Structure of carotid sinus atherosclerotic plaques and disturbances of cerebral blood circulation

A morphological study of 200 atherosclerotic carotid sinus (CS) plaques obtained at carotid endarterectomy revealed the structural components and processes characteristic for severe atherosclerosis: foci of atheromatosis and edema, necrosis of collagen and elastic fibres, newly formed vessels and hemorrhages of various duration, lipophages and lymphocytes, portions of fibrosis and calcification, covering thinning and ulceration, thrombi and the contents of plaques (atheromatous masses, cholesterol crystals, lipophages, calcificates) on their surface. Clinical and morphological comparisons indicated that patients with ischemic stroke in their history had more severe atherosclerosis than those with asymptomatic CS stenosis. They were more commonly found to have vulnerable atherosclerotic plaques that showed a predominance of atheromatosis foci over the portions of fibrosis and calcification, covering thinning and destruction, formation of thrombi on its surface. It was ascertained that concomitant arterial hypertension might play a crucial role in the pathogenesis of hemorrhages into the atherosclerotic CS plaque.