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November 6, 2009Journal of Vascular Research

Differences in Lesion Severity and Cellular Composition between in vivo Assessed Upstream and Downstream Sides of Human Symptomatic Carotid Atherosclerotic Plaques

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Why the study?

Does the upstream side of symptomatic carotid plaques differ in morphology and cellular composition compared to the downstream side?

Population

41 endarterectomized specimens from patients with symptomatic carotid stenosis

Comparison

Upstream side of the maximum stenosis vs Downstream side of the maximum stenosis

Design

Cross-sectional

Authors

BFBjörn FagerbergGeneral / Preventive / Lipids MRM. RyndelSahlgrenska University Hospital JKJosefin KjelldahlSahlgrenska University Hospital

Discussion

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Implication

Location matters for carotid plaque histology; leaves open whether upstream vulnerability drives symptoms or warrants side-specific risk models.

Structured PICO

Does the upstream side of symptomatic carotid plaques differ in morphology and cellular composition compared to the downstream side?

P

Population

41 endarterectomized specimens from patients with symptomatic carotid stenosis

I

Intervention

Upstream side of the maximum stenosis

C

Comparator

Downstream side of the maximum stenosis

O

Outcome

Plaque morphology and cellular composition (incidence of severe lesions with cap rupture, intraplaque hemorrhage, macrophages, smooth muscle cells, and collagen)surrogate

Symptomatic carotid plaques exhibit more vulnerable morphological and compositional features on the upstream side of the maximum stenosis compared to the downstream side, highlighting the importance of sampling location in plaque studies.

Cite This Study

Fagerberg et al. (2009) studied this question.

synapsesocial.com/papers/6a709d1a8031ec7bb1dc7659 https://doi.org/10.1159/000255965

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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

1Gelatinolytic Activity in Atherosclerotic Plaques Is Highly Localized and Is Associated With Both Macrophages and Smooth Muscle Cells In Vivo2007 · 40 citations
2Urokinase-type plasminogen activator receptor is associated with macrophages and plaque rupture in symptomatic carotid atherosclerosis1998 · 54 citations
3Site of Carotid Plaque Ulceration in Relation to Direction of Blood Flow: An Angiographic and Pathological Study2003 · 117 citations