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Types of Carotid Plaques

The carotid artery serves as the pathway of blood to the head and neck, and it serves an important role in providing not only blood but also oxygen to the brain and the other parts of the head. Strokes usually occur when plaque builds up and causes traffic in the carotid artery, hindering the blood to supply oxygen to the head.

  1. Types

    • There are five types of carotid plaques, classified by their level of opaqueness and calcification. Type 1 plaques are uniformly echolucent, while type 2 plaques are predominantly echoculent. Type 3 plaques are echogenic, and those under type 4 are uniformly echogenic. Type 5 plaques cannot be determined due to heavy acoustic shadows and calcification. All types of plaque occur in both symptomatic and asymptomatic strokes, although they differ in frequency of occurrence.

    Behavior

    • Aneurysm, or stroke, may occur with or without the presence of symptoms, thus a person may not notice that he is developing carotid plaque. Type 1 and type 2 plaques are usually found in most symptomatic strokes, while types 3 and 4 are more common in asymptomatic aneurysm. Echolucent plaques are found in patients with stenosis of more than 70 percent; in contrast, asymptomatic stroke patients have echogenic plaques.

    Detection

    • Carotid plaques can be detected by an ultrasound procedure. It does not require the use of radiation and is safe and effective not only in finding the plaques but also carotid artery disease. It also is used in defining the condition of the disease in the carotid artery.

    Treatment

    • Patients suffering from carotid artery disease caused by plaques are prescribed anti-platlet therapy, such as regular aspirin medication. Plaque buildup that has caused further problems in blood and oxygen delivery to the brain and neck may have to be surgically removed; this procedure is called carotid endarterectomy. Patients who respond best to carotid endarterectomy are those with 50 percent or greater stenosis if their stroke is associated with neurological finding. Those whose strokes are not related to neurological findings, however, respond best to treatment if the carotid artery has 60 percent or greater stenosis.

    Significance

    • Determining the types of carotid plaques is important to finding the kind of treatment that should be given to a patient suffering from carotid artery disease or aneurysm. Once the type of plaque is found, the right medication, as well as carotid endarterectomy, can be provided to remove the plaque blocking the blood vessel and allow blood and oxygen to pass through.

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