Background and Purpose-Histological data associate proliferation of adventitial vasa vasorum and intraplaque neovascularization with vulnerable plaques represented by symptomatic vascular disease. In this observational study, the presence of carotid intraplaque neovascularization and adventitial vasa vasorum were correlated with the presence and occurrence of cardiovascular disease (CVD) and events (CVE). Methods-The contrast-enhanced carotid ultrasound examinations of 147 subjects (mean age 64Ϯ11 years, 61% male)were analyzed for the presence of intraluminal plaque, plaque neovascularization (Grade 1ϭabsent; Grade 2ϭpresent), and degree of adventitial vasa vasorum (Grade 1ϭabsent, Grade 2ϭpresent). These observations were correlated with preexisting cardiovascular risk factors, presence of CVD, and history of CVE (myocardial infarction and transient ischemic attack/stroke). Results-The presence of intraluminal carotid plaque was directly correlated to cardiovascular risk factors, CVD, and CVE (PϽ0.05). Adventitial vasa vasorum Grade 2 was associated with significant more subjects with CVD than vasa vasorum Grade 1 (73 versus 54%, Pϭ0.029). Subjects with intraplaque neovascularization Grade 2 had significantly more often a history of CVE than subjects with intraplaque neovascularization Grade 1 (38 versus 20%, Pϭ0.031).Multivariate logistic regression analysis revealed that presence of plaque was significantly associated with CVD (odds ratio 4.7, 95% CI 1.6 to 13.8) and intraplaque neovascularization grade 2 with CVE (odds ratio 4.0, 95% CI 1.3 to 12.6). Conclusion-The presence and degree of adventitial vasa vasorum and plaque neovascularization were directly associated with CVD and CVE in a retrospective study of 147 patients undergoing contrast-enhanced carotid ultrasound. (Stroke. 2010;41:41-47.)

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