Diabetes‐specific characteristics of atherosclerotic plaques in femoral arteries determined by three‐dimensional magnetic resonance vessel wall imaging

Abstract

ObjectivesThis study aimed to investigate the characteristics of femoral atherosclerotic plaques in patients with diabetes mellitus (DM) compared with those without DM using three‐dimensional magnetic resonance vessel wall imaging.MethodsLower extremity atherosclerotic disease patients with and without DM (age ≥ 50 year‐old) were recruited and underwent three‐dimensional magnetic resonance imaging for femoral arteries. The femoral arteries were divided into common femoral artery (CFA), proximal of superficial femoral artery (pSFA), adductor canal (AC), and popliteal artery (PA) segments. The characteristics of femoral artery atherosclerotic plaques were compared between patients with and without DM.ResultsForty‐eight patients with DM (69.5 ± 8.2 years; 26 males) and 50 patients without DM (71.9 ± 5.7 years; 28 males) were included. Significant differences were found in maximum wall thickness in CFA and AC segments, eccentricity index in AC segment, prevalence of plaque in CFA, pSFA and AC segments, stenosis and prevalence of calcification in pSFA, AC and PA segments, prevalence of lipid‐rich necrotic core (LRNC) in all segments, and prevalence of intraplaque haemorrhage in PA segment between patients with and without DM (all P < .05). After adjusted for confounding factors of age, gender, hyperlipidemia, coronary artery disease, and statin use, the differences in eccentricity index, stenosis and prevalence of plaque, calcification and LRNC in pSFA and AC segments, and stenosis and prevalence of LRNC in PA segment remained statistically significant between patients with and without DM (all P < .05).ConclusionsPatients with DM have significantly larger plaque burden, higher prevalence of plaques, and more complex plaque compositions in femoral arteries than those without DM.

Comparison of symptomatic vertebrobasilar plaques between patients with and without Diabetes Mellitus using computed tomographic angiography and vessel wall magnetic resonance imaging

“…Gao et al 30 reported neovascularization was more frequent in the coronary atherosclerotic lesions of patients with DM using optical coherence tomography. Han et al 31 recently demonstrated more IPH presence in femoral arteries of DM patients using vessel wall imaging. In the present study, we found a significantly higher incidence of IPH in patients with diabetes, especially those with poor glycemic control.…”

“…Gao et al 30 reported neovascularization was more frequent in the coronary atherosclerotic lesions of patients with DM using optical coherence tomography. Han et al 31 recently demonstrated more IPH presence in femoral arteries of DM patients using vessel wall imaging.…”

Comparação das alterações angiográficas entre pacientes diabéticos e não diabéticos com doença arterial periférica

“…Arterial narrowing in the adductor canal and arterial encapsulation inside this muscular aponeurotic canal have been identified as factors predisposing to plaques in this area. 36 However, there is no explanation for the fact that diabetics exhibit different behavior in this sector.…”

“…No escore de Bollinger et al, também houve predomínio de lesões nas artérias femoral profunda, femoral superficial e poplíteas entre os não diabéticos. O estreitamento arterial no canal dos adutores e o encapsulamento arterial dentro desse canal musculoaponeurótico são apontados como fatores de favorecimento de placas nesse local 36 . No entanto, não há explicação para o fato de os diabéticos terem comportamento diferente nesse setor.…”

Comparison of Carotid Atherosclerotic Plaque Characteristics between Symptomatic Patients with Transient Ischemic Attack and Stroke using High-Resolution Magnetic Resonance Imaging

“…In addition, another study by Thiruvoipati et al also showed that diabetes was associated with greater severity of cardiovascular disease and worse clinical outcomes compared to nondiabetics [16]. Diabetes may promote in ammation in ltration and larger LRNC formation in carotid plaques, leading to plaque rupture and larger emboli formation [17], which will be more likely to result in a subsequent ischemic stroke rather than a TIA.…”