Atherosclerosis plaque is the underline cause of ischemic stroke and acute coronary syndrome. In this article, the applications of molecular imaging in vulnerable plaque are reviewed.
Atherosclerosis ; diagnosis ; pathology ; Humans ; Molecular Imaging ; methods

Atherosclerosis ; etiology ; pathology ; Coronary Angiography ; Humans ; Myocardial Bridging ; diagnosis ; epidemiology ; physiopathology

OBJECTIVE: To explore the imaging characteristics of cerebral stenosis and peripheral vascular stenosis in patients with ischemic stroke.
 METHODS: The data collected from 1 060 patients with ischemic stroke, who were examined by cerebral angiography and abdominal angiography, were retrospectively analyzed. All relevant parameters for atherosclerosis were recorded. Then the correlation of cerebrovascular stenosis with peripheral vascular stenosis was analyzed, and the risk factors of multi-artery stenosis and ulcerative plaque were examined.
 RESULTS: Peripheral vascular stenosis was closely correlated to cerebrovascular stenosis (r=0.236, P<0.01). The stenosis degree and quantity of cerebrovascular were positively correlated with peripheral vascular stenosis (r=0.228, P<0.01; r=0.231, P<0.01). The age (OR=1.059, 95% CI: 1.015-1.117; P<0.05), smoking (OR=3.423, 95% CI: 1.524-7.780; P<0.01) and diabetes (OR=3.651, 95% CI: 1.536-8.425; P<0.01) were risk factors for the occurrence of multi-artery stenosis. But the risk factor of ulcerative plaque was not found by single factor analysis.
 CONCLUSION The cerebral angiography combined abdominal angiography is an effective method to identify cerebrovascular and peripheral vascular stenosis in the patients with stroke. Age, smoking and diabetes are independent risk factors for multi-artery stenosis in patients with ischemic stroke.
Atherosclerosis ; pathology ; Cerebral Angiography ; Constriction, Pathologic ; Humans ; Risk Factors ; Stroke ; diagnosis

Optical coherence tomography (OCT) has been recently applied to investigate coronary artery disease in interventional cardiology. Compared to intravascular ultrasound, OCT is able to visualize various vascular structures more clearly with higher resolution. Several validation studies have shown that OCT is more accurate in evaluating neointimal tissue after coronary stent implantation than intravascular ultrasound. Novel findings on OCT evaluation include the detection of strut coverage and the characterization of neointimal tissue in an in-vivo setting. In a previous study, neointimal healing of stent strut was pathologically the most important factor associated with stent thrombosis, a fatal complication, in patients treated with drug-eluting stent (DES). Recently, OCT-defined coverage of a stent strut was proposed to be related with clinical safety in DES-treated patients. Neoatherosclerosis is an atheromatous change of neointimal tissue within the stented segment. Clinical studies using OCT revealed neoatherosclerosis contributed to late-phase luminal narrowing after stent implantation. Like de novo native coronary lesions, the clinical presentation of OCT-derived neoatherosclerosis varied from stable angina to acute coronary syndrome including late stent thrombosis. Thus, early identification of neoatherosclerosis with OCT may predict clinical deterioration in patients treated with coronary stent. Additionally, intravascular OCT evaluation provides additive information about the performance of coronary stent. In the near future, new advances in OCT technology will help reduce complications with stent therapy and accelerating in the study of interventional cardiology.
Atherosclerosis/diagnosis/pathology/ultrasonography ; Coronary Artery Disease/*diagnosis/pathology/ultrasonography ; Humans ; Postoperative Complications/diagnosis/pathology/ultrasonography ; Stents/*adverse effects ; Tomography, Optical Coherence/*methods ; Ultrasonography, Interventional

To assess the regional difference and influence of the biological variables on atherosclerosis in female, we analyzed 7 segments of aorta (2 ascending, 3 thoracic, and 2 abdominal) from 90 superficially healthy Korean women (39+/-14 yr of age) who died from external causes. Tissue specimens were macroscopically examined and histopathologically divided into 7 grades for scoring (ATHERO, from 0=intact, to 6=thrombi formation). Lumen diameter (LD), wall thickness (WT), intima thickness (INT), and media thickness (MED) were obtained by computed morphometry. Atherosclerosis was common in the distal infrarenal (C2), proximal thoracic (B1), and proximal ascending (A1) segments. Total 95.6% of all subjects had atherosclerosis of variable degree in one or more segments, but an aneurysmal change was not found. The number of atherosclerotic segments and atherosclerosis score in the 7 segments increased with aging. However, the body size did not affect the aortic size and ATHERO. With aging, LD and INT of the A1, B1 and C2 increased (p<.00001); WT of the B1 and C2 increased (p<.01); and MED of C2 decreased (p<.01). LD and WT of the B1 and C2 (p<.05), INT of the A1, B1 and C2 (p<.00001) increased, and MED of C2 decreased (p<.01) with ATHERO. These data suggest that age is simple but a reliable parameter for estimating the progression of atherosclerosis.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Aorta/*anatomy & histology/pathology ; Aortic Diseases/*diagnosis/*pathology ; Atherosclerosis/*diagnosis/*pathology ; Autopsy ; Cadaver ; Disease Progression ; Female ; Humans ; Korea ; Middle Aged

