The Circumferential Length of the Internal Elastic Membrane Measured by Computer Digitizer Morphometry, and Its Relation to in vivo Aorta Diameter

Svendsen, Einar; Tindall, A. R.

doi:10.1159/000145780

Cited by 6 publications

(2 citation statements)

References 7 publications

(8 reference statements)

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“…When determining the area of the original lumen, the foldings of the internal elastic lamina were not taken into account since this seems to reflect the in vivo situation better than the total length of the lamina. 42 We discarded specimens from five patients because the lumen was completely occluded by organized material in one segment, even though recent thrombus material was usually present proximal or distal to this segment. The specimen from one patient had no thrombus at all.…”

Section: Methodsmentioning

confidence: 99%

Pathogenesis of carotid thrombosis.

Torvik

Svindland

Lindboe

1989

Stroke

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We histologically examined specimens from 11 patients with recent occluding thrombi at the carotid bifurcation to study local factors in the vessel wall that precipitated the thrombi. The area of stenosis of the vessel lumen was determined morphometrically. Severe atherosclerotic stenosis was frequent but was not a prerequisite for thrombus formation since specimens from almost one half of the patients had only moderate narrowing of the lumen (<60% stenosis). Specimens from three patients showed ulcerations, those from one showed intraplaque hemorrhage, and those from one massive plaque rupture, all of which were thought to be important in thrombogenesis. All such types of plaque complications may thus precipitate thrombi but no single complication was particularly predominant, and specimens from one half of the patients showed no complications at all. Screening of the carotid arteries for stenosis can therefore detect only one half of the individuals who ultimately will develop thrombosis, and the risk caused by plaque complications seems to be moderate in unselected materials. In a recent study of the carotid bifurcation in elderly asymptomatic individuals, we found that one half had >50% stenosis and one third had >60% stenosis. 41 Nearly all individuals in the latter group had recent or old intraplaque hemorrhages, Received February 28, 1989; accepted June 2, 1989. and one half of them had ulcerations and/or recent mural thrombi. In addition, numerous healed ulcerations and endothelialized mural thrombi were seen. We concluded that all types of atherosclerotic complications are frequent in asymptomatic individuals but that the complications apparently have a great tendency for self-healing without deleterious effects on the cerebral circulation. Furthermore, we pointed out that all types of complications were correlated and that the clinical significance of each complication would therefore probably be difficult to elucidate.To study the pathogenesis of carotid thrombi more directly, we examined serial sections from 11 patients with recent thrombi. As will be described, atherosclerotic stenosis was clearly an important factor, but one half of the cases had only moderate narrowing. One half of the thrombi were precipitated by plaque complications, but no single complication was of particular importance. Subjects and MethodsWe collected 17 cases with suspected recent thrombi in the region of the carotid bifurcation in 1985 and 1986. We inspected the carotid bifurcation from all patients with a clinical history suggesting recent infarction in the territory of the middle cerebral artery, and we included all vessels showing local hyperemia in the region of the bifurcation. In our experience, local hyperemia of this type is strongly suggestive but is not a definite sign of recent thrombosis.The removed specimens were fixed unopened in 10% formaldehyde. When necessary, they were by guest on May 12, 2018 http://stroke.ahajournals.org/ Downloaded from

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Section: Methodsmentioning

confidence: 99%

Pathogenesis of carotid thrombosis.

Torvik

Svindland

Lindboe

1989

Stroke

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“…Since then, reports against [Davies and Bowyer, 1975;Clark and Glagov, 1976;Swinehart et al, 1976] and in favour of [Crawford et al, 1976;Svendsen and Jorgensen, 1977;Svendsen, 1980;Tindall and Svendsen, 1982] their possi ble existence in vivo have been published. Svendsen and Tindall [1983] made morphometric measurements of the internal elastic membrane on cross-sections of rabbit aorta compared with the in vivo luminal circumference. It was shown that the internal elastic membrane was too large to fit into the blood vessel wall unless it was corrugated.…”

Section: Introductionmentioning

confidence: 99%