Correlation Between Cerebral Microbleeds and Vulnerable Plaque in Patients with Severe Carotid Artery Stenosis;
Satoshi Hori1, Emiko Hori1, Takashi Shibata1
1Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan.
Goal:
There are an increasing idea that the inflammation contributes to vascular diseases in various organs. The pathogenesis of both cerebral small vessel disease such as cerebral microbleeds and carotid plaque may be associated with chronic inflammation. This study was aimed to evaluate the correlation between microbleeds and carotid plaque characteristics.
Materials And Methods:
This study enrolled 85 patients who underwent surgical/endovascular treatments for carotid artery stenosis between January 2009 and July 2016. Their clinical data were precisely analyzed. T2*-weighted magnetic resonance (MR) imaging was performed to detect the cerebral microbleeds. The carotid plaque with high signal intensity on T1-weighted MR imaging was categorized into vulnerable plaque.
Findings:
The microbleeds was detected in 17 of 85 (20%). The prevalence of vulnerable carotid plaque and previous symptomatic lacunar infarction was significantly greater in the patients with microbleeds than in those without (P = .001 and P = .03, respectively). Multiple logistic regression analysis showed that the vulnerable plaque was significantly associated with the presence of microbleeds when adjusted for age, alcohol intake, antiplatelet drug use, the presence of previous symptomatic lacunar infarction, and coronary artery disease (P = .009, OR = 5.38, 95% CI = 1.51-21.0).
Conclusions:
These findings suggest the correlation between microbleeds and vulnerable plaque in patients with severe (>70%) carotid artery stenosis. Systemic, chronic inflammation may play a key role in both small and large arteries' disease of the brain. The knowledge may be valuable to fully understand the entity of cerebrovascular diseases as one of systemic, chronic inflammation.
Insights
Cerebral microbleeds are linked to vulnerable carotid plaque in patients with severe carotid artery stenosis. This suggests chronic inflammation may drive both small and large artery diseases in the brain.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Inflammation Research
Background:
- Chronic inflammation is increasingly implicated in vascular diseases affecting various organs.
- Cerebral small vessel disease, including microbleeds, and carotid plaque pathogenesis may involve chronic inflammation.
Purpose of the Study:
- To evaluate the correlation between cerebral microbleeds and carotid plaque characteristics.
- To investigate the role of inflammation in cerebrovascular and large artery diseases.
Main Methods:
- 85 patients with carotid artery stenosis undergoing treatment were analyzed.
- T2*-weighted MRI detected cerebral microbleeds.
- Vulnerable carotid plaque was identified by high signal intensity on T1-weighted MRI.
Main Results:
- Cerebral microbleeds were detected in 20% of patients.
- Patients with microbleeds had a higher prevalence of vulnerable carotid plaque and symptomatic lacunar infarction.
- Vulnerable plaque was significantly associated with microbleeds (OR=5.38, P=.009) after adjusting for confounders.
Conclusions:
- A correlation exists between microbleeds and vulnerable plaque in severe carotid artery stenosis.
- Systemic chronic inflammation may be a key factor in both small and large cerebral artery diseases.
- Understanding this link enhances comprehension of cerebrovascular diseases as manifestations of systemic inflammation.
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