Angiogenesis and the atherosclerotic carotid plaque: An association between symptomatology and plaque morphology
Angiogenesis and the atherosclerotic carotid plaque: An association between symptomatology and plaque morphology
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DOI：
10.1016/s0741-5214(99)70136-9
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发表时间：
1999-08-01
影响因子：
4.3
通讯作者：
Brindle, NPJ
中科院分区：
文献类型：
--
作者：
McCarthy, MJ;Loftus, IM;Brindle, NPJ
目的：由血栓形成引起的症状性颈动脉疾病与斑块不稳定和斑块内出血有关。病变的这些特征可能受到斑块内新生血管的脆弱性和位置的影响。本研究的目的是确定是否存在任何关联之间的新生血管密度，位置，形态，和thromboembolic sequentials.Methods：颈动脉内膜切除术样本收集了15例无症状患者大于80%狭窄和13例高度有症状的患者患有同侧颈动脉狭窄事件在1个月内的手术。两组在性别、年龄、危险因素、颈动脉狭窄程度和斑块大小方面相匹配。样品用苏木精/伊红和货车Geison染色。通过使用内皮特异性抗体CD 31进行免疫组织化学。斑块的组织学特征进行了评估，新生血管进行了计数，其特点是大小，地点，和shelf.Results：有症状的斑块（P < .00001）和纤维帽（P < .0001），与无症状斑块相比，有显着更多的新生血管。症状性斑块中的新生血管更大（P <0.004）且更不规则。有症状的斑块中斑块坏死和破裂显著增加。斑块出血和破裂与斑块内（P <0.017，P <0.001）和纤维帽内（P <0.046，P <0.004）更多的新生血管相关。术前和术中栓塞的患者斑块和纤维帽新生血管明显增多（P <0.025，P <0.001）。结论：症状性颈动脉疾病与动脉粥样硬化斑块和纤维帽内新生血管增多有关。这些血管更大，更不规则，可能导致斑块不稳定和血栓栓塞后遗症的发生。
Purpose: Symptomatic carotid disease resulting from generation of thromboemboli has been associated with plaque instability and intraplaque hemorrhage. These features of the lesion could be influenced by the fragility and position of neovessels within the plaque. The purpose of this study was to determine whether any association exists between neovessel density, position, morphology, and thromboembolic sequelae.Methods: Carotid endarterectomy samples were collected from 15 asymptomatic patients with greater than 80% stenoses and from 13 highly symptomatic patients who had suffered ipsilateral carotid stenotic events within 1 month of surgery. Both groups were matched for gender, age, risk factors, degree of carotid artery stenosis, and plaque size. Samples were stained with hematoxylin/eosin and van Geison. Immunohistochemistry was performed by using an endothelial specific antibody to CD31. Plaques were assessed for histologic characteristics, and neovessels were counted and characterized by size, site, and shape.Results: There were significantly more neovessels in plaques (P < .00001) and fibrous caps (P < .0001) in symptomatic compared with asymptomatic plaques. Neovessels in symptomatic plaques were larger (P < .004) and more irregular. There was a significant increase in plaque necrosis and rupture in symptomatic plaques. Plaque hemorrhage and rupture were associated with more neovessels within the plaque (P < .017, P < .001) and within the fibrous cap (P < .046, P < .004). Patients with preoperative and intraoperative embolization had significantly more plaque and fibrous cap neovessels (P < .025, P < .001).Conclusion: Symptomatic carotid disease is associated with increased neovascularization within the atherosclerotic plaque and fibrous cap. These vessels are larger and more irregular and may contribute to plaque instability and the onset of thromboembolic sequelae.