Intraplaque hemorrhage: Its significance in cerebrovascular disease

Ammar, Alex D.; Wilson, Richard; Travers, Henry; Lin, Joe J.; Farha, S.Jim; Chang, Frederic C.

doi:10.1016/0002-9610(84)90450-1

Cited by 42 publications

(18 citation statements)

References 4 publications

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“…However, when remote hemorrhage was also taken into consideration, the differences between the 2 groups lost significance. To estimate the age of IPH, considerable work 1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16]20 was done, and a modified elastochrome stain that could clearly delineate hemorrhages was introduced for the first time. 7 Three pathologic categories were defined: acute (Ͻ1week), recent (1 to 6 weeks), and remote (Ͼ6 weeks) hemorrhage.…”

Section: Age Of the Iphmentioning

confidence: 99%

“…7 Three pathologic categories were defined: acute (Ͻ1week), recent (1 to 6 weeks), and remote (Ͼ6 weeks) hemorrhage. 3,7,15,16 An age of 4 weeks was used as the threshold for recent and old hemorrhage in the report of Lenninhan et al, 4 wherein there was no association between acute hemorrhage and the onset of ipsilateral symptoms. Recent (or "significant") hemorrhage was otherwise graded when it involved Ͼ50% of the plaque thickness.…”

Section: Age Of the Iphmentioning

confidence: 99%

“…2 However, it was reported that a correlation could not be corroborated, and the mere presence of IPH at the carotid bifurcation did not necessarily produce symptoms. [3][4][5] Most recently, Milei et al 6 found that IPH was not potentially associated with symptoms, and it appeared that IPH might occur at any time, irrespective of symptoms. Moreover, the age of IPH (acute, recent, or old) and its role have been the subject of disagreement.…”

mentioning

confidence: 99%

“…Moreover, the age of IPH (acute, recent, or old) and its role have been the subject of disagreement. 1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16] Quite a few studies have indicated that the presence of IPH appears to increase with the severity of carotid artery stenosis. 2,4,5,13,16 -23 Some attention has focused on the quantification of hemorrhage volume.…”

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confidence: 99%

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Correlation Between Carotid Intraplaque Hemorrhage and Clinical Symptoms

Gao

Chen

Bao

et al. 2007

Stroke

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Background and Purpose-We sought to investigate the association between carotid intraplaque hemorrhage (IPH) and ipsilateral symptoms of cerebral ischemia. Methods-A search was performed for clinical observational studies comparing the incidence of IPH between symptomatic and asymptomatic patients. Odds ratios (ORs) for IPH as a factor in the pathogenesis of neurologic events were calculated and combined by a meta-analysis. Interstudy heterogeneity, estimated effects, and methodologic quality of the studies were assessed. Results-Thirty-one studies were included for analysis. The reported ORs varied widely. Overall, the incidence of IPH in the symptomatic groups was significantly higher than in the asymptomatic group. However, there was an apparent trend for heterogeneity (PϽ0.00001) between studies. The random-effects summary estimator of ORs was 2.25 (95% CI, 1.57 to 3.22; PϽ0.00001). To identify potential sources of heterogeneity, subgroup analyses were performed. The pooled ORs varied greatly by stratification. Major heterogeneity was found among studies with low quality, microscopic methods of examination, significant effects, small sizes, early publication, and unequal severity of carotid stenosis in both groups. Large, recent, macroscopic, or high-quality studies, as well as studies with equal degrees of stenosis, tended to yield insignificant associations. The methods in defining and evaluating hemorrhage were very heterogeneous. Characterizations of the age, size, number, and location of hemorrhages were poorly reported and highly variable. In addition, a lack of control of confounders and selection bias were frequently identified among studies. Conclusions-Statistical inferences have suggested a plausible role in the production of cerebral ischemia; however, reliable interpretation was strongly undermined by poor methodologic quality, substantial heterogeneity, and suspicious publication bias. To preciously estimate the underlying correlation, a well-designed study with uniformity in definition and evaluation for IPH might be warranted.

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Section: Age Of the Iphmentioning

confidence: 99%

Section: Age Of the Iphmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Correlation Between Carotid Intraplaque Hemorrhage and Clinical Symptoms

Gao

Chen

Bao

et al. 2007

Stroke

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show abstract

“…1,9,10,12,13,20) In this paper, we studied a clinicopathological examination of atheromatous plaques and discussed about the indication for CEA, particularly in an asymptomatic carotid artery disease from the pathological viewpoint.…”

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confidence: 99%