Abstract Body: Introduction
A calcified nodule (CN) is defined as a lesion with fibrous cap disruption and luminal thrombus associated with eruptive, dense, calcific nodules. CNs have been reported as an important cause of acute coronary syndrome, including sudden coronary death. However, few reports have discussed CNs in the context of carotid artery stenosis. This study aimed to evaluate the prevalence and distribution of CNs in carotid arteries using carotid endarterectomy (CEA) specimens in correlation with clinical symptoms.
Methods
We included 508 consecutive patients with moderate to severe (50–95%) carotid artery stenosis who underwent CEA between April 2008 and March 2023. We performed pathological analysis of plaque characteristics in carotid arteries and compared with patient characteristics.
Results
Of the 508 specimens, 462 (90.9%) were from male patients and mean degree of stenosis was 73.8±16.4%. Fourteen CNs (2.8%) were identified. Seventy-eight calcified plaques (10.4%) defined as the presence of nodular or sheet calcifications were also identified. The number of women was significantly higher in CN group (9/14: 64.3%) than in non-CN group (37/494: 7.5%; P<0.001) for all specimens. CNs were slightly more frequent in the common carotid artery (8/14: 57.1%) than in the internal carotid artery (6/14: 42.9%). In cases of calcified plaque, the number of symptomatic stenosis was significantly higher in CN group (11/14: 78.6%) than in non-CN group (29/64: 45.3%; P=0.049).
Conclusion
This is the first clinical report on the prevalence and distribution of CNs in carotid artery stenosis. CNs were found in 2.8% of patients with moderate to severe carotid artery stenosis who underwent CEA. CNs were significantly more prevalent in women and cases of symptomatic stenosis, suggesting that CNs play an important role in the pathogenesis of ischemic stroke in moderate to severe carotid artery stenosis.