Histologic characterization of mobile and nonmobile carotid plaques detected with ultrasound imaging Takeshi Funaki, MD, Koji Iihara, MD, PhD, Susumu.

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Histologic characterization of mobile and nonmobile carotid plaques detected with ultrasound imaging Takeshi Funaki, MD, Koji Iihara, MD, PhD, Susumu Miyamoto, MD, PhD, Kazuyuki Nagatsuka, MD, PhD, Tomohito Hishikawa, MD, PhD, Hatsue Ishibashi-Ueda, MD, PhD Journal of Vascular Surgery Volume 53, Issue 4, Pages 977-983 (April 2011) DOI: 10.1016/j.jvs.2010.10.105 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 A, A longitudinal duplex ultrasound image of a mobile plaque demonstrates an ulcerated plaque in the extracranial internal carotid artery. B, A schema representing the mobile component in the plaque: an ulcer's inner surface rose and fell according to the pulsation, as indicated with arrows, which was defined as “movements localized within an ulcer's inner surface” (see also Video 1, online only). ICA, Internal carotid artery; IJV, internal jugular vein. Journal of Vascular Surgery 2011 53, 977-983DOI: (10.1016/j.jvs.2010.10.105) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 A, A longitudinal duplex ultrasound image demonstrates a massive mobile plaque almost occluding the internal carotid artery (ICA) and a protuberance from the distal end of the plaque. B, A schema representing the shaking movement of the protuberance (arrows): the original video also revealed a mobile component inside the plaque that changed slowly and irregularly like viscous liquid (liquefaction sign, see also Video 2, online only). ECA, External carotid artery. Journal of Vascular Surgery 2011 53, 977-983DOI: (10.1016/j.jvs.2010.10.105) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 An example of histologic features of a mobile plaque (the same plaque as shown in Fig 1). A, A photomicrograph of the carotid bifurcation (Masson's trichrome staining, original magnification ×1) demonstrates complete disruption of the fibrous cap (arrowhead). B, Another cross-section (Masson's trichrome staining, original magnification ×1) demonstrates a large necrotic core with a fresh intraplaque hemorrhage (asterisk), which was covered with thin fibrous cap (arrow). C, A photomicrograph (Masson's trichrome staining, original magnification ×2) shows intramural fibrin deposit, indicating mural thrombus (double arrow). Journal of Vascular Surgery 2011 53, 977-983DOI: (10.1016/j.jvs.2010.10.105) Copyright © 2011 Society for Vascular Surgery Terms and Conditions