atherosclerosis, vulnerable plaque, carotid artery stenosis, stroke, endarterectomy