PB0017 - Combined lithotripsy and photobiomodulation therapy, accompanied by high-dose atorvastatin administration for vulnerable thin-fibrous cap calcified atheromatous plaque stabilization

Background: Atherosclerosis result in plaque formation and plaque rupture leads to arterial thromboembolism. Atherosclerosis is the leading cause of cerebrovascular and cardiovascular diseases. The risk of stroke and myocardial infarction, as well as the deaths that result from them, is decreased by treating advanced atherosclerosis with calcification.

Aims: In this study, we created a combined experimental lithotripsy and laser photobiomodulation therapy system and examined its efficacy in stabilizing calcified atheromatous plaque with thin, vulnerable cap, wherein diagnostic B- mode ultrasound is combined with therapy system, with a goal of increased safety.

Methods: Briefly, New Zealand white rabbits were subjected to a primary intravascular severe balloon damage in the right femoral artery, followed by an 8-week diet injury high in vitamin D3, nicotine, and cholesterol. Results from histopathology and ultrasonography revealed that all of the rabbits' arteries had developed atherosclerotic, calcified atheromatous plaque with thin, vulnerable cap and severe stenosis (> 70%). Animals were then given high-dose (5 mg/kg/day) atorvastatin along with combined extracorporeal shock wave (V= 21 Kv, F= 4 Hz, Impulses= 150)- based focused electrohydraulic lithotripsy therapy and polarized near-infrared laser (1064 nm, 130 J/cm2) photobiomodulation therapy.

Results: The treatment group had a significantly lower mean value for intraplaque lipid, immune cells, and calcium density and higher mean value for intraplaque fibrous content, compared to the control groups, according to the results of histopathology and ultrasonography (p < 0.05).

Conclusion(s): A vulnerable thin-cap calcified atheromatous plaque can be stabilized by lithotripsy and the anti-inflammatory effects of shock waves, as well as the anti-inflammatory and collagen, smooth muscle cell, and extracellular matrix promoting effects of near- infrared laser therapy.