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Sondore et al. | Journal of Clinical and Translational Research 2023; 9(4): 253-260   259
        the quantity of atherosclerotic debris obtained on retrieval of the   Disease. Clin Physiol Funct Imaging 2021;41:271-80.
        distal embolic protection device [17]. Winston et al. showed an   [2]   Cohen  GI, Aboufakher  R,  Bess  R,  Frank  J,  Othman  M,
        association  between  periprocedural  cerebrovascular  events  and   Doan D, et al. Relationship between Carotid Disease on
        plaque composition by VH-IVUS [18]. We compared patients with   Ultrasound and Coronary Disease on CT  Angiography.
        and without cerebrovascular complications  (cerebral infarction   JACC Cardiovasc Imaging 2013;6:1160-7.
        and  transitory  ischemic  attack  <24  h)  after  CAS  and  found  no   [3]   Den  Ruijter  HM,  Peters  SA,  Anderson  TJ,  Britton AR,
        difference in carotid tissue composition by VH-IVUS. However,   Dekker JM, Eijkemans MJ, et al. Common Carotid Intima-
        our study was not designed and does not have sufficient power   Media  Thickness  Measurements  in  Cardiovascular  Risk
        to draw conclusions regarding post-procedural  cerebrovascular   Prediction: A Meta-Analysis. JAMA 2012;308:796-803.
        complications. Similar carotid plaque composition in symptomatic   [4]   Amato  M,  Montorsi  P,  Ravani  A,  Oldani  E,  Galli  S,
        and asymptomatic  patients  by  VH-IVUS  analysis highlights a   Ravagnani  PM,  et al.  Carotid  Intima-Media  Thickness
        need for further research to detect high-risk plaques combining   by  B-Mode  Ultrasound  as  Surrogate  of  Coronary
        invasive and non-invasive imaging modalities.                 Atherosclerosis: Correlation with Quantitative  Coronary
          In our study, we found a higher percentage of calcium in the   Angiography and Coronary Intravascular  Ultrasound
        coronary compared to carotid arteries. A global registry of more   Findings. Eur Heart J 2007;28:2094-101.
        than 3000 patients undergoing coronary VH IVUS showed that NC   [5]   Nasu K, Tsuchikane E, Katoh O, Vince DG, Virmani R,
        and DC content increases with age, were more common in men than   Surmely JF, et al. Accuracy of In Vivo Coronary Plaque
        in women, and were positively associated with serum low-density   Morphology Assessment: A  Validation  Study  of  In Vivo
        lipoprotein cholesterol, diabetes, and hypertension [19]. Pooled data   Virtual Histology Compared with In Vitro Histopathology.
        from two clinical trials showed coronary calcium increase in patients   J Am Coll Cardiol 2006;47:2405-12.
        receiving long-term high-dose statin therapy without impact on   [6]   Virmani  R,  Burke  AP,  Farb  A,  Kolodgie  FD.
        adverse cardiovascular events suggesting plaque stabilization [20].   Pathology  of the  Vulnerable  Plaque.  J Am Coll  Cardiol
        All patients in our study received guideline-directed lipid-lowering   2006;47(8 Suppl):C13-8.
        therapy which could explain higher amount of DC in analyzed
        coronary arteries. In line with published evidence, our data confirm   [7]   Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E,
        the  systemic  characteristics  of  atherosclerosis and  the  similar   Mintz GS, et al. A Prospective Natural-History Study of
        carotid and coronary plaque composition, but differences in calcium   Coronary Atherosclerosis. N Engl J Med 2011;364:226-35.
        distribution between arterial territories.              [8]   Cheng  JM,  Garcia-Garcia  HM,  de  Boer  SP,  Kardys  I,
          The main limitation of our study was lack of blinded core   Heo JH, Akkerhuis KM, et al. In Vivo Detection of High-
        laboratory VH-IVUS analysis. Furthermore, patients included in the   Risk Coronary  Plaques  by Radiofrequency  Intravascular
        CAS group were in greater proportion compared to the PCI group.  Ultrasound  and  Cardiovascular  Outcome:  Results  of  the
                                                                      ATHEROREMO-IVUS Study. Eur Heart J 2014;35:639-47.
        5. Conclusion                                           [9]   Musialek P, Pieniazek P, Tracz W, Tekieli L, Przewlocki T,

          The  percentage  of  all  analyzed  plaque  components  was   Kablak-Ziembicka A, et al. Safety of Embolic Protection
        correlated  among coronary  and carotid  artery  plaques.     Device-Assisted and Unprotected Intravascular Ultrasound
        Nevertheless, coronary arteries contained more NCs and calcium,   in Evaluating Carotid Artery Atherosclerotic Lesions. Med
        while carotid arteries had a higher percentage of fibrolipidic tissue.   Sci Monit 2012;18:MT7-18.
        Patients  with cerebrovascular  events  had a tendency  toward a   [10]  Thim  T,  Hagensen  MK,  Bentzon  JF,  Falk  E.  From
        higher percentage of NCs in the carotid plaques.              Vulnerable  Plaque  to  Atherothrombosis.  J  Intern  Med
                                                                      2008;263:506-16.
        Acknowledgments                                         [11]  Stefanadis C, Antoniou CK, Tsiachris D, Pietri P. Coronary

          None.                                                       Atherosclerotic Vulnerable Plaque: Current Perspectives.
                                                                      J Am Heart Assoc 2017;6:e005543
        Funding                                                 [12]  Samady  H,  Eshtehardi  P,  McDaniel  MC,  Suo  J,
                                                                      Dhawan SS, Maynard C, et al. Coronary Artery Wall Shear
          None.                                                       Stress is Associated with Progression and Transformation
        Conflicts of Interest                                         of  Atherosclerotic Plaque and  Arterial Remodeling in
                                                                      Patients with Coronary  Artery Disease. Circulation
          None.                                                       2011;124:779-88.
        References                                              [13]  Eshtehardi  P,  McDaniel  MC,  Suo  J,  Dhawan  SS,
                                                                      Timmins LH, Binongo JN, et al. Association of Coronary
        [1]   Shenouda R, Vancheri S, Bassi EM, Nicoll R, Sobhi M, El   Wall Shear Stress  with  Atherosclerotic Plaque Burden,
             Sharkawy E, et al. The Relationship between Carotid and   Composition, and Distribution in Patients with Coronary
             Coronary  Calcification  in  Patients  with  Coronary Artery   Artery Disease. J Am Heart Assoc 2012;1:e002543.
                                          DOI: http://dx.doi.org/10.18053/jctres.09.202304.23-00030
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