Abstract #4144

Vulnerable plaque characteristics on MR vessel wall imaging predict hemodynamic instability during carotid artery stenting

Qi Meng¹, Chao Jiang², Keqiang Zhao², Huabin Zhang¹, Hongliang Zhao³, Xihai Zhao⁴, Weiwei Wu², and Zhuozhao Zheng³

¹Department of Ultrasound, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China, ²Department of Vascular Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China, ³Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China, ⁴Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

Synopsis

It has been shown that about 30%-70% of the patients underwent carotid artery stenting (CAS) suffered from perioperative hemodynamic instability (HI) characterized by transient hypotension and bradycardia. This study investigated the association between vulnerable plaque characteristics on MR vessel wall imaging and HI during CAS. We found that patients in HI group had significantly larger wall area and total vessel area, higher prevalence of intraplaque hemorrhage and vulnerable plaque, and larger volume of lipid-rich necrotic core (LRNC) of carotid plaque compared to those in non-HI group. The volume of LRNC and presence of vulnerable plaque could effectively predict HI.

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