Mofidi R, Crotty T B, McCarthy P, Sheehan S J, Mehigan D, Keaveny T V
Department of Vascular Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Br J Surg. 2001 Jul;88(7):945-50. doi: 10.1046/j.0007-1323.2001.01823.x.
Angiogenesis is a recognized feature of the atherosclerotic process and has been described in the context of unstable coronary atherosclerotic lesions. The aim of this study was to assess the association between angiogenesis in atherosclerotic carotid plaques and microscopic features of plaque instability, in particular intraplaque haemorrhage.
Consecutive patients undergoing carotid endarterectomy were included. Endarterectomy specimens were divided into their constituent atherosclerotic lesions. Histological sections were prepared and stained with haematoxylin and eosin, and immunohistochemically with an endothelial cell marker (CD34). The quantity of intraplaque haemorrhage was measured in transverse histological sections using computerized image analysis. Microvessel counts were performed in CD34-stained sections and were verified through computerized image analysis.
Some 239 atherosclerotic lesions from 73 patients were available for analysis; 73 were early lesions, 74 were raised fibroatheromas and 92 were unstable atherosclerotic plaques. One hundred and fifty lesions were not haemorrhagic; 89 exhibited intraplaque haemorrhage, of which 28 involved less than 50 per cent of the plaque sectional area. There were higher microvessel counts in plaques containing over 50 per cent haemorrhage (P < 0.0001), unstable atherosclerotic lesions (P < 0.0001) and atherosclerotic lesions obtained from symptomatic patients (P < 0.001).
There are strong associations between plaque vascularity, quantity of intraplaque haemorrhage and presence of symptomatic carotid occlusive disease.
血管生成是动脉粥样硬化进程的一个公认特征，并且已在不稳定冠状动脉粥样硬化病变的背景下被描述。本研究的目的是评估动脉粥样硬化性颈动脉斑块中的血管生成与斑块不稳定的微观特征之间的关联，尤其是斑块内出血。
纳入接受颈动脉内膜切除术的连续患者。将内膜切除术标本分为其组成的动脉粥样硬化病变。制备组织学切片，并用苏木精和伊红染色，以及用内皮细胞标记物（CD34）进行免疫组织化学染色。使用计算机图像分析在横向组织学切片中测量斑块内出血的量。在CD34染色的切片中进行微血管计数，并通过计算机图像分析进行验证。
来自73名患者的约239个动脉粥样硬化病变可供分析；73个为早期病变，74个为隆起的纤维粥样瘤，92个为不稳定动脉粥样硬化斑块。150个病变没有出血；89个表现出斑块内出血，其中28个涉及不到50%的斑块横截面积。在出血超过50%的斑块（P<0.0001）、不稳定动脉粥样硬化病变（P<0.0001）以及从有症状患者获得的动脉粥样硬化病变（P<0.001）中微血管计数更高。
斑块血管化、斑块内出血量与有症状的颈动脉闭塞性疾病的存在之间存在密切关联。
