Surface features of human aortic atherosclerosis as seen with scanning electron microscopy

Using SEM, we have observed surface structures of atherosclerotic lesions of human aortas obtained from autopsies ranging from 59 to 84 years of age (5 males and 4 females). We have found four major interesting features on the lumenal surface of the aortas: 1) blood cells including leukocytes adhering to the endothelial surface, 2) a de-endothelialized surface showing both elastogenesis and elastolysis, 3) abundant cholesterol-ester crystals in extracellular spaces, and 4) cave-like structures possibly suggesting new capillarization in the thrombotic atherosclerotic plaques. We concluded that SEM has a great value in revealing more interesting surface structures if morphological studies are previously done in detail so that the characteristic shapes can be identified, and perhaps then meaningful interpretations can be made on the mechanism of human atherogenesis.