Key result
Imaging and molecular biomarkers identify vulnerable carotid plaques to potentially lower cerebrovascular event risk.
Why the study?
Carotid plaque risk stratification has traditionally relied on luminal stenosis, but plaque vulnerability contributes to stroke risk, and emerging microscopic molecular markers warrant an updated review alongside macroscopic imaging.
This review highlights the emerging role of microscopic molecules and macroscopic imaging in identifying vulnerable carotid plaques to better stratify stroke risk beyond luminal stenosis.
Vulnerable plaques have been a hot topic in the field of stroke and carotid atherosclerosis. Currently, risk stratification and intervention of carotid plaques are guided by the degree of luminal stenosis. Recently, it has been recognized that the vulnerability of plaques may contribute to the risk of stroke. Some classical interventions, such as carotid endarterectomy, significantly reduce the risk of stroke in symptomatic patients with severe carotid stenosis, while for asymptomatic patients, clinically silent plaques with rupture tendency may expose them to the risk of cerebrovascular events. Early identification of vulnerable plaques contributes to lowering the risk of cerebrovascular events. Previously, the identification of vulnerable plaques was commonly based on imaging technologies at the macroscopic level. Recently, some microscopic molecules pertaining to vulnerable plaques have emerged, and could be potential biomarkers or therapeutic targets. This review aimed to update the previous summarization of vulnerable plaques and identify vulnerable plaques at the microscopic and macroscopic levels.
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Wang et al. (2022) conducted a review in Carotid vulnerable plaques. Macroscopic imaging technologies and emerging microscopic molecular biomarkers can identify carotid vulnerable plaques, potentially lowering the risk of cerebrovascular events.
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