Atherosclerosis-related diseases have increasingly become health concerns with the increased living conditions and aging.Globally,about 200 million people have suffered from arteriosclerosis obliterans(ASO),which can even be life-threatening in some cases.The past seven decades have witnessed the rapid advances in the treatment of ASO,which has developed from surgery to endovascular interventions including plain balloon angioplasty,bare metal stent placement,drug-coated balloon,and drug-eluting stent.However,the roles of these new techniques for femoral-popliteal lesions,especially their real-world clinical outcomes and indications,remain unclear.This article reviews the latest evidences on the use of drug-eluting devices in treating femoral-popliteal arteriosclerosis obliterans.
Angioplasty, Balloon ; Arteriosclerosis Obliterans ; therapy ; Drug-Eluting Stents ; trends ; Humans ; Popliteal Artery ; pathology ; Stents ; Treatment Outcome

Intracranial atherosclerosis is one of the leading causes of ischemic stroke and occurs more commonly in patients of Asian, African or Hispanic origin than in Caucasians. Although the histopathology of intracranial atherosclerotic disease resembles extracranial atherosclerosis, there are some notable differences in the onset and severity of atherosclerosis. Current understanding of intracranial atherosclerotic disease has been advanced by the high-resolution magnetic resonance imaging (HRMRI), a novel emerging imaging technique that can directly visualize the vessel wall pathology. However, the pathological validation of HRMRI signal characteristics remains a key step to depict the plaque components and vulnerability in intracranial atherosclerotic lesions. The purpose of this review is to describe the histological features of intracranial atherosclerosis and to state current evidences regarding the validation of MR vessel wall imaging with histopathology.
Asian Continental Ancestry Group ; Atherosclerosis ; Autopsy ; Hispanic Americans ; Humans ; Intracranial Arteriosclerosis* ; Magnetic Resonance Imaging* ; Microscopy* ; Pathology ; Stroke

This study was designed to investigate the correlation between autophagy and polarization of macrophages in atherosclerosis (AS) plaque in arteriosclerosis obliterans amputees. Femoral artery specimens from arteriosclerosis obliterans amputees were performed hematoxylin and eosin (HE) staining, oil red O and immunofluorescence staining to observe the morphology of atherosclerotic plaque, phenotype of macrophages and autophagy in plaque; using real-time quantitative RT-PCR technology to detect the mRNA level of M1 and M2 type markers in arterial tissue; to analyze polarized signal pathway and autophagy protein levels in macrophages by Western blotting. Arterial specimens staining showed obvious lipid deposition and obvious infiltration of amount of foam cells and inflammatory cells. Macrophages were mainly expression M1 type in percentage in fibrous plaque. Although both M1 and M2 macrophages were upregulated in atheromatous plaque, the increase was dominant in M2 type in percentage. The level of autophagy was significantly higher in the atheromatous plaque than that of fibrous plaque. The expression of tumor necrosis factor- α (TNF-α), monocyte chemotactic protein-1 (MCP-1), inducible nitric oxide synthase (iNOS), interleukin-6 (IL-6) and interleukin-12 (IL-12) mRNA was significantly higher in fibrous plaque than that of atheromatous plaque (P < 0.01 or 0.05), and arginase-1 (Arg-1), transforming growth factor-β (TGF-β), CD163 and interleukin-10 (IL-10) mRNA was significantly lower than that in atheromatous plaque (P < 0.01). The levels of p-STAT1 and NF-κB were significantly increased in fibrous plaque (P < 0.01), while p-STAT6 expression was significantly increased in atheromatous plaque (P < 0.01). The level of LC3-II was significantly higher in atheromatous plaque than that in fibrous plaque (P < 0.01). Macrophages in early atherosclerotic plaque were induced to M1 type through p-STAT1/NF-κB pathway and expressed moderate levels of autophagy; while macrophages in advanced plaques were induced to polarization of M2 type through p-STAT6 pathway. M2 macrophages expressed a higher level of autophagy than M1 macrophages.
Amputees ; Arginase ; metabolism ; Arteriosclerosis Obliterans ; pathology ; Atherosclerosis ; pathology ; Autophagy ; Cell Polarity ; Chemokine CCL2 ; metabolism ; Foam Cells ; cytology ; Humans ; Interleukin-10 ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-6 ; metabolism ; Macrophages ; cytology ; NF-kappa B ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Phenotype ; STAT6 Transcription Factor ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; Up-Regulation

