title: Diffuse calcifications protect carotid plaques regardless of the amount of neoangiogenesis and related histological complications.
abstract: BACKGROUND
  Neoangiogenesis is crucial in plaque progression and instability. Previous data from our group showed that Nestin-positive intraplaque neovessels correlated with histological complications. The aim of the present work is to evaluate the relationship between neoangiogenesis, plaque morphology, and clinical instability of the plaque.
  
  
  METHODS
  Seventy-three patients (53 males and 20 females, mean age 71 years) were consecutively enrolled. Clinical data and 14 histological variables, including intraplaque hemorrhage and calcifications, were collected. Immunohistochemistry for CD34 and Nestin was performed. RT-PCR was performed to evaluate Nestin mRNA (including 5 healthy arteries as controls).
  
  
  RESULTS
  Diffusely calcified plaques (13/73) were found predominantly in females (P = 0.017), with a significantly lower incidence of symptoms (TIA/stroke (P = 0.019) than noncalcified plaques but with the same incidence of histological complications (P = 0.156)). Accordingly, calcified and noncalcified plaques showed similar mean densities of positivity for CD34 and Nestin. Nestin density, but not CD34, correlated with the occurrence of intraplaque hemorrhage.
  
  
  CONCLUSIONS
  Plaques with massive calcifications show the same incidence of histological complications but without influencing symptomatology, especially in female patients, and regardless of the amount of neoangiogenesis. These results can be applied in a future presurgical identification of patients at major risk of developing symptoms.
authors.affiliation: Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vasuri
authors.affiliation: Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fittipaldi
authors.affiliation: Vascular Surgery Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Pini
authors.affiliation: Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Degiovanni
authors.affiliation: Vascular Surgery Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Mauro
authors.affiliation: Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: D'Errico-Grigioni
authors.affiliation: Vascular Surgery Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Faggioli
authors.affiliation: Vascular Surgery Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Stella
authors.affiliation: Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Gianandrea
authors.identifier: 0000-0003-1506-1829
authors.initials: G
authors.lastname: Pasquinelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000378:metabolism*; D002340:Carotid Artery Diseases / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology; D064231:Nestin / Q000378:metabolism*; D058226:Plaque, Atherosclerotic / Q000378:metabolism / Q000473:pathology; D012737:Sex Factors; D061205:Vascular Calcification / Q000378:metabolism / Q000473:pathology
chemical_list: D018952:Antigens, CD34; C577484:NES protein, human; D064231:Nestin