Intraplaque hemorrhage causing recurrent stroke treated by carotid endarterectomy

Atherosclerotic plaque characteristics such as intraplaque hemorrhage, thickness of fibrous cap and large lipid-rich necrotic core are the predictors of future cerebrovascular events. Those features are examined by vessel wall magnetic resonance imaging. In this article, we present a 60-year-old male patient who underwent carotid endarterectomy because of intraplaque hemorrhage causing recurrent transient ischemic attacks. Because of the recurrent ischemic attacks, carotid endarterectomy was performed emergently. Patient was discharged after uneventful postoperative course. Vessel wall magnetic resonance imaging is the advanced evaluation of carotid artery disease which determines high-risk plaque according to intraplaque hemorrhage and thin fibrous cap. In case of recurrent symptoms and presence of high-risk plaque, carotid intervention should be considered regardless of the degree of stenosis.