Document Detail


Histologic atherosclerotic plaque characteristics are associated with restenosis rates after endarterectomy of the common and superficial femoral arteries.
MedLine Citation:
PMID:  20570468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study assessed the predictive value of histologic plaque characteristics for the occurrence of restenosis after femoral artery endarterectomy.
BACKGROUND: It would be advantageous if patients at increased risk for restenosis after arterial endarterectomy could be identified by histologic characteristics of the dissected plaque. Differences in atherosclerotic plaque composition of the carotid artery have been associated with restenosis rates after surgical endarterectomy. However, whether atherosclerotic plaque characteristics are also predictive for restenosis in other vascular territories is unknown.
METHODS: Atherosclerotic plaques of 217 patients who underwent a common femoral artery endarterectomy (CFAE; n = 124) or remote superficial femoral artery endarterectomy (RSFAE; n = 93) were examined and scored microscopically for the presence of collagen, macrophages, smooth muscle cells, lipid core, intraplaque hemorrhage, and calcifications. The 12-month restenosis rate was assessed using duplex ultrasound imaging (peak systolic velocity [PSV] ratio >or=2.5).
RESULTS: The 1-year restenosis rate was 66% (61 of 93) after RSFAE compared to 21% (26 of 124) after CFAE. Plaque with characteristics of high collagen and smooth muscle cell content were positively associated with the occurrence of restenosis, with odds ratios (ORs) of 2.90 (95% confidence interval [CI], 1.82-4.68) and 2.20 (1.50-3.20) for superficial femoral artery (SFA) and common femoral artery (CFA), respectively. SFA plaques showed significantly heavier staining for collagen (69% vs 31% for CFA; P < .001) and smooth muscle cells (64% vs 36% for CFA; P < .001). After multivariate analysis, the operation type (CFAE or RSFAE), gender, and the presence of collagen were independent predictive variables for restenosis after endarterectomy of the CFA and SFA.
CONCLUSION: Plaque composition of the CFA and SFA differs. Furthermore, the dissection of a fibrous collagen-rich plaque is an independent predictive variable for restenosis after endarterectomy of the CFA and SFA.
Authors:
Wouter J M Derksen; Jean-Paul P M de Vries; Aryan Vink; Evelyn Velema; Jan-Albert Vos; Dominique de Kleijn; Frans L Moll; Gerard Pasterkamp
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-06-08
Journal Detail:
Title:  Journal of vascular surgery     Volume:  52     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-09-27     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-9     Citation Subset:  IM    
Affiliation:
Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arterial Occlusive Diseases / pathology,  surgery*,  ultrasonography
Chi-Square Distribution
Constriction, Pathologic
Endarterectomy* / adverse effects
Female
Femoral Artery / pathology,  surgery*,  ultrasonography
Humans
Logistic Models
Male
Middle Aged
Netherlands
Odds Ratio
Recurrence
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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