Investigating the Association Between Carotid Atherosclerotic Plaque Characteristics And Lacunar Infarction Using...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Radiology

Background:

• Large artery atherosclerosis is increasingly linked to cerebral small vessel disease.
• The specific relationship between carotid vulnerable plaque characteristics and lacunar infarction (LAC) requires further investigation, especially in patients with moderate-to-severe carotid stenosis.

Purpose of the Study:

• To investigate the association between carotid vulnerable plaque features and the presence and severity of lacunar infarction (LAC) in patients with moderate-to-severe carotid stenosis.

Main Methods:

• Patients with symptomatic or asymptomatic moderate-to-severe carotid stenosis underwent carotid MRI and brain MRI.
• Carotid plaque burden and composition were assessed, and LAC presence and severity were determined.
• Logistic regression analysis was used to examine the associations between plaque features and LAC.

Main Results:

• Of 194 patients, 110 (56.7%) had LAC. LAC patients exhibited larger calcification volume and calcified area percentage.
• Mild and moderate LAC were associated with larger calcified area percentages.
• Severe LAC was correlated with higher lipid-rich necrotic core (LRNC) and intraplaque hemorrhage (IPH) volumes.

Conclusions:

• Carotid plaque calcification burden is significantly greater in LAC patients, particularly in mild-to-moderate cases.
• Severe LAC shows stronger correlations with IPH and LRNC volumes.
• These findings suggest that vulnerable plaque characteristics may play distinct pathophysiological roles in patients with severe LAC.