Arterioesclerosis carotídea: correlación clínico-histológica de placas vulnerables

  1. Robles-Martín, María L.
  2. Rodríguez-Morata, Alejandro
  3. Reyes-Ortega, Juan P.
  4. Garzón-Bello, Ingrid Johanna
Revista:
Actualidad médica

ISSN: 0365-7965

Año de publicación: 2018

Tomo: 103

Número: 804

Páginas: 61-65

Tipo: Artículo

DOI: 10.15568/AM.2018.804.OR01 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Actualidad médica

Resumen

Objectives: Histological characterization of vulnerable human carotid plaques to propose new diagnostic and therapeutic options through the application of tissue engineering strategies in asymptomatic patients. Methods: In this study three male patients were included who presented carotid disease with surgical criteria (classic endarterectomy). The plaques were stained with hematoxylin-eosin, Masson’s trichrome, picrosirius and orcein. All samples were histologically analyzed to study remodeling capability, lipid nucleus, inflammatory infiltration, presence of foam cells, calcification, neovascularization and intraplaque hemorrhage. In addition, we performed a comparative statistical analysis of the fibrosis percentage, as well as its intensity by thirds between samples and intra-sample. Results: Clinical analysis revealed that Plaque 1 was syntomathic, trigging a stroke. Plaque 2 set up a carotid aneurism with a large mural thrombus. Plaque 3 was asynthomatic. Histologycal analysis from Plaques 1 and 2 determined they had developed a more advanced stage than Plaque 3. Plaques 1 and 2 were rupture plaques with a severe macrophages infiltrated and overall calcification and neovascularization with hemorrage. All plaques differed in the degree of fibrosis. At Plaque 3 foams cells were standing out, migrating to lipidic nucleous, as well as calcification lines. Statistic analysis presented a notorious Plaque 1 fibrosis (5,4%), below Plaque 3 (2,51%), and Plaque 2 (1,84%). They were statistically significant differences between the lower third of Plaques 1 and, 3, and at intra-sample analysis of Plaque 2. Conclusions: The present study allowed us to determine the histological characteristics of vulnerable plaques that can be associated with the manifestation of clinical symptoms. These findings suggest a potential knowledge for the development of new diagnostic and therapeutic options that improve clinical currently available tools.

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