Am J Cardiol. 2026 Feb 26:S0002-9149(26)00099-8. doi: 10.1016/j.amjcard.2026.02.046. Online ahead of print.
ABSTRACT
Different vascular beds show different tissue characteristics. The mechanism of progression at the culprit site in femoropopliteal arteries remains unclear. This study aims to assess the causes of significant stenosis at culprit lesions in femoropopliteal arteries using optical frequency domain imaging (OFDI). Femoropopliteal arteries were evaluated in 54 legs from 44 patients with lower extremity artery disease undergoing OFDI-guided endovascular therapy. The causes of stenosis at the culprit sites were evaluated and types of acute thrombus were assessed. Multivariate logistic regression analysis was used to find the factors significantly associated with acute thrombus and healed plaque at the culprit sites. Acute thrombus (48%) and healed plaque (46%) were two major causes at the culprit sites. Among the types of acute thrombus at the culprit sites, eruptive calcified nodule was the most frequent (66%), erosion (24%) was second, and rupture (10%) was third. Dual antiplatelet therapy before admission of endovascular therapy and low run-off number (0, 1 and 2) were significantly related to acute thrombus, whereas the factors significantly associated with healed plaque were run-off number 0, lipidic plaque and longer lesions. In conclusion, regardless of acute thrombus or healed plaque, mechanisms of lower extremity artery disease at culprit sites were associated with thrombus. The prevalence of types of acute thrombus in femoropopliteal arteries was in order of eruptive calcified nodule, erosion and rupture.
PMID:41763628 | DOI:10.1016/j.amjcard.2026.02.046