Hemodynamic Characteristics of Carotid Plaques as Potential Biomarkers for Predicting Anterior Circulation Acute Cerebral Infarction: A Prospective Study

This study aimed to examine the hemodynamic properties of carotid artery plaques, exploring their potential as indicators for predicting anterior circulation acute cerebral infarction (ACI). A prospective analysis was performed on 113 carotid atherosclerotic plaques from 68 patients, dividing them into two groups: those with ACI (73 plaques) and those without (NACI, 40 plaques). Computational fluid dynamics (CFD) was applied to measure hemodynamic parameters, focusing on wall shear stress (WSS) in the upstream, downstream, and core regions of the plaque, as well as pressure and blood flow velocity. The results indicated that patients with ACI had significantly lower WSS in all regions compared to the NACI group (P < 0.05). The ACI group also showed higher pressures and core blood flow velocities, while downstream velocity was reduced. Among the WSS parameters, WSSdown was the most efficient predictor for ACI, with an area under the receiver operating characteristic curve (AUC) of 0.96, an F1 Score of 0.95, and a diagnostic Odds Ratio significantly higher than other parameters. The findings suggest that reduced WSS is a significant correlate of ACI and may be a reliable biomarker for its early detection.