vulnerable plaque
Atherosclerotic lesion with high-risk morphological features predisposing to rupture and thrombotic events.
Full Definition
Vulnerable plaque refers to atherosclerotic lesions characterized by specific morphological features that increase the risk of plaque rupture and subsequent acute coronary syndrome. These plaques typically contain a large necrotic core covered by a thin fibrous cap (<65 micrometers), extensive inflammatory infiltrate, and positive remodeling. Advanced imaging modalities like OCT, IVUS, and NIRS can identify vulnerable plaque characteristics including thin-cap fibroatheroma (TCFA), lipid-rich pools, and macrophage infiltration. Recognition of vulnerable plaque is crucial for risk stratification and preventive interventions, as these lesions may cause acute events even when causing minimal luminal stenosis.
Usage
Usage note: Distinguish from culprit lesion - vulnerable plaques may not be flow-limiting
In Context
- "OCT identified multiple vulnerable plaque features including thin fibrous cap and lipid pool." — Imaging report
- "The concept of vulnerable plaque has shifted focus from stenosis severity to plaque composition." — Review article