The aim of our study is to demonstrate whether there is a relationship between the angle of Common Carotid Artery (CCA) and Internal Carotid Artery (ICA) and atherosclerotic plaque composition in terms of Fat, Mixed, Calcific plaque and plaque volume. Plaque composition analysis by MDCTA has been proved to be a highly reliable toolcompared to the histopathology of the plaque, and it is also an important indicator of risk.

The institutional review board approval for this study was obtained. This is a prospective single institution pilot study enrolling 59 patients, for a total of 118 carotids, who were scheduled to perform a MDCTA of the supra-aortic vessels with a 16-multidetector-row computed tomography (CT) system (Philips Brilliance, Eindhoven, Netherlands). Patient Population: The examinations were performed between April 2016 and February 2017 for a total of 118 carotids, 59 patients. Patients were chosen per two main criteria: symptomatic and asymptomatic. Asymptomatic patients are recruited from those...

Of the 119 carotids analysed, in 9 cases the image quality was insufficient, due to dental hardware which made the semiautomatic plaque quantification measurement impossible. In 3 cases the stenosis was total and there was an occlusion of the vessel; this patients have been exluded as well from the calculations. In 21 cases the stenosis was significative according to the NASCET criteria (stenosis > 50%). There is almost no correlation between the angle value and the fatty plaque percentage (r -0.005784, significance level p= 0.9533)....

Among the three different type of plaque compostion analysed we have found a strong correlation between the CCA-ICA angle and the presence of a fibrotic plaque. The bigger the angle the highest is the probability to find a fibrotic plaque, compared to a plaque which is purely calcific or purely fatty. This could be related to the flux and the wall shear stress changes in different angles bifurcation. Further studies with different techniques are needed to analyse hystopatologically and to further confirm these data.

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