Comparative Analysis of Atherosclerotic Disease in the Carotid and Femoral Arteries

Abstract

K Hurst¹, R Choudhury^2, A Handa¹

1. Nuffield Department of Surgical Sciences, University of Oxford

2. Radcliffe Department of Medicine, University of Oxford

Introduction

The outcomes for patients with PAOD have remained unchanged for over 25 years, whereas primary prevention has made a marked difference to the incidence of stroke and MI. Why is treatment more effective for certain types of atherosclerotic plaques than others? Why do certain patients experience a stroke but never an amputation?

Methods

The study aims to use in vivo and ex vivo analysis of carotid and femoral atherosclerotic plaque from patients enrolled in the OxPVD study. Each participant will undergo pre-operative in vivo carotid and femoral vessel (ipsilateral) imaging using T1/T2 weighted MRI; inclusive of plaque, and ex vivo plaque analysis using micro CT, micro MRI and histological staining. Comparative analysis of the carotid versus femoral plaques will be completed using above techniques.   

Results

Primary results from this study have shown that novel MRI DANTE sequences can successfully characterise femoral atherosclerotic plaque in vivo. Using micro CT and mass spectrometry techniques from micro MRI, we have further quantified the differences in composition of carotid and femoral disease. Finally, histological staining has implied that the disease processes behind femoral and carotid atherosclerosis may be different; with carotid narrowing by fat infiltration and statistically significant reduction in nuclei, compared to femoral plaque showing intra luminal calcium deposition without intimal destruction.

 Conclusion

These preliminary results are beginning to highlight the key compositional differences between carotid and femoral atherosclerosis, and with these results it may be possible to trial different therapeutic targets, particularly in the context of PAOD.