Assessment of radial artery atherosclerosis in acute coronary syndrome patients: an in vivo study using optical coherence tomography

Abstract

Background Radial artery (RA) atherosclerosis in acute coronary syndrome (ACS) patients has not been systematically observed in vivo. The study aims to characterize plaque morphology and intimal hyperplasia of the RA in patients with ACS, using optical coherence tomography (OCT). Methods In this retrospective study involving 239 ACS patients underwent RA OCT without guidewire shadow, 3 groups were divided according to the following criteria: radial artery plaque (RAP) group included patients with fibrous, lipid or calcified plaque; patients without RAP were further classified into radial intimal hyperplasia (RIH) group (intima media thickness ratio [IMR] ≥ 1) or normal group (IMR < 1). The presence and characteristics of RAP and its related risk factors were identified. Results The RAP, RIH and normal groups included 76 (31.8%), 69 (28.9%) and 94 (39.3%) patients, respectively. Patients in RAP group were the oldest, compared with those in the RIH and normal groups (p < 0.001), and more frequently had triple vessel disease (p = 0.004). The percentage of plaque rupture (72.4% vs. 56.4%, p = 0.018) and calcification (42.1% vs. 27.6%, p = 0.026) at culprit lesion were significantly higher in patients with RAP than those without RAP. A total of 148 RAP were revealed by OCT, including fibrous (72, 48.6%), lipid (50, 33.8%) and calcified plaques (26, 17.6%). The microvessels were also frequently observed in the RAP group than that in RIH and normal groups (59.2% vs. 8.7% vs. 9.6%, p < 0.001). Multivariate logistic regression analysis showed that age, diabetes, and smoking history (all p < 0.05) were independent risk factors for RAP. Conclusions In terms of insights gained from OCT, RA atherosclerosis is not uncommon in ACS patients by OCT, sharing several morphological characters with early coronary atherosclerosis. Aging, diabetes, and smoking are risk factors for RAP.

Volar wrist ganglion associated with radial artery atherosclerosis: A case report

“…[ 8 , 9 ] Risk factors for radial artery atherosclerosis include age (≥50 years), smoking, diabetes, and peripheral vascular disease. [ 10 ] In the present case, the patient’s age was the only risk factor associated with atherosclerosis. However, treatment for hypertension over the past 25 years may have been a predisposing factor.…”

Relationship between thrombolysis in myocardial infarction blood flow before percutaneous coronary intervention and the morphological characteristics of culprit vessel plaques in patients with STEMI

“…1B) and calcified plaque (signal-poor or heterogeneous region with a sharply delineated border; Fig. 1C) (18). In the present study, the culprit lesion was categorized into plaque rupture, plaque erosion or calcified nodule (19).…”

Radial artery lumen diameter and intima thickness in patients with abdominal aortic aneurysm

“… 3 The IT of the radial artery has not been studied in patients with AAA earlier, but could be increased on the basis of atherosclerosis as shown in the radial artery and common carotid artery in patients with cardiovascular disease, further illustrating the potential advantage of examining IT separately. 17 , 34 Higher radial artery IT and IMT have been shown to be associated with higher risk of future cardiovascular events. 18 , 35 Moreover, serum levels of P-apolipoprotein B and P-apolipoprotein A1 have been shown to greatly correlate with the presence of vascular atherogenesis.…”

“… 12 , 13 Furthermore, systemic atherosclerosis is positively correlated with increased arterial intima-media thickness and possibly even more strongly with intima thickness (IT). 14 , 15 , 16 , 17 The proposed general defect in the vasculature in AAA involves the medial layer of arteries whereas coexisting atherosclerosis primarily involves the intimal layer. 6 , 9 , 18 It is thus of interest to investigate the thickness of each arterial wall layer in patients with AAA.…”