Arterial calcification

Arterial calcification is a common disease among the elderly and poses a great threat to their health. Many patients with arterial calcification may even suffer from ischemic stroke, which may threaten the patient's life if not treated in time. Therefore, if you suffer from arterial calcification, you must get checked as soon as possible. So, what should we do about arterial calcification?

1. What is carotid artery calcification?

Carotid artery sclerosis, also known as carotid atherosclerosis, is the manifestation of systemic atherosclerosis in the carotid artery. It usually occurs in adolescence and gradually worsens with age. It is currently believed to be closely related to the occurrence of ischemic stroke in the elderly. In the early stage of carotid artery sclerosis, the first manifestation is the thickening of the intima-media, and then gradually forms atherosclerotic plaques. On this basis, intraplaque hemorrhage, plaque rupture and detachment, mural thrombosis and secondary vascular stenosis occur, causing corresponding hemodynamic changes and leading to the occurrence of ischemic cerebrovascular events.

2. Causes of carotid artery calcification

Like atherosclerosis, carotid artery sclerosis is affected by multiple factors. Among them, age > 60 years old, male, long-term smoking history, history of hypertension, history of diabetes and hyperlipidemia are risk factors for the formation of carotid artery plaques.

3. Harm of carotid artery calcification

Carotid artery plaques not only cause stenosis of the lumen, but can also rupture, bleed, fall off, and block blood vessels. These plaques are also called vulnerable plaques, unstable plaques or soft plaques.

The pathological characteristics of damaged plaques are large lipid core, thinning and rupture of the fibrous cap, ulceration, accumulation of a large number of macrophages, intraplaque hemorrhage and calcium deposition. Unstable sclerotic plaques can bleed, form lipid cores, and cause arterial stenosis.

How to detect carotid artery calcification

1. Doppler ultrasound

It is currently the preferred non-invasive method for carotid artery examination and is widely used in the screening and follow-up of carotid artery sclerosis. It can not only show the location and size of the plaque, the location and severity of lumen stenosis, but also perform hemodynamic measurement and morphological evaluation of the plaque. Color Doppler ultrasound can detect the carotid artery intima-media thickness (IMT) to determine whether there is atherosclerotic plaque formation. Normal IMT should be less than 1.0 mm. IMT between 1.0 and 1.2 mm indicates intimal thickening, and IMT greater than 1.2 mm indicates plaque formation. According to the morphology and echo characteristics under ultrasound, plaques can be divided into: low-echo lipid soft plaques, medium-echo fibrous flat plaques rich in collagen tissue, strong-echo calcified hard plaques with acoustic shadows, and ulcerative mixed plaques with varying echo strengths. Among them, soft plaques, flat plaques and mixed plaques are unstable plaques, which are one of the important causes of ischemic stroke.

2. Transcranial Doppler (TCD)

Another non-invasive examination method, it can show the stenosis site, degree, blood flow velocity, blood flow direction and whether there is open collateral circulation of the intracranial and extracranial arteries. It is often used in combination with Doppler ultrasound for the diagnosis and postoperative evaluation of carotid artery stenosis.

3. CT angiography (CTA)

CTA is more accurate in determining carotid artery stenosis than Doppler ultrasound, but it is poor in showing the morphology of plaques. It is currently widely used in the diagnosis of stenosis and can serve as an important basis for preoperative diagnosis and formulation of treatment plans.