Ultrasound Assessment of Plaque Characteristics to Predict Re-occlusion after Surgical Treatment of Internal Carotid Artery Occlusion

Abstract

The purpose of this study was to explore the relationship between plaque characteristics and re-occlusion after surgical treatment of internal carotid artery occlusion (ICAO). From January 2015 to January 2021, 177 patients with ICAO underwent surgery. Eighty-five cases were included in the study, and in 13 of them, re-occlusion occurred within 6 mo after surgery treatment (13/85, 15.85%). The calcification at the base of the plaque was longer in the re-occlusion group than in the non-occlusion group (10.70 ± 4.22 mm vs. 7.15 ± 1.41 mm, p = 0.001). Multivariate regression analysis revealed that the length of calcification at the base of the plaque was an independent risk factor for postoperative re-occlusion (odds ratio [OR]: 1.414, 95% confidence interval [CI]: 1.078-1.855, p = 0.012). The cutoff value for the length of calcification at the base of the plaque predicting re-occlusion after ICAO was 8.5 mm (95% CI: 0.700-0.962, p = 0.001). The area under the receiver operating characteristic curve was 0.831. Sensitivity and specificity were 70% and 80.9%, respectively. These results indicate that pre-operative ultrasound examination of the length of calcification at the base of the plaque could predict re-occlusion after surgical treatment of ICAO.

Keywords: Carotid artery disease; Plaque; Re-occlusion; Surgery; Ultrasonography.