Document Detail

Primary peripheral arterial stenoses and restenoses excised by transluminal atherectomy: a histopathologic study.
MedLine Citation:
PMID:  2137149     Owner:  NLM     Status:  MEDLINE    
Atherectomy is a new therapeutic intervention for the treatment of peripheral arterial disease, and permits the controlled excision and retrieval of portions of stenosing lesions. The gross and light microscopic features of 218 peripheral arterial stenoses resected from 100 patients by atherectomy were studied. One hundred seventy of these lesions were primary stenoses and 48 were restenoses subsequent to prior angioplasty or atherectomy. Microscopically, primary stenoses were composed of atherosclerotic plaque (150 lesions), fibrous intimal thickening (15 lesions) or thrombus alone (5 lesions). Atherosclerotic plaques had a variable morphology and, in one-third of cases, were accompanied by abundant surface thrombus that probably added to the severity of stenosis. Most patients with fibrous intimal thickening or thrombus alone had typical atherosclerotic plaque removed elsewhere from within the same artery. Intimal hyperplasia, with or without underlying residual plaque, was found at 36 sites of restenosis, the remaining 12 consisting of plaque only. Intimal hyperplasia had a distinctive histologic appearance and was due to smooth muscle cell proliferation within a loosely fibrous stroma. Superimposed thrombus may have contributed to arterial narrowing in 25% of hyperplastic and 8% of atherosclerotic restenoses (p = 0.41). Pathologic examination of tissues recovered by peripheral atherectomy is an important adjunct that may provide insight into the efficacy of vascular interventions and the phenomenon of postintervention restenosis.
D E Johnson; T Hinohara; M R Selmon; L J Braden; J B Simpson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  15     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1990 Feb 
Date Detail:
Created Date:  1990-03-13     Completed Date:  1990-03-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  419-25     Citation Subset:  AIM; IM    
Department of Pathology, Medical College of Virginia, Richmond 23298.
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MeSH Terms
Aged, 80 and over
Angioplasty, Balloon
Arterial Occlusive Diseases / pathology,  surgery*,  therapy
Arteries / pathology*
Arteriosclerosis / pathology
Constriction, Pathologic
Middle Aged
Comment In:
J Am Coll Cardiol. 1990 Feb;15(2):426-8   [PMID:  2137150 ]

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