Thin Calcification Predicts Lipid Component in Carotid Plaque-Relationship Between Lipid Distribution and Thin...

Area of Science:

• Vascular Imaging and Intervention
• Cardiovascular Disease Research
• Biomedical Engineering

Background:

• Lipid-rich plaques in carotid arteries increase thromboembolic risk during stenting.
• Near-infrared spectroscopy (NIRS) identifies lipid components but not calcification distribution.
• Accurate plaque characterization is crucial for managing stroke risk.

Purpose of the Study:

• To investigate calcification characteristics in unstable carotid plaques.
• To explore relationships between computed tomography angiography (CTA) calcification and NIRS-derived lipid core distribution.
• To assess the potential of calcification patterns in predicting plaque instability.

Main Methods:

• Retrospective analysis of 35 patients undergoing carotid artery stenting (Jan 2021-Dec 2022).
• Evaluation of carotid calcification thickness and length using preoperative CTA.
• Analysis of the correlation between calcification features and maximum lipid core burden index (max-LCBI) from NIRS.

Main Results:

• Strong negative linear correlations found between calcification thickness and max-LCBI (r = -0.795, P < 0.001).
• Significant negative linear correlations observed between calcification length distribution and max-LCBI (r = -0.443, P = 0.008).
• These correlations indicate that thinner, more distributed calcifications are associated with higher lipid core burden.

Conclusions:

• Thin and ubiquitous carotid calcification is linked to NIRS-derived lipid plaque distribution.
• This association suggests the possibility of predicting carotid lesion instability.
• Calcification patterns may serve as a biomarker for identifying high-risk carotid plaques.