Computed Histological Quantification of Atherosclerotic Plaque Microcalcifications

Abstract

<jats:p> Inflammation has a central role in atherosclerotic plaque formation and rupture. Intense macrophage inflammatory activity results in microcalcifications which are strongly associated with plaque vulnerability. Microcalcifications with specific critical size between 5 and 65 μ, located in the fibrous cap producing local mechanical stress on the plaque surface and may directly contribute to plaque rupture. Hence, accurate assessment of microcalcifications size and dimension has significant clinical importance. Current invasive and noninvasive plaque imaging has limited spatial resolution which limits accurate definition of microcalcifications in the atherosclerotic plaques. We describe a new imaging technique with high spatial resolution, based on confocal microscopic analysis, using a dedicated software which allows automatic characterization of microcalcifications and quantitative assessment of their extent and localization. </jats:p>

Percutaneous Coronary Intervention Is Not Superior to Optimal Medical Therapy in Chronic Coronary Syndrome: A Meta-Analysis

“…The commonest presentation of coronary atherosclerosis is plaque formation at the site of bifurcation, although not always exclusively, as plaques may also develop at mid-arterial segments. These atherosclerotic coronary manifestations are identified based on conventional angiographic examination [ 44 , 45 ]. Additional atherosclerosis manifestations in the segments that look normal on angiography can be detected by the presence of atherosclerotic plaques on CT examination [ 46 ].…”

The Role of Inflammation in Cardiovascular Disease

“…Longitudinal imaging studies, using PET, have shown that inflamed arterial sites undergo the subsequent deposition of calcium, and within the same arterial segment, different degrees of inflammation show different rates of calcium deposition [ 106 ]. The death of macrophages and smooth muscle cells release vesicles acting as nucleating sites for the deposition of hydroxyapatite crystals which can aggregate, resulting in microcalcifications less than 50 µm in diameter being embedded in the fibrous cap [ 107 , 108 ]. Plaque calcification further stimulates macrophage infiltration, thus increasing the nucleating sites and new calcification [ 109 ].…”

Coronary Computed Tomography Angiography Analysis of Calcium Content to Identify Non-culprit Vulnerable Plaques in Patients With Acute Coronary Syndrome

“…Indeed, inflammation has a key role in atherosclerotic plaque formation and rupture. Intense macrophage inflammatory activity results in microcalcifications which are strongly associated with plaque vulnerability (27). The pioneering work of Vengrenyuk (28) attributed cap rupture to microcalcification within the cap (29).…”