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Published on: July 21, 2013

Intraplaque Hemorrhage in Chronic Anterior Circulation Arterial Occlusion: Associated Factors and Vessel-Specific

Yaping Meng1, Lingmin Zhao1, Tao Chen1

  • 1Huanhu Hospital Affiliated to Tianjin Medical University Tianjin China.

Journal of the American Heart Association
|August 8, 2026
PubMed

Insights

Intraplaque hemorrhage (IPH) is common in chronic arterial occlusion, especially in the internal carotid artery. IPH is linked to recent ischemic stroke, indicating ongoing plaque activity and aiding risk assessment.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Radiology

Background:

  • Chronic anterior circulation arterial occlusion poses a significant risk for ischemic events.
  • Intraplaque hemorrhage (IPH) is a key indicator of atherosclerotic plaque instability.
  • The prevalence and clinical significance of IPH in chronic occlusive cerebrovascular disease are not well understood.

Purpose of the Study:

  • To investigate the prevalence, distribution, and clinical correlates of IPH in patients with chronic anterior circulation arterial occlusion.
  • To determine if IPH is associated with specific clinical factors and occlusion locations.
  • To assess the utility of high-resolution MRI in characterizing plaque phenotype.

Main Methods:

  • Retrospective analysis of 210 patients with chronic anterior circulation arterial occlusion.
  • High-resolution magnetic resonance imaging (MRI) was used to identify IPH.
  • Logistic regression models were employed to analyze associations between IPH and clinical, imaging, and laboratory factors, stratified by occlusion site.

Main Results:

  • IPH was detected in 41.0% of patients, being more frequent in internal carotid artery occlusions (60.5%) than middle cerebral artery (MCA) occlusions (38.4%).
  • IPH was associated with male sex, smoking history, lower platelet counts, higher creatinine, and recent acute ischemic stroke.
  • Recent acute ischemic stroke (aOR 2.08) and occlusion location (MCA vs. internal carotid artery, aOR 0.51) were independently associated with IPH.

Conclusions:

  • IPH is a frequent finding in chronic anterior circulation arterial occlusion with distinct vessel-specific patterns.
  • The association of IPH with recent ischemic stroke, particularly in MCA occlusions, suggests ongoing plaque activity.
  • High-resolution MRI can aid in characterizing plaque phenotype and improving risk stratification in chronic occlusive cerebrovascular disease.
Abstract

Keywords:
chronic artery occlusionhigh‐resolution magnetic resonance imagingintraplaque hemorrhagevessel‐specific differences

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