Histomorphological evaluation of atherosclerotic lesions in patients with peripheral artery occlusive disease.
OBJECTIVE
Peripheral arterial occlusive disease (PAOD) is mainly caused by atherosclerosis of the vessel wall. These pathological changes are classified into different stages and are well described for carotid and coronary vessels, but not for PAOD. The aim of our study was to analyze plaque morphology of femoral arteries in patients with intermittent claudication and critical limb ischemia.


METHODS
In this retrospective study 85 atherosclerotic plaques (common and superficial femoral artery) of 71 patients with a clinical symptomatic PAOD were analyzed, by histology (01/2009-07/2010). Atherosclerotic lesions were classified according to Stary (type I-VIII). For further characterization, plaques were evaluated for the presence of collagen, elastin, calcifications, smooth muscle cells, macrophages, leucocytes, and cellularity.


RESULTS
The majority (91%) of atherosclerotic lesions were of advanced types according to Stary (V-VII). Atherosclerotic lesion type VI was associated with significant higher amount of inflammatory cells in comparison to all other atherosclerotic plaque types (CD45: p<0.001; CD68: p=0.013). In addition, atherosclerotic plaques with a pronounced neovascularization contained a higher amount of CD45 (p=0.015; rho=0.273) and CD68 (p=0.016; rho=0.275) positive cells.


CONCLUSIONS
Atherosclerotic lesions of femoral arteries show similar morphological changes as coronary or carotid arteries. But inflammatory cells had a higher impact on plaque progression and destabilization than any other factor.
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany. Electronic address: a.zimmermann@gmx.org.
Alexander
A
Zimmermann
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
Simon
S
Senner
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
Hans-Henning
HH
Eckstein
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
Jaroslav
J
Pelisek
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000473:pathology*; D005260:Female; D005263:Femoral Artery / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000473:pathology*; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D012189:Retrospective Studies
Atherosclerosis; Femoral artery; Histological classification; Inflammatory cells; Peripheral arterial occlusive disease