http://www.sciencedirect.com/science/article/pii/0741521491903593 Journal of Vascular Surgery
Volume 13, Issue 5, May 1991, Pages 719–724
of carotid artery plaque
Carotid plaque characteristics associated with the production of symptoms were identified
with quantification of carotid plaque constituents in high-grade stenotic asymptomatic (n = 8) and symptomatic (n = 44) plaques. Asymptomatic
plaques contained significantly more fibrous/collagen material (88%) than symptomatic plaques (66%) (p < 0.05). Hemorrhage [bleeding, discharged blood] constituted 2% and 1% of asymptomatic and symptomatic
plaques, respectively. The predominant non-fibrous material
was a pink amorphous material mixed with cholesterol, which composed 7% of asymptomatic and 27% of symptomatic plaques (p < 0.05). No relationship was found between plaque composition and the number of ipsilateral [affecting the same side of
the body] ischemic neurologic events, nor was there evidence of a healing process.
B-mode ultrasound scanning had a sensitivity of 94% in identifying plaque with > 80% fibrous content. We believe that plaque
composition may be a useful discriminating factor in selecting asymptomatic patients for carotid endarterectomy.
(J VASC SURG 1991;13:719-24.).
Morphometric analysis of the composition of coronary arterial plaques in
isolated unstable angina pectoris with pain at rest
Coronary artery plaque morphology was studied in 354 five-mm segments of the 4 major (left
main, left anterior descending, left circumflex and right) epicardial coronary arteries in 10 patients with isolated unstable angina pectoris with pain at rest. The 4 major coronary arteries were sectioned
at 5mm intervals and a drawing of each of the resulting 354 Movat-stained histologic sections was analyzed using a computerized
morphometry system. The
major component of plaque was a combination of dense acellular and cellular fibrous tissue with much smaller portions of plaque
being composed of pultaceous debris, calcium, foam cells with and without inflammatory infiltrates and inflammatory infiltrates
without foam cells. There were no differences in plaque composition among any of the 4 major epicardial coronary arteries. Plaque
composition varied as a function of the degree of luminal narrowing. Linear increases
were observed in the mean percent of dense fibrous tissue (from 5 to 50%), calcific deposits (from 1 to 10%), pultaceous [resembling
pulp] debris (from 0 to 10%) and inflammatory infiltrates without significant numbers of foam cells (from 0 to 5%), and a
linear decrease was observed in the mean percent of cellular fibrous tissue (from 94 to 22%) in sections narrowed up to 25%
to more than 95% in cross-sectional area. Multi-luminal channels were seen in all 10 patients (28 [19%] of the 146 sections
narrowed >75% in cross-sectional area and in 36 [10%] of all 354 segments); occlusive thrombi in no patient; non-occlusive
thrombi in 2 patients (1 section each of 2 arteries); plaque rupture in 2 patients (4 segments from 2 arteries); and plaque
hemorrhages in 6 patients (11 sections from 10 arteries).