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Clinical Trial
. 2014 Nov;237(1):169-76.
doi: 10.1016/j.atherosclerosis.2014.08.034. Epub 2014 Sep 2.

High-risk plaque in the superficial femoral artery of people with peripheral artery disease: prevalence and associated clinical characteristics

Tamar S Polonsky  1 , Kiang Liu  2 , Lu Tian  3 , James Carr  4 , Timothy J Carroll  5 , Jarett Berry  6 , Michael H Criqui  7 , Luigi Ferrucci  8 , Jack M Guralnik  9 , Melina R Kibbe  10 , Christopher M Kramer  11 , Feiyu Li  12 , Dongxiang Xu  13 , Xihao Zhao  14 , Chun Yuan  15 , Mary M McDermott  16
Affiliations
Clinical Trial

High-risk plaque in the superficial femoral artery of people with peripheral artery disease: prevalence and associated clinical characteristics

Tamar S Polonsky et al. Atherosclerosis. 2014 Nov.

Abstract

Objective: We used magnetic resonance imaging (MRI) to study the prevalence and associated clinical characteristics of high-risk plaque (defined as presence of lipid-rich necrotic core [LRNC] and intraplaque hemorrhage) in the superficial femoral arteries (SFA) among people with peripheral artery disease (PAD).

Background: The prevalence and clinical characteristics associated with high-risk plaque in the SFA are unknown.

Methods: Three-hundred-three participants with PAD underwent MRI of the proximal SFA using a 1.5 T S platform. Twelve contiguous 2.5 mm cross-sectional images were obtained.

Results: LRNC was present in 68 (22.4%) participants. Only one had intra-plaque hemorrhage. After adjusting for age and sex, smoking prevalence was higher among adults with LRNC than among those without LRNC (35.9% vs. 21.4%, p = 0.02). Among participants with vs. without LRNC there were no differences in mean percent lumen area (31% vs. 33%, p = 0.42), normalized mean wall area (0.71 vs. 0.70, p = 0.67) or maximum wall area (0.96 vs. 0.92, p = 0.54) in the SFA. Among participants with LRNC, cross-sectional images containing LRNC had a smaller percent lumen area (33% ± 1% vs. 39% ± 1%, p < 0.001), greater normalized mean wall thickness (0.25 ± 0.01 vs. 0.22 ± 0.01, p < 0.001), and greater normalized maximum wall thickness (0.41 ± 0.01 vs. 0.31 ± 0.01, p < 0.001), compared to cross-sectional images without LRNC.

Conclusions: Fewer than 25% of adults with PAD had high-risk plaque in the proximal SFA using MRI. Smoking was the only clinical characteristic associated with presence of LRNC. Further study is needed to determine the prognostic significance of LRNC in the SFA.

Clinical trial registration-url: http://www.clinicaltrials.gov. Unique identifier: NCT00520312.

Keywords: Atherosclerosis; Magnetic resonance imaging; Peripheral vascular disease; Plaque.

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Figures

Figure 1
Figure 1. Recruitment for Walking and Leg Circulation Study (WALCS) III
PAD = peripheral artery disease; ABI = ankle-brachial index, MR = magnetic resonance
Figure 2
Figure 2. MRI images of the proximal superficial femoral artery (SFA) from a participant in the Walking and Leg Circulation Study III cohort
Imaging sequence is time of flight (a), T1 (b), proton-density (c) and T2 (d). Panels on the left are the original images, and panels on the right include the traced contours for the plaque composition analysis. The blue contour delineates the outer boundary of the SFA, the red contour delineates the lumen, and the yellow contour delineates the lipid rich necrotic core.
Figure 2
Figure 2. MRI images of the proximal superficial femoral artery (SFA) from a participant in the Walking and Leg Circulation Study III cohort
Imaging sequence is time of flight (a), T1 (b), proton-density (c) and T2 (d). Panels on the left are the original images, and panels on the right include the traced contours for the plaque composition analysis. The blue contour delineates the outer boundary of the SFA, the red contour delineates the lumen, and the yellow contour delineates the lipid rich necrotic core.
See this image and copyright information in PMC

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