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Histomorphological evaluation of atherosclerotic lesions in patients with peripheral artery occlusive disease

Alexander Zimmermann1, Simon Senner1, Hans-Henning Eckstein1

  • 1Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.

Advances in Medical Sciences
|May 1, 2015
PubMed

Insights

Atherosclerosis in femoral arteries shows advanced plaque types. Inflammatory cells significantly impact plaque progression and destabilization, more than other factors in peripheral arterial occlusive disease.

Area of Science:

  • Vascular Biology
  • Pathology
  • Cardiovascular Research

Background:

  • Peripheral arterial occlusive disease (PAOD) is primarily caused by atherosclerosis.
  • Morphological staging of atherosclerotic plaques is well-defined for coronary and carotid arteries, but less so for PAOD.
  • Understanding PAOD plaque morphology is crucial for managing intermittent claudication and critical limb ischemia.

Purpose of the Study:

  • To analyze the plaque morphology of femoral arteries in patients with symptomatic PAOD.
  • To compare the characteristics of atherosclerotic lesions in the femoral arteries with established classifications.
  • To investigate the factors influencing plaque progression and destabilization in PAOD.

Main Methods:

  • Retrospective analysis of 85 atherosclerotic plaques from 71 patients with symptomatic PAOD.
  • Histological classification of lesions using the Stary scale (Type I-VIII).
  • Evaluation of plaque composition including collagen, elastin, calcifications, smooth muscle cells, macrophages, leucocytes, and cellularity.

Main Results:

  • The majority (91%) of analyzed lesions were advanced types (Stary V-VII).
  • Atherosclerotic lesion Type VI showed significantly higher inflammatory cell infiltration (CD45, CD68) compared to other types.
  • Plaques with neovascularization exhibited increased levels of CD45 and CD68 positive cells.

Conclusions:

  • Femoral artery atherosclerotic lesions exhibit morphological changes comparable to those in coronary and carotid arteries.
  • Inflammatory cells play a more significant role in the progression and destabilization of PAOD plaques than other factors.
  • Targeting inflammation may be a key strategy in managing advanced PAOD.
Abstract

Keywords:
AtherosclerosisFemoral arteryHistological classificationInflammatory cellsPeripheral arterial occlusive disease

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