Structure of carotid sinus atherosclerotic plaques and disturbances of cerebral blood circulation

Abstract

A morphological study of 200 atherosclerotic carotid sinus (CS)plaques obtained at carotid endarterectomy revealed the structuralcomponents and processes characteristic for severe atherosclerosis:foci of atheromatosis and edema, necrosis of collagenand elastic fibres, newly formed vessels and hemorrhages of variousduration, lipophages and lymphocytes, portions of fibrosisand calcification, covering thinning and ulceration, thrombi andthe contents of plaques (atheromatous masses, cholesterol crystals,lipophages, calcificates) on their surface. Clinical and morphologicalcomparisons indicated that patients with ischemicstroke in their history had more severe atherosclerosis than thosewith asymptomatic CS stenosis. They were more commonlyfound to have vulnerable atherosclerotic plaques that showed apredominance of atheromatosis foci over the portions of fibrosisand calcification, covering thinning and destruction, formationof thrombi on its surface. It was ascertained that concomitantarterial hypertension might play a crucial role in the pathogenesisof hemorrhages into the atherosclerotic CS plaque.

Keywords

• atherosclerosis
• carotid sinus
• carotid endarterectomy
• plaque structure