Carotid Calcification Shape, Size, and Lumen Proximity Are Associated with Ischemic Events

Area of Science:

• Vascular Medicine
• Radiology
• Cardiovascular Imaging

Background:

• Carotid artery calcification is common in atherosclerosis and affects plaque stability.
• The relationship between carotid calcification characteristics and ischemic events remains unclear.

Purpose of the Study:

• To investigate the association between geometric features of carotid calcifications and their changes over time with ischemic events.
• To analyze the morphometric characteristics of calcifications in symptomatic versus asymptomatic carotid arteries.

Main Methods:

• Retrospective analysis of 128 carotid arteries from 64 patients using multi-detector computed tomography angiography.
• 3D reconstruction of artery and calcification geometries with semi-automatic pipeline and morphometric assessment.
• Generalized linear mixed models used to assess associations with ischemic events.

Main Results:

• Symptomatic carotids had more calcification bodies (1.9 vs. 1.6) but smaller areas (3.7 mm² vs. 4.5 mm²) and widths (2.7 mm vs. 3.1 mm) at baseline.
• At 2-year follow-up, calcifications in symptomatic arteries were narrower (2.9 mm vs. 3.3 mm) and longer (8.6 mm vs. 7.5 mm) compared to asymptomatic ones.
• Calcifications in symptomatic arteries showed a tendency for longitudinal growth.

Conclusions:

• Symptomatic carotid arteries exhibit more numerous, smaller calcifications compared to asymptomatic ones.
• These calcifications demonstrate a tendency for increased longitudinal growth.
• The geometric features and temporal changes of carotid calcifications offer insights into their role in ischemic events.