Evaluation of the emboligenic potential of carotid plaques. Apropos of 113 echographic and macroscopic comparisons

113 cases of atheromatous plaques in carotid arteries (69 cases where symptoms were present and 44 were asymptomatic) surgically treated by endarterectomy, including an accurate description of gross lesions, were compared to findings obtained with echographic examination to determine if there are specific echographic criteria corresponding to exact anatomical lesions. The echographic criteria selected for this study were the echo-inducing structure of the plaques; the relationship of the plaque with the artery wall (presence of a lesion continuous with the wall); the regular configuration of the endoluminal edge of the plaque or not; and finally, the notion of a discrepancy between the extent of the carotid artery stenosis visualized by ultrasound and that observed with echography (E much less than U). The primary results of this study demonstrate that echo-inducing, uniform and regular (36 cases) atheromatous plaques corresponded to ordinary, fibrous or calcified plaques in 69.4% of cases, with regular endoluminal borders. Irregular and non-uniform plaques (31 cases) suggested irregular, friable and/or ulcerated substance in 64.4% of cases. Poor echo-conducting plaques (9 cases) suggested formation of a thrombus, basically, in 44.4% or of soft and friable plaques (33.3% of cases). Those plaques which were continuous with the wall do not correspond to a precise type of lesion but, rather, are characteristic (with poor echo-conducting plaques) of the embolic nature of the plaques (100%). The criteria echo much less than ultrasound is specific for a thrombus in 75% of cases. On the other hand, the thrombus may also assume very diverse echographic presentations. Finally, three negative echo-ultrasound results were observed in this study.(ABSTRACT TRUNCATED AT 250 WORDS).