Correlation between TLR2 expression and common carotid artery bifurcation angle in carotid atherosclerotic plaque: a cross-sectional study

OBJECTIVE: During eversion carotid endarterectomy (CEA), optimizing the bifurcation angle can reduce hemodynamic disturbances and postoperative restenosis risk. However, determining the precise degree of bifurcation angle modification during eversion CEA remains an unresolved issue. This study aims to investigate the correlation between TLR2 expression in carotid artery plaque and the carotid bifurcation angle. METHODS: In this cross-sectional study, 128 patients were enrolled. For all subjects before surgery, carotid bifurcation angle were measured with picture archiving and communication system. After surgery, the expression of inflammation factor TLR2, NF-κB, and MYD88 in the plaque specimens was analyzed using RT-qPCR. RESULTS: = 0.004). In multivariate piecewise linear regression and restricted cubic spline, the levels of TLR2 increased with the elevation of bifurcation angles when bifurcation angles was more than 49.1. CONCLUSION: This study demonstrated that TLR2 expression in carotid atherosclerotic plaque exhibited a significant positive correlation with the carotid bifurcation angle. When the bifurcation angle exceeded 49.1°, TLR2 expression increased sharply, suggesting a therapeutic potential of angle-optimized eCEA, particularly in patients with wider bifurcation angles. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/index.html identifier: ChiCTR2500102233.