A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity

Objective: This systematic literature review sought to determine the effects of carotid atherosclerotic plaque on local arterial stiffness. Methods: MedLine, EMBASE, and grey literature were searched with the following term: (atherosclerosis or carotid atherosclerosis or carotid artery disease or carotid plaque) AND (distensibility or elasticity or stiffness or compliance) NOT (pulse wave velocity or PWV or carotid-ankle or ankle-brachial or augmentation index or cardio-ankle or CAVI or flow mediated dilation or FMD). Results were restricted to English language articles reporting local arterial stiffness in human subjects with carotid atherosclerosis. Results: Of the 1466 search results, 1085 abstracts were screened and 191 full-text articles were reviewed for relevance. The results of the 50 studies that assessed some measure of carotid arterial elasticity or stiffness in patients with carotid plaque were synthesized and reviewed. Discussion: A number of different measures of carotid elasticity were found in the literature. Regardless of which metric was used, the majority of studies found increased carotid stiffness (or decreased distensibility) to be associated with carotid plaque presence, the degree of atherosclerosis, and incident stroke. Conclusion: Carotid artery mechanics are influenced by the presence of atherosclerotic plaque. The clinical applicability of carotid elasticity measures may be limited by the lack of reference values and standardized techniques.