Abstract 12048: Aortic Vulnerable Plaques Including Cholesterol Crystals: Non-Obstructive General Angioscopy and Pathological Study

Abstract

Introduction: Severe atherosclerosis of the aorta is known to be a risk of embolism to peripheral organs such as cerebral infarction and acute lower limb ischemia. Non-obstructive general angioscopy (NOGA) has high spatial and temporal resolution, and it is possible to dynamically observe various atherosclerosis in the aorta. Cholesterol crystals (CCs) which could be observed by NOGA scattered into the blood from ruptured plaques and caused inflammation. However, which NOGA-derived aortic plaques are high risk has not fully investigated yet. Aims: The purpose of our study was to evaluate aortic vulnerable plaques based on their frequency of scattering CCs. Methods: We investigated 52 consecutive patients with coronary artery disease who underwent NOGA between September 2021 and May 2023. Blood specimens were taken from a total of 118 NOGA-derived atheromatous plaques in the infrarenal abdominal aorta. Then, presence of CCs at each plaque was evaluated with polarized light microscopy using the filter paper rinse method. Results: The mean age of 52 patients in this study was 67.4 years, 82.7% were male, 36.5% had diabetes, 76.9% had dyslipidemia, and 82.7% had hypertension. CCs were detected in 28.8% (n=34/118) of the samples. The frequency of detection of CCs in aortic plaques was 52.5% for Puff Chandelier Rupture (PCR), 15.4% for Puff Rupture (PR), 4.5% for yellow plaques (YP), 0% for thrombi, and 0% for ulcer and fissure. P < 0.0001). Conclusions: Among aortic atherosclerotic plaques, many CCs were detected from PCR. PCR may be a vulnerable plaque that has a high impact on peripheral organs.