Critical carotid stenoses: Morphologic and chemical similarity between symptomatic and asymptomatic plaques Hisham S. Bassiouny, MD, Harry Davis, PhD,

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Presentation transcript:

Critical carotid stenoses: Morphologic and chemical similarity between symptomatic and asymptomatic plaques Hisham S. Bassiouny, MD, Harry Davis, PhD, Nobuhide Massawa, MD, Bruce L. Gewertz, MD, Seymour Glagov, MD, Christopher K. Zarins, MD Journal of Vascular Surgery Volume 9, Issue 2, Pages 202-212 (February 1989) DOI: 10.1016/0741-5214(89)90039-6 Copyright © 1989 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Histologic manifestations of hemorrhage in stenotic plaques removed from the carotid bifurcation by endarterectomy. A, Recent hemorrhage (H) enlarges a region of the plaque matrix and is associated with focal bulging of the plaque surface into the lumen (L). (Hematoxylin and eosin; original magnification × 30.) B, Clusters of iron-laden macrophages (arrows), deep within the plaque, connote remote hemorrhage. (Perl's Prussian blue stain; original magnification × 85.) Journal of Vascular Surgery 1989 9, 202-212DOI: (10.1016/0741-5214(89)90039-6) Copyright © 1989 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Typical complications observed in the carotid bifurcation specimens. A, Ulceration with extrusion of plaque debris (D) into the artery lumen (L). The thin fibrous cap (arrows) is disrupted in several locations. (Hematoxylin and eosin; original magnification × 15.) B, Recent thrombus (T) attached to the lumen surface. There is evidence of organization by ingrowth of vessels and connective tissue (arrows) from the artery wall. L indicates the lumen. (Hematoxylin and eosin; original magnification × 25.) Journal of Vascular Surgery 1989 9, 202-212DOI: (10.1016/0741-5214(89)90039-6) Copyright © 1989 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Marked focal erosion (E) of the fibrous cap (C) is associated with a florid inflammatory exudate (arrows) consisting largely of lymphocytes. Clusters of foam cells (F) are noted within the underlying plaque matrix. (Hematoxylin and eosin; original magnification × 25.) Journal of Vascular Surgery 1989 9, 202-212DOI: (10.1016/0741-5214(89)90039-6) Copyright © 1989 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions