Plaque hemorrhage in carotid artery disease: pathogenesis, clinical and biomechanical considerations

Area of Science:

• Cerebrovascular disease research
• Cardiovascular pathology
• Biomedical engineering

Background:

• Stroke is a major cause of disability, often resulting from internal carotid artery stenosis due to atherosclerosis.
• Current risk stratification and surgical decisions primarily rely on stenosis severity.
• Plaque morphology, particularly plaque hemorrhage, may offer improved risk assessment.

Purpose of the Study:

• To review the pathogenesis and significance of plaque hemorrhage (PH) in atherosclerotic plaques.
• To explore the role of PH in plaque vulnerability and biomechanics.
• To discuss imaging techniques for PH and material properties of atherosclerotic tissues.

Main Methods:

• Literature review focusing on plaque hemorrhage in internal carotid artery stenosis.
• Analysis of studies on plaque components, vulnerability, and biomechanics.
• Examination of in vivo measurement techniques for atherosclerotic tissue properties.

Main Results:

• Plaque hemorrhage (PH) is a critical but understudied component of atherosclerotic plaques.
• PH can significantly influence plaque vulnerability and local biomechanics.
• Advanced imaging and in vivo measurements are crucial for understanding PH's impact.

Conclusions:

• Plaque hemorrhage is a key determinant of atherosclerotic plaque instability and stroke risk.
• Incorporating PH assessment into risk stratification could improve patient outcomes.
• Further research into PH imaging and biomechanical effects is warranted.