Carotid Plaque Morphologic Characteristics

Carotid artery atherosclerosis is predominantly believed to mirror atherosclerosis elsewhere in the body. Endothelial injury results in expression of cell surface adhesion molecules with expression of sequence of genes involved in the inflammatory pathway and expression of proinflammatory cytokines. The combination of the inflammatory mediators and contribution by monocytes infiltrating the intima and vascular smooth muscle cell proliferation result in the development of atheromatous plaque with a lipid-rich necrotic core. Complications of these atheromatous plaques can lead to plaque instability, rupture, and subsequent hemorrhage or ulceration. The significant risk factors, characteristics associated with symptoms, and available diagnostic imaging modalities are also discussed with review of the relevant literature.