Atherosclerotic plaque often develops at branch points or curving portions along extracranial and intracranial arteries where blood flow is slowed and more turbulent. This is common in carotid arteries, arteries that supply the head and neck with oxygenated blood.
Researchers at BUSM report that a patient with severe blockages in both the left and right carotid arteries was examined prior to operations (endarterectomy) conducted two months apart to remove the plaques. Sometime after removal of the left carotid plaque, the patient experienced plaque rupture in the right carotid artery without stroke and even without showing any neurological symptoms. This was observed in a second MR image obtained prior to endarterectomy.
Project leader, James Hamilton, Ph.D., professor of biophysics and physiology at BUSM explains, “This illustrates the healing of silent atherosclerotic ulceration, which is a specific type of rupture detected by MRIs over a period of two months. This has not been reported previously. In the past there had been evidence of plaques removed from the carotid and human coronary artery through postmortem specimens that small plaque ruptures may occur without notice.
Hamilton and his collaborator Alik Farber, M.D., an associate professor of surgery at BUSM and chief of vascular and endovascular surgery at Boston Medical Center, pointed out that these hemorrhages "disappear" into the plaques but make the plaque more vulnerable to future rupture.
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