Structure of carotid sinus atherosclerotic plaques and disturbances of cerebral blood circulation

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Abstract

A morphological study of 200 atherosclerotic carotid sinus (CS) plaques obtained at carotid endarterectomy revealed the structural components and processes characteristic for severe atherosclerosis: foci of atheromatosis and edema, necrosis of collagen and elastic fibres, newly formed vessels and hemorrhages of various duration, lipophages and lymphocytes, portions of fibrosis and calcification, covering thinning and ulceration, thrombi and the contents of plaques (atheromatous masses, cholesterol crystals, lipophages, calcificates) on their surface. Clinical and morphological comparisons indicated that patients with ischemic stroke in their history had more severe atherosclerosis than those with asymptomatic CS stenosis. They were more commonly found to have vulnerable atherosclerotic plaques that showed a predominance of atheromatosis foci over the portions of fibrosis and calcification, covering thinning and destruction, formation of thrombi on its surface. It was ascertained that concomitant arterial hypertension might play a crucial role in the pathogenesis of hemorrhages into the atherosclerotic CS plaque.

 

About the authors

Tat'yana S. Gulevskaya

Research Center of Neurology

Email: anufriev@neurology.ru
Russian Federation, Moscow

V. A. Morgunov

Research Center of Neurology

Email: anufriev@neurology.ru
Russian Federation, Moscow

Pavel L. Anufriev

Research Center of Neurology

Author for correspondence.
Email: anufriev@neurology.ru
ORCID iD: 0000-0002-5327-2275

Cand. Sci. (Med.), senior researcher, Laboratory of neuromorphology

Russian Federation, 125367, Moscow, Volokolamskoye shosse, 80

References

  1. Верещагин Н.В., Моргунов В.А., Гулевская Т.С. Патология головного мозга при атеросклерозе и артериальной гипертонии. М.: Медицина, 1997.
  2. Гавриленко А.В., Скрылев С.И., Воронов Д.А. Показания к каротидной эндартерэктомии и ее результаты. Вестник РАМН 2002; 5: 7–12.
  3. Гулевская Т.С., Моргунов В.А. Очерки ангионеврологии / Под ред. З.А. Суслиной. М.: Атмосфера. 2005: 49–65.
  4. Гулевская Т.С., Моргунов В.А., Ануфриев П.Л. Морфологические особенности сосудов атеросклеротических бляшек синуса внутренней сонной артерии (на материале биоптатов, полученных при каротидной эндартерэктомии). Архив патологии 2002; 6: 47–50.
  5. Гулевская Т.С., Моргунов В.А., Ануфриев П.Л. и др. Морфологическая структура атеросклеротических бляшек синуса внутренней сонной артерии и их ультразвуковая характеристика. Ультразвуковая и функциональная диагностика 2004; 4: 68–77.
  6. Покровский А.В. Первичная профилактика ишемического инсульта и возможности сосудистой хирургии. Журн. неврол. и психиатр. Прил. Инсульт 2003; 9: 96–99.
  7. Суслина З.А., Варакин Ю.Я., Верещагин Н.В. Сосудистые заболевания головного мозга. М.: МЕДпресс-информ, 2006.
  8. Bassiouny H., Sakaguchi Y., Mikucki S. et al. Juxtalumenal location of plaque necrosis and neoformation in symptomatic carotid stenosis. J. Vasc. Surg. 1997; 26: 585–594.
  9. Blakeley D., Oddone E., Hasselblad V. et al. Noninvasive carotid artery testing. A metaanalytic review. Ann. Intern. Med. 1995; 122: 360–367.
  10. Carr S., Farb A., Pearce W. et al. Atherosclerotic plaque rupture in symptomatic carotid artery stenosis. J. Vasc. Surg. 1996; 23: 755–766.
  11. Fisher M., Paganini-Hill A., Martin A. et al. Carotid plaque pathology. Thrombosis, ulceration and stroke pathogenesis. Stroke 2005; 36: 253–257.
  12. Golledge J., Greenhalgh R., Davies A. The symptomatic carotid plaque. Stroke 2000; 31: 774–781.
  13. Halliday A., Mansfield A., Marro J. et al. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 2004; 8: 1491–1502.
  14. Hatsukami T., Ferguson M., Beach K. et al. Carotid plaque morphology and clinical events. Stroke 1997; 28: 95–100.
  15. Husain T., Abbott C., Scott J., Gough M. Macrophage accumulation within the cap of carotid atherosclerotic plaques is associated with the onset of cerebral ischemic events. J. Vasc. Surgery 1999; 30: 269–276.
  16. Jander S., Sitzer M., Schumann R. et al. Inflammation in high-grade carotid stenosis: a possible role for macrophages and T cells in plaque destabilization. Stroke 1998; 29: 1625–1630.
  17. McCarthy M., Loftus J., Thompson M. et al. Angiogenesis and the atherosclerotic carotid plaque: an association between symptomatology and plaque morphology. J. Vasc. Surg. 1999; 30: 261–268.
  18. Moore W., Barnett H., Beebe H. Guidelines for carotid endarterectomy. A multidisci-plinary consensus statement from the Ad hoc Committee, American Heart Association. Circulation 1995; 91: 566–579.
  19. Nederkoorn P., Mali W., Eikelboom B. et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke 2002; 33: 2003–2006.
  20. Price T., Manolio T., Kronmal R. et al. Silent brain infarction on MRI and neurological abnormalities in community-dwelling older adults. Stroke 1997; 28: 1158–1164. 21. Rothwell P., Goldstein L. Carotid endarterectomy for asymptomatic stenosis: Carotid Asymptomatic Surgery Trial. Stroke 2004; 35: 2425–2427.

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Copyright (c) 2010 Gulevskaja T.S., Morgunov V.A., Anufriev P.L.

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