Lesion width as a discriminator of plaque characteristics

This study evaluated the relative ability of two techniques to quantify carotid atheroma. Diameter stenosis and lesion width were used to predict clinical significance and morphologic characteristics of 54 carotid endarterectomy specimens. Diameter stenosis was a better predictor of symptoms than lesion width (P=0.03 versus P=0.085). Both parameters were predictive of complex atheroma (diameter stenosis P=0.000; lesion width P=0.03). However, use of lesion width allowed finer definition of categories permitting more precise subclassification of plaque. This resulted in a better correlation of symptoms to complexity when lesion width was used as the discriminating variable (lesion width P=0.04; diameter stenosis P=0.121). Lesion width is a valuable parameter for the classification of carotid atheroma, correlating with symptoms and plaque complexity. Lesion width should be evaluated in future studies of carotid atheroma. The discriminative ability of lesion width as detected by high-resolution ultrasonography needs to be evaluated.