Intracranial atherosclerotic disease (ICAD) of a major intracranial artery, including middle cerebral artery (MCA),basilar artery, is the most common causes of stroke and is associated with a high risk of recurrent stroke in China. The difficulty to treatment these high-risk disease is to identify high-risk stroke subgroups and to develop more effective treatments (aggressive medical therapy/endovascular therapy). With the benefits, including non-invasive, in vivo, and no-ionizing radiation, 3.0 Tesla high-resolution magnetic resonance imaging (HR MRI) could be used to stratify high-risk patients, monitor progression of disease, and evaluate clinical efficacy, based on MCA wall structure and plaque characteristic. HR MRI has the latency of predicting high-risk patients benefit from endovascular therapy, having a broad application prospect during psot-SAMMPRIS era. The current research on MCA stenosis using HR MRI focuses on methodoiogy, diagnosis and differential diagnosis, etiology, and lacks of clinical efficiency evaluation and prognostic analysis of ICAD treatment, especially lacks the research on in-stent restenosis, which needs further investigation.
Brain ; China ; Constriction, Pathologic ; Diagnosis, Differential ; Humans ; Intracranial Arteriosclerosis ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; pathology ; Plaque, Atherosclerotic ; Prognosis ; Stroke ; Treatment Outcome

OBJECTIVE: To examine the expression of notch3 in the kidneys of patients with primary hypertension and rats with spontaneous hypertension, and to explore the relationship of notch3 and hypertension renal fibrosis. METHODS: Thirteen patients with primary hypertension served as a primary hypertension group (HP group), and 15 patients with kidney tumor served as a control group (CP group). The spontaneous hypertensive rats served as a primary hypertension group (SHR group, n=6), and WKY rats served as a control group (WKY group, n=6). Masson stainning was used to examine the collagen in the kidneys in the SHR group and the WKY group. Immunohistochemical staining was used to detect the levels of Notch3 in kidneys of the patients and the rats. The expression of snail mRNA in the kidneys in the SHR group and the WKY group was examined by real-time PCR. RESULTS: Masson staining showed much more collagen in the SHR group than that in the WKY group (P<0.05); the expression of Notch3 in the HP group was much higher than that in the CP group ( 6.741±0.231 vs 0.763±0.358, P<0.01). The expression of Notch3 in the SHR group was much higher than that in the WKY group (5.487±0.774 vs 0.421±0.163, P<0.01), and The expression of snail mRNA was much higher in the SHR group than that in the WKY group (0.996±0.120 vs 0.208±0.090, P<0.01 ). CONCLUSION Notch3 may be related to the occurrence of hypertension renal fibrosis.
Animals ; Arteriosclerosis ; Essential Hypertension ; Fibrosis ; Humans ; Hypertension ; metabolism ; pathology ; Kidney ; pathology ; Kidney Diseases ; metabolism ; pathology ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Receptor, Notch3 ; Receptors, Notch ; metabolism

OBJECTIVETo identify distinct proteins involved in human atherosclerosis obliterans (ASO) by a differential proteomic approach.

METHODSEight atherosclerotic femoral arteries with a mean age of 68.6 years (6 male and 2 female) and 5 normal femoral arteries with a mean age of 44.2 years (3 male and 2 female) were obtained from high amputation patients. Then the first 2-dimensional maps of the proteome of human femoral arteries was plotted to compare ASO and control specimens. Proteomic profiling was to differentiate and identify histological proteins that were associated with ASO. The differentially expressed proteins were sequenced by matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS). The result was verified by immunohistochemistry (IHC) and Western blot.

RESULTSASO was associated with distinct patterns of protein expression in the femoral arteries. A total of 25 distinct spots corresponding to 13 different proteins were identified by MALDI-TOF-MS using the NCBI and IPI databases. These proteins were mainly involved in the pathogenetic mechanisms such as inflammation, oxidative stress, proliferation and transformation of SMCs. The low level of heat shock protein 27 (HSP27) in ASO was verified by IHC and western-blot in accord with the result of MS.

CONCLUSIONProteomic analysis can be used to investigate differentially expressed proteins, which may provide new insights into ASO pathogenesis, such as HSP27.

Adult ; Aged ; Arteriosclerosis Obliterans ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Proteome ; metabolism

We measured the ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) and ABI in 97 ischemic stroke patients and 93 control subjects to investigate the relationship between baPWV, ABI and risk factors of ischemic stroke. The stroke patients were grouped according to the results of MRA and Carotid artery color Doppler ultrasound. The correlation of baPWV and ABI to the arteriosclerosis was discussed. There was a significant difference in the patients with hypertension, diabetes mellitus, baPWV and ABI between ischemic stroke patients and control subjects. baPWV was the most sensitive risk factor for ischemic stroke. ABI and diabetes mellitus were the relatively sensitive risk factors for ischemic stroke. baPWV were found to have a positive correlation with common carotid arteriosclerosis (gamma=0.215, P=0.048), while ABI had a negative correlation with intracranial arteriosclerosis (gamma=-0.237, P<0.05). BaPWV and ABI may closely relate to severity of ischemic stroke. Simple measurements of baPWV and ABI in patients could be a useful tool for evaluating the risk of ischemic stroke.
Aged ; Ankle ; blood supply ; Ankle Brachial Index ; Arteriosclerosis ; physiopathology ; Blood Flow Velocity ; Brachial Artery ; physiopathology ; Brain ; blood supply ; pathology ; Brain Ischemia ; complications ; Carotid Arteries ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Pulsatile Flow ; Pulse ; Risk Factors ; Stroke ; diagnosis ; etiology ; physiopathology

OBJECTIVETo evaluate whether taking atorvastatin for long time has positive effects on age-related renal impairment.

