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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


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

Date of Web Publication17-May-2014

Correspondence Address:
Zeljko Zivanovic
Department of Neurology, Clinical Centre of Vojvodina, 1 Hajduk Veljkova St, Novi Sad - 21000
Serbia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.132666

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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

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 2019 Oct 22];17:242. Available from: http://www.annalsofian.org/text.asp?2014/17/2/242/132666


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: Magnetic resonance (MR) angiography showed the small transversely positioned plaque which divided the lumen of the common carotid artery

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   References Top

1.Akgün H, Battal B, Akgün V, Yücel M, Oz O, Demirkaya S. Two conjoined plaques or a flap? Ann Indian Acad Neurol 2013;16:293.  Back to cited text no. 1
    
2.Petar 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.  Back to cited text no. 2
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