Aged ; Atherosclerosis ; complications ; Blue Toe Syndrome ; diagnosis ; etiology ; metabolism ; pathology ; Cell Nucleus ; Cholesterol ; blood ; Color ; Epidermis ; Female ; Humans ; Male

BACKGROUNDThe ankle brachial index (ABI) is a simple, inexpensive, noninvasive tool that correlates well with angiographic disease severity and functional symptoms. The aim of this study was to identify the manifestation of lower extremity atherosclerotic lesions in patients with high ABI by retrospective clinical study.

METHODSA cohort of 184 diabetic patients, (63 +/- 14) years old, 144 males, who underwent simultaneously ABI testing and low extremity arterial duplex ultrasound within one week, were enrolled randomly into this study. According to the ABI value, they were divided into three groups: the high, normal and low ABI groups. The severity and location of atherosclerotic lesions in the lower extremity were determined based on the results of low extremity artery duplex ultrasound. The chi-square test was used to compare the atherosclerosis severity grade and lesion location across the three groups.

RESULTSThe prevalence of low extremity artery occlusion was significantly lower in the high ABI group than in the low ABI group (3.3% vs. 63.5%, P < 0.01), and the main atherosclerotic lesions were diffuse dot-like hyperechogenicity spots or small plaques (86.7%). In addition, the atherosclerotic lesions were mostly found in the distal segment of the lower extremity in patients with high ABI (46.3%).

CONCLUSIONA high ABI may be an integrative marker for intimal and medial calcification, which has a high positive predictive value for artery calcification.

Aged ; Aged, 80 and over ; Ankle Brachial Index ; Arterial Occlusive Diseases ; diagnosis ; Atherosclerosis ; diagnosis ; Cohort Studies ; Female ; Humans ; Lower Extremity ; pathology ; Male ; Middle Aged ; Peripheral Vascular Diseases ; diagnosis

Atherosclerosis is an inflammatory disease as well as a lipid disorder. Atherosclerotic plaque formed in vessel walls may cause ischemia, and the rupture of vulnerable plaque may result in fatal events, like myocardial infarction or stroke. Because morphological imaging has limitations in diagnosing vulnerable plaque, molecular imaging has been developed, in particular, the use of nuclear imaging probes. Molecular imaging targets various aspects of vulnerable plaque, such as inflammatory cell accumulation, endothelial activation, proteolysis, neoangiogenesis, hypoxia, apoptosis, and calcification. Many preclinical and clinical studies have been conducted with various imaging probes and some of them have exhibited promising results. Despite some limitations in imaging technology, molecular imaging is expected to be used both in the research and clinical fields as imaging instruments become more advanced.
Atherosclerosis/*diagnosis/pathology/radiography ; Endothelial Cells/metabolism ; Humans ; Inflammation/pathology ; Lipoproteins, LDL/metabolism ; Macrophages/immunology/metabolism ; Plaque, Atherosclerotic ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon

The greatest advances in understanding and treating stroke have occurred during the past 30 years. The advantages of ultrasound for vascular diagnosis are well known: it is a fast, portable, non-invasive, repeatable and inexpensive technique. Among various clinical situations for the application of ultrasound to stroke care, the best established ones include: (1) early detection and characterization of extracranial atherosclerosis and occlusive diseases especially at the carotid bifurcation; (2) evaluation of consequences of proximal arterial occlusive disease on the distal cerebral vasculature; (3) follow-up of the natural history and response to treatment of acute arterial occlusion that causes hyperacute stroke; (4) detection of microemboli associated with cardiac and aortic pathology and carotid artery surgical manipulation; and (5) follow-up of the time course and reversibility of cerebral vasospasm after subarachnoid hemorrhage. The field of ultrasonic diagnosis also has detractors and limitations. Even now, the technique is 'operator-dependent' in terms of the accuracy and validity of its results. Newer technology has provided significant advances in this regard; however, it is necessary for each laboratory to maintain a strict quality control in order to maximize the benefits that this powerful technology can provide.
Arterial Occlusive Diseases ; Atherosclerosis ; Carotid Arteries ; Diagnosis* ; Follow-Up Studies ; Natural History ; Pathology ; Quality Control ; Stroke* ; Subarachnoid Hemorrhage ; Ultrasonography* ; Vasospasm, Intracranial

Atherosclerosis (AS) is one of the most essential factors to cause cardio-cerebrovascular diseases. Abundant experience has been acquired in treatment of AS by traditional Chinese medicine (TCM) with its own distinctive diagnostic and therapeutic principles. To expell phlegm and relieve blood stasis, a hot topic of TCM therapeutic principle for AS, is reviewed in this paper.
Atherosclerosis ; blood ; drug therapy ; pathology ; Blood Circulation ; drug effects ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Syndrome