Aortic Plaque Distribution, and Association between Aortic Plaque and Atherosclerotic Risk Factors: An Aortic Angioscopy Study

Abstract

Aim: Knowledge of subclinical plaque morphology and plaque distribution in the aorta in vivo remains unclear. This study aimed to increase the body of knowledge in this area.Methods: We enrolled 37 consecutive patients with stable angina pectoris patients who underwent non-obstructive angioscopy for both the coronary artery and aorta immediately after percutaneous coronary intervention. We evaluated the presence of aortic plaques and the distribution of plaque instability. Patients were allocated into two groups according to the number of vulnerable plaques in whole aorta (a low [0–11] and high [≥ 12] group). We evaluated the relationships between the two groups in terms of cardiovascular risk factors.Results: Aortic plaques were identified using non-obstructive angioscopy in all patients, and the greatest number of plaques was found at the infrarenal abdominal aorta (IAA) (the aortic arch, the descending thoracic aorta, the suprarenal abdominal aorta, the IAA, and common iliac artery; 65%, 76%, 65%, 95%, and 49%, respectively; p < 0.001). The maximum yellow grade, and the number of intense yellow plaques, ruptured plaques, and thrombi were highest at the IAA (p < 0.001). The prevalence of diabetes mellitus and peripheral arterial disease was higher in the high vulnerable plaque group (83.3% vs. 40.0%, p = 0.010, 50.0% vs. 8.0%, p = 0.005, respectively).Conclusions: Aortic atherosclerosis was the most severe at the IAA, and aortic plaque vulnerability and distribution were associated with the prevalence of diabetes mellitus and peripheral artery disease in patients with stable angina pectoris. Non-obstructive angioscopy may identify patients at high risk of future aortic events.

Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation

“…First, we introduced TEE examination for 71.6% of continuous cases. The patients in the group who did not undergo TEE were significantly older (82.9 9.5 years vs 75.6 9.4 years, P 0.0001), had a lower prevalence of hypertension (66.7% vs 84.0%, P 0.05), predominantly female (64.3 % vs 30.2 %, P 0.0001), had a higher prevalence of chronic AF (64.3 % vs 40.6 %, P significantly associated with vulnerable plaques, such as intense yellow plaques, ruptured plaques, and thrombi 20) . Taken together with our results, these data suggest that diabetes mellitus is an important predictor of aortic arch atherosclerosis in patients with acute ischemic stroke who have AF.…”

“…Further, MRI based plaque imaging showed that type 2 diabetes was significantly associated with the presence of vulnerable carotid plaques, independent of the degree of stenosis 19) . Another study showed that the presence of diabetes was an independent risk factor for vulnerable aortic plaque burden, as evaluated by aortic angioscopy 20) . They evaluated the presence of aortic plaques and the distribution of plaque instability in patients with coronary artery disease, and found that diabetes mellitus and peripheral arterial disease were 12.4, 95%CI: 2.6-59.3, P 0.01).…”

Spontaneous ruptured aortic plaque and injuries: insights for aging and acute aortic syndrome from non-obstructive general angioscopy

“…Various types of plaques and injuries detected using NOGA have been reported in aorta [3][4][5][6][8][9][10][11][12][13][14][15] (Table 1). The terms of angioscopic findings are going to be standardized [16].…”

Spontaneous Ruptured Aortic Plaques and Injuries Detected using Non-obstructive General Angioscopy

“…Various types of SRAPs have been detected ( Fig. 1) 1,12,13,[20][21][22][23][24] . The normal aortic intima is white with a smooth surface ( Fig.…”

“…Initially, the distribution of aortic SRAPs and aortic injuries were ─ 63 ─ reported 12,24) . SRAPs are dominant in the infrarenal abdominal artery, suprarenal abdominal artery, and aortic arch.…”