Dilated microvessel with endothelial cell proliferation involves intraplaque hemorrhage in unstable carotid plaque
- PDF / 1,335,142 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 97 Downloads / 171 Views
ORIGINAL ARTICLE - VASCULAR NEUROSURGERY - ISCHEMIA
Dilated microvessel with endothelial cell proliferation involves intraplaque hemorrhage in unstable carotid plaque Daina Kashiwazaki 1 & Shusuke Yamamoto 1 & Naoki Akioka 1 & Emiko Hori 1 & Takashi Shibata 1 & Naoya Kuwayama 1 & Kyo Noguchi 2 & Satoshi Kuroda 1 Received: 3 August 2020 / Accepted: 22 September 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Background The purpose of the present study was to clarify the characteristics of endothelial cell (EC) proliferation in intraplaque microvessels in vulnerable plaques and impact on clinical results. Methods The present study included 76 patients who underwent carotid endarterectomy. Patients were classified into three groups based on their symptoms: asymptomatic, symptomatic without recurrent ischemic event, and symptomatic with recurrent ischemic event. MR plaque imaging was performed and surgical specimens underwent immunohistochemical analysis. The number of CD31+ microvessels, and Ki67+ and CD105+ ECs in the carotid plaques was quantified, as measurements of maximum CD31+ microvessel diameter. Results MR plaque imaging yielded 41 subjects (54.0%) diagnosed with plaque with intraplaque hemorrhage (IPH), 14 subjects (18.4%) diagnosed with fibrous plaques, and 21 (27.6%) subjects diagnosed with lipid-rich plaques. The average largest diameter of microvessel in fibrous plaques, lipid-rich plaques, and plaque with IPH was 12.7 ± 4.1 μm, 31.3 ± 9.3 μm, and 56.4 ± 10.0 μm, respectively (p < 0.01). Dilated microvessels (>40 μm) were observed in 9.6% of plaques with IPH but only in 2.8% of lipid-rich plaques and 0% of fibrous plaques (p < 0.01). Ki67+/CD31+ ECs were identified in 2.8 ± 1.2% of fibrous plaques, 9.6 ± 6.9% of lipid-rich plaques, and in 19.5 ± 5.9% of plaques with IPH (p < 0.01). The average largest diameter of microvessels in the asymptomatic group was 17.1 ± 8.7 μm, 32.3 ± 10.8 μm in the symptomatic without recurrence group, and 55.2 ± 13.2 μm in the symptomatic with recurrence group (p < 0.01). Conclusion Dilated microvessels with proliferative ECs may play a key role in IPH pathogenesis. Furthermore, dilated microvessels are likely related to clinical onset and the recurrence of ischemic events. The purpose of the present study was to clarify the characteristics of EC proliferation in intraplaque microvessels in vulnerable plaques and their impact on clinical results, focusing on dilated intraplaque microvessels. Keywords Carotid stenosis . Dilated microvessel . Intraplaque hemorrhage . Ischemic stroke
Introduction Atherosclerotic carotid stenosis is present in up to 20% of stroke or transient ischemic attack (TIA) patients, and is This article is part of the Topical Collection on Vascular Neurosurgery Ischemia * Daina Kashiwazaki [email protected] 1
Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
2
Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, Univ
Data Loading...
