Atherosclerotic Plaque Hemorrhage and Rupture Associated with Crescendo Claudication
Authors: Michael Mecley, Kenneth Rosenfield, Jenifer Kaufman, R. Eugene Langevin, Syed Razvi, Jeffrey M. Isner
Journal: Annals of Internal Medicine (1992)

Brief Reports15 October 1992Atherosclerotic Plaque Hemorrhage and Rupture Associated with Crescendo ClaudicationMichael Mecley, MD, Kenneth Rosenfield, MD, Jenifer Kaufman, BS, R. Eugene Langevin Jr., MD, Syed Razvi, MD, Jeffrey M. Isner, MDMichael Mecley, MD, Kenneth Rosenfield, MD, Jenifer Kaufman, BS, R. Eugene Langevin Jr., MD, Syed Razvi, MD, Jeffrey M. Isner, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-8-663 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptUnstable atherosclerotic plaque morphology has been established as the major factor responsible for escalating symptoms of myocardial ischemia and extracranial vascular disease. Previous histopathologic (1-5) and ultrasound (6) studies have suggested that plaque hemorrhage, plaque rupture, and intraluminal thrombosis characterize the sequence of pathologic findings in such cases. Surprisingly, however, this same sequence of unstable plaque morphology has not been previously recognized as a basis for accelerated symptoms of arterial insufficiency in patients with peripheral vascular disease. The evidence we obtained by directional atherectomy and intravascular ultrasound suggests that unstable plaque morphology should be considered as a pathogenetic mechanism for...References1. Falk E. Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis. Characteristics of coronary atherosclerotic plaque underlying fatal occlusive thrombi. Br Heart J. 1983;50:127-34. CrossrefMedlineGoogle Scholar2. DaviesThomas MA. Plaque-fissuring—the cause of acute myocardial infarction, sudden ischemic death, and crescendo angina. Br Heart J. 1985;53:363-73. CrossrefMedlineGoogle Scholar3. FusterSteinAmbroseBadimonBadimonChesbro VBJLJJ. Atherosclerotic plaque rupture and thrombosis. Evolving concepts. Circulation. 1990;82:II47-59. MedlineGoogle Scholar4. LusbyFerrellEhrenfeldStoneyWylie RLWRE. Carotid plaque hemorrhage. Arch Surg. 1982;117:1479-87. CrossrefMedlineGoogle Scholar5. FisherBlumenfeldSmith MAT. The importance of Carotid artery plaque disruption and hemorrhage. Arch Neurol 1987;44:1086-9. CrossrefMedlineGoogle Scholar6. O'DonnellErdoesMackeyMcCulloughShepardHoggerick TLWJAP. Correlation of B-mode ultrasound imaging and arteriography with pathologic findings at carotid endarterectomy. Arch Surg. 1985;120:443-9. CrossrefMedlineGoogle Scholar7. RosenfieldLosordoRamaswamyPastoreLangevinRazvi KDKJRS. Three-dimensional reconstruction of human coronary and peripheral arteries from images recorded during two-dimensional intravascular ultrasound examination. Circulation 1991;84:1928-56. CrossrefGoogle Scholar8. RahillyNanda GN. Two-dimensional echographic identification of tumor hemorrhages in atrial myxomas. Am Heart J. 1981;101:237-9. CrossrefMedlineGoogle Scholar9. BarbanoNewmanMcCannHackelStackPalmos EGRDRL. Correlation of clinical history with quantitative histology of lower extremity atheroma biopsies obtained with the Simpson atherectomy catheter. Atherosclerosis. 1989;78:183-96. CrossrefMedlineGoogle Scholar10. JohnsonHinoharaSelmonBradenSimpson DTMLJ. Primary peripheral arterial stenoses and restenoses excised by transluminal atherectomy. A histopathologic study. J Am Coll Cardiol. 1990;15:419-25. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From St. Elizabeth's Hospital and Tufts University School of Medicine, Boston, Massachusetts. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByNatural history of stenosis in the iliac arteries in patients with intermittent claudication undergoing clinical treatmentFatty acid oxidation products in human atherosclerotic plaque: an analysis of clinical and histopathological correlatesSuperficial femoral artery stenoses: Characteristics of progressing lesionsRedefining the treatment of peripheral artery disease. Role of percutaneous revascularization.Protruding Atheromas in the Thoracic Aorta:.Combined physiologic and anatomic assessment of percutaneous revascularization using a Doppler guidewire and ultrasound catheter 15 October 1992Volume 117, Issue 8Page: 663-666KeywordsAtheromasHemorrhageHospital medicineMuscular dystrophiesPathogensPeripheral vascular diseaseThrombosisUltrasound imagingVascular diseasesVascular surgery Issue Published: 15 October 1992 PDF DownloadLoading ...