Histologic characterization of carotid plaques

Damme, Hendrik Van; Vivario, M; Boniver, Jacques; Limet, R

doi:10.1016/1054-8807(94)90003-5

Cited by 32 publications

(30 citation statements)

References 17 publications

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“…More recent blind studies, however, indicate that a link between complicated plaques and symptomatic disease might not exist (33)(34)(35)(36). Accordingly, the North American Symptomatic Carotid Endarterectomy Trial (NASCET) (37) demonstrated that most carotid strokes occur without warning symptoms.…”

Section: So-called 'Cirrhotic' Appearance (Asterisk) Hematoxylin Andmentioning

confidence: 99%

Carotid barochemoreceptor pathological findings regarding carotid plaque status and aging

Milei

Lavezzi

Bruni

et al. 2009

Canadian Journal of Cardiology

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Section: So-called 'Cirrhotic' Appearance (Asterisk) Hematoxylin Andmentioning

confidence: 99%

Carotid barochemoreceptor pathological findings regarding carotid plaque status and aging

Milei

Lavezzi

Bruni

et al. 2009

Canadian Journal of Cardiology

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“…All patients underwent a carotid artery MRI examination within 1 week of the surgical procedure to reduce potential errors in the correlation between image and pathology. 14 …”

Section: Study Populationmentioning

confidence: 99%

In Vivo Accuracy of Multispectral Magnetic Resonance Imaging for Identifying Lipid-Rich Necrotic Cores and Intraplaque Hemorrhage in Advanced Human Carotid Plaques

et al. 2001

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Background-High-resolution MRI has been shown to be capable of identifying plaque constituents, such as the necrotic core and intraplaque hemorrhage, in human carotid atherosclerosis. The purpose of this study was to evaluate differential contrast-weighted images, specifically a multispectral MR technique, to improve the accuracy of identifying the lipid-rich necrotic core and acute intraplaque hemorrhage in vivo. Methods and Results-Eighteen patients scheduled for carotid endarterectomy underwent a preoperative carotid MRI examination in a 1.5-T GE Signa scanner using a protocol that generated 4 contrast weightings (T1, T2, proton density, and 3D time of flight). MR images of the vessel wall were examined for the presence of a lipid-rich necrotic core and/or intraplaque hemorrhage. Ninety cross sections were compared with matched histological sections of the excised specimen in a double-blinded fashion. Overall accuracy (95% CI) of multispectral MRI was 87% (80% to 94%), sensitivity was 85% (78% to 92%), and specificity was 92% (86% to 98%). There was good agreement between MRI and histological findings, with a value of ϭ0.69 (0.53 to 0.85). Conclusions-Multispectral MRI can identify the lipid-rich necrotic core in human carotid atherosclerosis in vivo with high sensitivity and specificity. This MRI technique provides a noninvasive tool to study the pathogenesis and natural history of carotid atherosclerosis. Furthermore, it will permit a direct assessment of the effect of pharmacological therapy, such as aggressive lipid lowering, on plaque lipid composition.

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“…24,45,52,59 Thrombus was found in many studies, though not always present in plaques from patients with recent symptoms. 63,65,66 This constituent is thought to be associated with the theory of plaque disruption, allowing the thrombogenic lipid core to communicate with the arterial lumen. Its presence may be intermittent, reflecting the dynamic process of rupture, thrombus formation, healing, and remodeling of the plaque.…”

Section: Histological Plaque Constituents Associated With Neurologicamentioning

confidence: 99%

Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery

Grønholdt

1999

ATVB

176

111

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Abstract-The aim of this review is to summarize present knowledge of the ultrasonic detection and determinants of carotid atherosclerosis with lipid-rich cores and to review the evidence that these measures of plaque type may predict cerebral events. With the use of high-resolution ultrasound B-mode imaging, carotid plaques evaluated as only weakly reflecting the ultrasound beam (echolucent) have been associated with a higher risk of neurological events than are plaques reflecting the ultrasound signal strongly (echorich). Histologically, these echolucent plaques have a higher content of lipid and hemorrhage than do echorich plaques, which contain more calcification and fibrous tissue. Findings in the coronary arteries indicate that a lipid-rich plaque with a thin, fibrous cap is more vulnerable, is more prone to rupture, and cause symptoms compared with fibrous plaques. A search for determinants in the blood for these vulnerable plaques suggests that low density lipoprotein (LDL) cholesterol is the best lipid predictor for the extent of atherosclerosis, whereas triglyceride-rich lipoproteins in particular seem to predict an echolucent plaque. Lowering of LDL cholesterol and triglyceride-rich lipoproteins in plasma is associated with reduced progression of coronary atherosclerosis and coronary events. LDL cholesterol reduction is also associated with a reduced stroke rate. These improvements in the prognosis are thought to be the result of a reduction in the lipid content of the plaques, making them more stable and resistant to rupture rather than an actual reduction in plaque volume and degree of stenosis. In conclusion, it appears that ultrasound B-mode imaging as well as lipoproteins presumably may predict dangerous and rupture-prone, lipid-rich plaques in the carotid arteries, thereby being potential diagnostic tools in the prevention of neurological events. (Arterioscler Thromb Vasc Biol. 1999;19:2-13.)

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Histologic characterization of carotid plaques

Cited by 32 publications

References 17 publications

Carotid barochemoreceptor pathological findings regarding carotid plaque status and aging

Carotid barochemoreceptor pathological findings regarding carotid plaque status and aging

In Vivo Accuracy of Multispectral Magnetic Resonance Imaging for Identifying Lipid-Rich Necrotic Cores and Intraplaque Hemorrhage in Advanced Human Carotid Plaques

Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery

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