Background
Microvessels in atheromatous plaques are well known to play a role in plaque vulnerability
associated with intraplaque hemorrhage, but their architecture remains unclear. The
morphometry of the microvasculature and hemorrhage of human carotid atheromatous plaques
(CAPs) were evaluated, and 3-dimensional (3D) reconstruction of the microvessels was
performed.
Methods
CAPs were obtained by endarterectomy in 42 patients. The specimens were analyzed using
light microscopy. Plaque hemorrhage was defined as an area-containing red blood cells
(>1 mm2). To determine the histopathologic features of plaque hemorrhage, the plaque area
was divided into 4 regions: cap, shoulder, lipid/necrotic core, and media. Then, the
density of microvessels and macrophages in each region was quantified. Two representative
lesions with either hemorrhagic or nonhemorrhagic plaque were cut into 90 serial sections.
The sections were double stained with anti-CD34 and anti-α smooth muscle actin antibodies,
scanned using a digital microscope, and reconstructed using TRI-SRF2 software.
Results
The hemorrhagic plaques showed a higher density of microvessels than nonhemorrhagic
plaques in the shoulder, cap, and lipid/necrotic core (P = .03, .009, and .001, respectively), and there was positive correlations between
its density and macrophages in each regions (P < .001, .001, and .019, respectively). 3D imaging also revealed dense microvessels
with a network structure in the cap and shoulder regions of hemorrhagic plaques, and
some of the vessels were fenestrated to the arterial lumen.
Conclusions
The microvasculature of plaques with intraplaque hemorrhage was dense, some of which
fenestrated to the arterial lumen. The pathologic 3D imaging revealed precise architecture
of microvasculature of plaques.
Key Words
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Article info
Publication history
Published online: February 14, 2014
Accepted:
December 3,
2013
Received in revised form:
October 27,
2013
Received:
August 26,
2013
Footnotes
Conflict of interest: None.
Sources of funding: This work was supported by a Kakenhi grant; a Grant-in-Aid for Young Scientists (B) (24791505) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT); the Japan Society for the Promotion of Science; and a Japan Heart Foundation Research Grant (M.K.).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.003
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
