Histological composition and progression of carotid plaque.
BACKGROUND
To analyse histological composition and progression of carotid plaque.


METHODS
Thirty-one patients (22 males, mean age 68.03 +/- 7.3 years) admitted for carotid endarterectomy for extracranial high-grade internal carotid artery stenosis (>or= 70% luminal narrowing) were enrolled. The patients were divided into 2 groups according to symptomatology (group I, 17 symptomatic patients; and group II, 14 asymptomatic patients). A histological analysis and inflammatory cell quantification of each excised carotid plaque was made. Nine carotid arteries were removed from human cadavers that were not preselected for carotid artery disease. These specimens were used as a control tissue without any macroscopic signs of atherosclerotic plaques.


RESULTS
Fifty eight percent of all carotid plaques were classified as complex plaque with possible surface defect, hemorrhage or thrombus. The inflammatory cells concentration did not differ between the two groups. All specimens from human cadavers were classified as preatheroma with extracellular lipid pools.


CONCLUSIONS
Asymptomatic and symptomatic patients could have the same histological components on their carotid plaques. Fibrotic and calcific plaques could become vulnerable as complex plaques with surface defect, hemorrhage and thrombus could remain silent. Asymptomatic carotid stenosis should be followed close with no invasive diagnostic methods and clinical evaluation.
Baroncini
Liz Andréa Villela
LA
Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, São Paulo, Brazil. lizandreabaroncini@hotmail.com
Filho
Antonio Pazin
AP
Ramos
Simone Gusmão
SG
Martins
Antonio Roberto
AR
Murta
Luiz Otavio
LO