Carotid Artery Plaque Calcifications: Lessons From Histopathology to Diagnostic Imaging.
| Title: | Carotid Artery Plaque Calcifications: Lessons From Histopathology to Diagnostic Imaging. |
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| Authors: | Saba L; Department of Radiology (L.S., R.C., A.B.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Nardi V; Azienda Ospedaliero Universitaria (A.O.U.), Department of Cardiovascular Medicine (V.N.), Mayo Clinic, Rochester, MN.; Cau R; Department of Radiology (L.S., R.C., A.B.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Gupta A; Department of Radiology (A.G.), Weill Cornell Medicine, New York, New York.; Kamel H; Department of Neurology (H.K.), Weill Cornell Medicine, New York, New York.; Suri JS; Stroke Diagnosis and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).; Balestrieri A; Department of Radiology (L.S., R.C., A.B.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Congiu T; Department of Pathology (T.C., D.F., G.C., G.F.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Butler APH; Department of Radiology, University of Otago, Christchurch, New Zealand (A.P.H.B., S.G.).; Gieseg S; Department of Radiology, University of Otago, Christchurch, New Zealand (A.P.H.B., S.G.).; Fanni D; Department of Pathology (T.C., D.F., G.C., G.F.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Cerrone G; Department of Pathology (T.C., D.F., G.C., G.F.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Sanfilippo R; Department of Vascular Surgery (R.S.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Puig J; Department of Radiology (IDI), Hospital Universitari de Girona, Spain (J.P.).; Yang Q; Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China (Q.Y.).; Mannelli L; IRCSS SDN, Naples, Italy (L.M.).; Faa G; Department of Pathology (T.C., D.F., G.C., G.F.), di Cagliari - Polo di Monserrato s.s, Cagliari, Italy.; Lanzino G; Department of Neurologic Surgery (G.L.), Mayo Clinic, Rochester, MN. |
| Source: | Stroke [Stroke] 2022 Jan; Vol. 53 (1), pp. 290-297. Date of Electronic Publication: 2021 Nov 10. |
| Publication Type: | Journal Article; Review |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0235266 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4628 (Electronic) Linking ISSN: 00392499 NLM ISO Abbreviation: Stroke Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins; Original Publication: Dallas : American Heart Association |
| MeSH Terms: | Carotid Arteries/*pathology ; Carotid Artery Diseases/*pathology ; Carotid Stenosis/*pathology ; Plaque, Atherosclerotic/*pathology ; Vascular Calcification/*pathology; Atherosclerosis/complications ; Atherosclerosis/pathology ; Carotid Artery Diseases/complications ; Carotid Stenosis/complications ; Plaque, Atherosclerotic/complications ; Humans |
| Abstract: | The role of calcium in atherosclerosis is controversial and the relationship between vascular calcification and plaque vulnerability is not fully understood. Although calcifications are present in ≈50% to 60% of carotid plaques, their association with cerebrovascular ischemic events remains unclear. In this review, we summarize current understanding of carotid plaque calcification. We outline the role of calcium in atherosclerotic carotid disease by analyzing laboratory studies and histopathologic studies, as well as imaging findings to understand clinical implications of carotid artery calcifications. Differences in mechanism of calcium deposition express themselves into a wide range of calcification phenotypes in carotid plaques. Some patterns, such as rim calcification, are suggestive of plaques with inflammatory activity with leakage of the vasa vasourm and intraplaque hemorrhage. Other patterns such as dense, nodular calcifications may confer greater mechanical stability to the plaque and reduce the risk of embolization for a given degree of plaque size and luminal stenosis. Various distributions and patterns of carotid plaque calcification, often influenced by the underlying systemic pathological condition, have a different role in affecting plaque stability. Modern imaging techniques afford multiple approaches to assess geometry, pattern of distribution, size, and composition of carotid artery calcifications. Future investigations with these novel technologies will further improve our understanding of carotid artery calcification and will play an important role in understanding and minimizing stroke risk in patients with carotid plaques. |
| Contributed Indexing: | Keywords: atherosclerosis; carotid arteries; mortality; tomography; vascular calcification |
| Entry Date(s): | Date Created: 20211110 Date Completed: 20220217 Latest Revision: 20220217 |
| Update Code: | 20260130 |
| DOI: | 10.1161/STROKEAHA.121.035692 |
| PMID: | 34753301 |
| Database: | MEDLINE |
Journal Article; Review