Author + information
- 1William Beaumont Hospital, Royal Oak, Michigan, United States
- 2Beaumont Health System, Detroit, Michigan, United States
- 3Beaumont Health System, Royal Oak, Michigan, United States
- 4Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan, United States
- 5Beaumont Health System, Troy, Michigan, United States
Several imaging and autopsy studies have described plaque morphology (PM) in different vascular beds, including lipid (LCP), fibrosis, and calcification. We sought to describe the PM in patients with peripheral arterial disease (PAD) using near infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) and compare PM in different vascular beds.
We performed invasive angiography and NIRS-IVUS in PAD patients prior to percutaneous revascularization. Imaging evaluation included parameters from angiography, IVUS, and NIRS. NIRS-IVUS findings were compared among different vascular beds with regard to the presence and extent of calcification and LCP.
Angiography and NIRS-IVUS were performed in 149 lesions in 126 PAD patients, including the internal carotid (n=10), subclavian/axillary (n=9), renal (n=14), iliac (n=35), femoro-popliteal (n=69), and infra- popliteal (n=12) arteries. The PM was calcified plaque in 89% of lesions and fibrous plaque in 11% of lesions. The prevalence of calcification varied from 100% of renal artery stenoses to 50% of subclavian/axillary artery stenoses. LCP was present in 32% of lesions and varied from 55.6% in carotid artery stenoses to 0% in renal artery stenoses. LCP was only observed in fibrocalcific plaque, and was circumferentially surrounded by a similar or more extensive degree of calcium. Four lesion types were found depending on the presence and absence of calcification and/or LCP (Figure 1)
NIRS-IVUS in PAD patients demonstrates differences in the frequency of calcific plaque and LCP in different arterial beds.
IMAGING: Imaging: Intravascular