Multi-Modality Imaging of Atheromatous Plaques in Peripheral Arterial Disease: Integrating Molecular and Imaging Markers

Abstract

Peripheral artery disease (PAD) is a common and debilitating condition characterized by the narrowing of the limb arteries, primarily due to atherosclerosis. Non-invasive multi-modality imaging approaches using computed tomography (CT), magnetic resonance imaging (MRI), and nuclear imaging have emerged as valuable tools for assessing PAD atheromatous plaques and vessel walls. This review provides an overview of these different imaging techniques, their advantages, limitations, and recent advancements. In addition, this review highlights the importance of molecular markers, including those related to inflammation, endothelial dysfunction, and oxidative stress, in PAD pathophysiology. The potential of integrating molecular and imaging markers for an improved understanding of PAD is also discussed. Despite the promise of this integrative approach, there remain several challenges, including technical limitations in imaging modalities and the need for novel molecular marker discovery and validation. Addressing these challenges and embracing future directions in the field will be essential for maximizing the potential of molecular and imaging markers for improving PAD patient outcomes.

Perivascular Adipose Tissue Density and Stenosis Plaque Degree in Lower Limb Peripheral Arteries in CT

“…Aside from the histopathological examination, there are different humoral factors that have been identified as potential biomarkers for PAD severity assessment. In fact, X. Wang et al [19,20] underlined how these factors, within CT angiography, can provide information about vascular and plaque calcification, which is crucial for risk stratification in PAD. In particular, they highlighted the elevated serum concentration of vascular endothelial growth factor C (VEGF-C) and interleukin-6 (IL-6) in patients with moderate/severe peripheral artery stenosis, aside from matrix metalloproteinases (MMPs) and lipoprotein-associated phospholipase A2 (Lp-PLA2).…”

Ghrelin Expression in Atherosclerotic Plaques and Perivascular Adipose Tissue: Implications for Vascular Inflammation in Peripheral Artery Disease

“…The vulnerable plaque is characterized by a large necrotic core, thin fibrous cap, spotty calcification [49], and increased inflammatory cell infiltrate [50]. In the late stage of atherosclerosis, plaque instability eventually causes complications to arise, such as plaque rupture, bleeding, and thrombosis, clinically manifesting as CLI [51].…”