Zimmermann Alexander, Senner Simon, Eckstein Hans-Henning, Pelisek Jaroslav
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
Adv Med Sci. 2015 Sep;60(2):236-9. doi: 10.1016/j.advms.2015.03.003. Epub 2015 Apr 4.
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.
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.
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.
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.
外周动脉闭塞性疾病（PAOD）主要由血管壁动脉粥样硬化引起。这些病理变化可分为不同阶段，在颈动脉和冠状动脉方面已有详尽描述，但在PAOD方面尚无相关描述。我们研究的目的是分析间歇性跛行和严重肢体缺血患者股动脉的斑块形态。
在这项回顾性研究中，对71例有临床症状的PAOD患者的85个动脉粥样硬化斑块（股总动脉和股浅动脉）进行了组织学分析（2009年1月 - 2010年7月）。动脉粥样硬化病变根据Stary分类法（I - VIII型）进行分类。为进一步表征，评估斑块中胶原蛋白、弹性蛋白、钙化、平滑肌细胞、巨噬细胞、白细胞和细胞密度的存在情况。
根据Stary分类，大多数（91%）动脉粥样硬化病变为晚期类型（V - VII型）。与所有其他动脉粥样硬化斑块类型相比，动脉粥样硬化VI型病变的炎症细胞数量显著更高（CD45：p<0.001；CD68：p = 0.013）。此外，具有明显新生血管形成的动脉粥样硬化斑块含有更高数量的CD45阳性细胞（p = 0.015；rho = 0.273）和CD68阳性细胞（p = 0.016；rho = 0.275）。
股动脉的动脉粥样硬化病变显示出与冠状动脉或颈动脉相似的形态学变化。但炎症细胞对斑块进展和不稳定的影响比任何其他因素都更大。
