Intraplaque neovascularization and progression of atherosclerosis: A review of SMI technical assessment and berberine-statin regulatory mechanisms

Intraplaque neovascularization (IPN) is a central driver of atherosclerosis (AS) progression and plaque vulnerability, and its dynamics are closely related to the risk of cardiovascular events. Superb microvascular imaging (SMI) has become a key tool for IPN assessment due to its noninvasive and highly sensitive characteristics, and the combination of berberine and statins has demonstrated significant synergistic effects in regulating IPN and stabilizing plaques. This article describes the pathological mechanisms of IPN in the progression of AS, summarizes the value of SMI technology and multimodal imaging in the assessment of IPN, and analyzes the molecular mechanisms and clinical evidence of berberine and statins in the regulation of IPN, so as to provide an integrated "assessment-intervention" basis for the precise prevention and treatment of AS.