Key result
Carotid plaque vessels >40 µm are linked to intensified calcification and connective tissue areas.
Observational
The number, diameter, and location of vessels in carotid atherosclerotic plaques reflect destructive and reparative processes, with larger vessels (>40 µm) potentially indicating reparative activation.
Larger neovessels may mark reparative plaque activity; hypothesis-generating and should not yet change practice.
OBJECTIVE: to identify the relationship between the magnitude of neovascularization of an atherosclerotic plaque and its other processes, such as atheromatosis, macrophage responses, hemorrhages, and calcification. MATERIAL AND METHODS: ; density of vessels of different diameters; localization in section), atheromatosis (a volume fraction), foam cells (a score of 0 to 5), hemorrhages (a score of 0 to 4), and calcification (a score of 0 to 4). The Mann-Whitney U test and the Spearman correlation coefficient with p<0.05 were used in the statistical analysis. RESULTS: There was a substantial variability in vessel diameters and densities in the plaque with a drastic predominance of vessels smaller than 20 µm in diameter (69.8±14.3%). The vessels with a diameter as large as 20 µm were more frequently located in the area of accumulation of foam cells or organizing hemorrhages (p<0.03), unlike those with a diameter of more than 40 µm, which were more common in the areas of connective tissue, especially adjacent to large calcifications, and in the foci of organized hemorrhages (p<0.008). Intensified calcification was accompanied by the higher density of vessels having a diameter of more than 40 µm (p<0.038) and particularly of those with a diameter of more than 60 µm (p=0.006). The degree of hemorrhages and the number of foam cells were unrelated to the density of vessels, but these increased with their localization in the surface areas of a plaque (p=0.000342). With the increasing severity of atheromatosis, there was a decrease in the density of vessels larger than 20 µm in diameter (p=0.00042). CONCLUSION: The number, diameter, and location of vessels in the plaque serve as a dynamic reflection of its destructive and reparative processes; and a larger number of vessels having a diameter of more than 40 µm can be an indicator for the activation of reparative processes.
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Евдокименко et al. (2018) conducted an observational in carotid atherosclerotic plaques. Neovascularization was evaluated on Relationship between neovascularization and plaque processes (atheromatosis, macrophage responses, hemorrhages, calcification). Neovascularization in carotid plaques showed that vessels >40 µm in diameter were associated with intensified calcification (p<0.038) and connective tissue areas (p<0.008).
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