Annals of Indian Academy of Neurology
LETTER TO THE EDITOR
Year
: 2014  |  Volume : 17  |  Issue : 2  |  Page : 242-

Author's reply: Evolution of mobile plaque to complete division of carotid lumen


Petar Slankamenac1, Zeljko Zivanovic1, Branka Vitic2, Aleksandar Jesic1,  
1 Department of Neurology, Clinical Centre of Vojvodina, Novi Sad; Medical faculty, University of Novi Sad, Novi Sad, Serbia
2 Department of Neurology, Clinical Centre of Vojvodina, Novi Sad, Serbia

Correspondence Address:
Zeljko Zivanovic
Department of Neurology, Clinical Centre of Vojvodina, 1 Hajduk Veljkova St, Novi Sad - 21000
Serbia




How to cite this article:
Slankamenac P, Zivanovic Z, Vitic B, Jesic A. Author's reply: Evolution of mobile plaque to complete division of carotid lumen.Ann Indian Acad Neurol 2014;17:242-242


How to cite this URL:
Slankamenac P, Zivanovic Z, Vitic B, Jesic A. Author's reply: Evolution of mobile plaque to complete division of carotid lumen. Ann Indian Acad Neurol [serial online] 2014 [cited 2022 Jan 21 ];17:242-242
Available from: https://www.annalsofian.org/text.asp?2014/17/2/242/132666


Full Text

Sir,

The comments by Akgün et al., [1] on our case report about mobile plaque were welcome and highly appreciated. We completely agree that there are substantial drawbacks of power Doppler ultrasound in the evaluation of the wall and plaque surface due to artifacts, and the advantages of the B-mode in the assessment of blood vessel intimal surface and intimal flap. [2] However, the power mode image that was published was the most illustrious one, and supplemented by a B-mode video clip. Sometimes a single ultrasound image got from one position of the ultrasound probe is not enough to present realistic picture that the examiner has. In that case, the projections of lateral and posterior probe positions should ensure the more thorough evaluation. Unfortunately, not all the images can be presented.

We strongly agree that mobile flap possibly remained after endarterectomy, gradually enlarged during the time and eventually caused an embolic stroke, as we noted in our case report. [2] Further on, we followed the mobile plaque enlargement which was in the form of a ridge, and grew until finally it divided the lumen of the common carotid artery. From the coronal magnetic resonance angiography images, longitudinal continuity of an intimal flap could not be seen. On contrary, there was only a short transversely positioned formation in the common carotid which divided the lumen, in length of about 5 mm [Figure 1]. This corresponded to the ridge-shaped plaque that had been previously monitored by ultrasound.{Figure 1}

References

1Akgün H, Battal B, Akgün V, Yücel M, Oz O, Demirkaya S. Two conjoined plaques or a flap? Ann Indian Acad Neurol 2013;16:293.
2Petar S, Zeljko Z, Branka V, Aleksandar J. Evolution of mobile plaque to complete division of carotid lumen. Ann Indian Acad Neurol 2012;15:347-8.