METHODS20-month-age normal female Wistar rats were divided into three groups (n = 9). First group were fed atorvastatin 10 mg/(kg x d). Second group were fed atorvastatin 1 mg/(kg x d). Third group were fed the same volume normal saline served as control. All the rats were sacrificed after four months. 3-month-age normal female Wistar rats (n = 9) also served as normal control. Kidney weight, serum creatinine (Scr) and blood-lipoids were measured. Paraffin sections of renal tissues were stained with PAS and Sirius red. Sclerosis index of glomerulus was calculated.

RESULTSRenal mass diminution was found in all the groups of aging rats. Scr was decreased in the group of aging rats with atorvastatin 1 mg/(kg x d). The level of blood-lipoids of aging rats was higher than that of young rats. The level of serum cholesterol and low-density lipoprotein (LDL) were decreased in first group (both P < 0.05) and only LDL decreased in second group (P < 0.05). Morphological changes of aging kidney were focal segmental glomerulosclerosis, widen of mesangial region, infiltration of inflammatory cells and sclerosis of arteriole. The treatment of atorvastatin improved the pathologic changes in the aging rats significantly, especially in the first group.

CONCLUSIONTaking atorvastatin for long time can notably improve the pathological changes of aging kidney. All these effects may be induced by lowing of blood-lipoids, relieving the sclerosis of renal arteriole and reducing the infiltration of inflammatory cells.

Aging ; physiology ; Animals ; Anticholesteremic Agents ; administration & dosage ; pharmacology ; Arteriosclerosis ; pathology ; prevention & control ; Atorvastatin Calcium ; Female ; Heptanoic Acids ; administration & dosage ; pharmacology ; Kidney ; pathology ; Kidney Diseases ; prevention & control ; Pyrroles ; administration & dosage ; pharmacology ; Rats ; Rats, Wistar ; Renal Artery ; pathology

OBJECTIVETo observe the effect of rosuvastatin on left ventricular cardiac function, arteriosclerotic plaque and high sensitive C-reactive protein (hs-CRP) in hypertensive patients with mild elevation of LDL-C.

METHODSSeventy-nine patients with a SBP of 140-179 mmHg and/or a DBP of 90-109 mmHg and mild elevated LDL-C were treated with rosuvastatin for 12 months (n=40) or not (n=39). The changes of hs-CRP, arteriosclerosis plaque and cardiac function at the end of the 12-months treatment relative to the baseline levels were analyzed.

RESULTSAfter 12 months of treatment, LDL-C was decreased by 33.2% in rosuvastatin group but remained unchanged in patients without rosuvastatin treatment. The left ventricular peak filling rate (LVPFR) increased significantly from 1.85 to 2.59 (P<0.05) and the serum levels of hs-CRP reduced significantly (P<0.05) after rosuvastatin treatment. The size of the plaques reduced significantly after a 12-month rosuvastatin therapy.

CONCLUSIONRosuvastatin therapy on the basis of conventional anti-hypertensive drugs can obviously improve the left ventricular diastolic function and produce favorable effects on arteriosclerotic plaques.

Aged ; Arteriosclerosis ; complications ; pathology ; C-Reactive Protein ; metabolism ; Cholesterol, LDL ; blood ; Female ; Fluorobenzenes ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Hyperlipidemias ; drug therapy ; pathology ; physiopathology ; Hypertension ; drug therapy ; pathology ; physiopathology ; Male ; Middle Aged ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use ; Ventricular Function, Left ; drug effects

OBJECTIVETo evaluate the correlation between arteriosclerotic risk factors and the severity of benign prostatic hyperplasia (BPH).

METHODSA total of 877 patients with diagnosed BPH were selected according to the inclusion criteria. The weight of the prostate was estimated by transrectal ultrasonography, the degree of bladder outlet obstruction determined by urodynamic examination, and the symptoms quantified by the International Prostate Symptom Score (IPSS). Arteriosclerotic risk factors included age, hypertension, dyslipidemia, type 2 diabetes mellitus, and smoking. Comparative studies were made on the data obtained by univariate and multivariate analyses.

RESULTSThe severity of BPH was increased with the increase in the severity of the risk factors and the incidence of the disease. The logistic regression analysis showed that type 2 diabetes mellitus was a prominent predictor of the prostate volume, IPSS and degree of bladder outlet obstruction (OR = 3.179, 3.862 and 2.847, P < 0.001), while the level of serum triglyceride was not (P > 0.05). Age, hypertension, high LDL, low HDL and smoking were all prominent predictors of the severity of BPH.

CONCLUSIONArteriosclerotic risk factors are obviously correlated with the development and severity of BPH, among which type 2 diabetes mellitus is the most important.

Aged ; Aged, 80 and over ; Arteriosclerosis ; pathology ; Diabetes Mellitus, Type 2 ; pathology ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostatic Hyperplasia ; pathology ; Risk Factors ; Urinary Bladder Neck Obstruction ; pathology