*7.8.1 Hemodynamic and clinical effects of IAC*

IAC can lead to three significant hemodynamic effects: Firstly, it can lead to increase the arterial stiffness. This phenomenon is associated with aging and accelerated by other vascular risk factors. It can be measured by the pulse wave velocity (PWV) and may indicate early atherosclerotic changes. Several studies have verified the correlation between IAC and arterial stiffness, and this may increase the risk of stroke. Secondly, arterial stenosis can be linked to arterial calcification, which may lead to ischemic stroke due to direct luminal stenosis. Thirdly, IAC may lead to plaque stability. Intravascular ultrasound studies found heavily calcified plaques to be more resistant to plaque progression. Therefore, the findings for CAC suggest that substantial calcification may help stabilize atherosclerotic plaques. Also, a heavy plaque burden hidden in heavily calcified arteries may partially account for the association between severe arterial calcification and ischemic events regardless of plaque vulnerability.
