Angiographically Undetected Ulceration of the Carotid Bifurcation as a Cause of Embolic Stroke

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Abstract
The accuracy of angiographic diagnosis of carotid artery ulceration was studied. Of the carotid bifurcations showing ulceration at surgery, 60% were diagnosed as having ulcers at angiography. Half of the remaining ulcers occurred in smooth, benign-appearing plaques and were to small to be seen at angiography. An incorrect angiographic diagnosis of ulceration was made in 17 of 50 carotid arteries; in most cases this was due to the presence of a subintimal hematoma in the wall of the artery.

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