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    Morphometric analysis of calcification and fibrous layer thickness in carotid endarterectomy tissues

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    Han, Richard I.; Wheeler, Thomas M.; Lumsden, Alan B.; Reardon, Michael J.; Lawrie, Gerald M.; More... Grande-Allen, K. Jane; Morrisett, Joel D.; Brunner, Gerd Less...
    Date
    2016
    Abstract
    Background: Advanced atherosclerotic lesions are commonly characterized by the presence of calcification. Several studies indicate that extensive calcification is associated with plaque stability, yet recent studies suggest that calcification morphology and location may adversely affect the mechanical stability of atherosclerotic plaques. The underlying cause of atherosclerotic calcification and the importance of intra-plaque calcium distribution remains poorly understood. Method: The goal of this study was the characterization of calcification morphology based on histological features in 20 human carotid endarterectomy (CEA) specimens. Representative frozen sections (10 μm thick) were cut from the common, bulb, internal and external segments of CEA tissues and stained with von Kossa׳s reagent for calcium phosphate. The morphology of calcification (calcified patches) and fibrous layer thickness were quantified in 135 histological sections. Results: Intra-plaque calcification was distributed heterogeneously (calcification %-area: bulb segment: 14.2±2.1%; internal segment: 12.9±2.8%; common segment: 4.6±1.1%; p=0.001). Calcified patches were found in 20 CEAs (patch size: <0.1mm2 to >1.0mm2). Calcified patches were most abundant in the bulb and least in the common segment (bulb n=7.30±1.08; internal n=4.81±1.17; common n=2.56±0.56; p=0.0007). Calcified patch circularity decreased with increasing size (<0.1 mm2: 0.77±0.01, 0.1–1 mm2: 0.62±0.01, >1.0 mm2: 0.51±0.02; p=0.0001). A reduced fibrous layer thickness was associated with increased calcium patch size (p<0.0001). Conclusions: In advanced carotid atherosclerosis, calcification appears to be a heterogeneous and dynamic atherosclerotic plaque component, as indicated by the simultaneous presence of few large stabilizing calcified patches and numerous small calcific patches. Future studies are needed to elucidate the associations of intra-plaque calcification size and distribution with atherothrombotic events.
    Citation
    Han, Richard I., Wheeler, Thomas M., Lumsden, Alan B., et al.. "Morphometric analysis of calcification and fibrous layer thickness in carotid endarterectomy tissues." Computers in Biology and Medicine, 70, (2016) Elsevier: 210-219. https://doi.org/10.1016/j.compbiomed.2016.01.019.
    Published Version
    https://doi.org/10.1016/j.compbiomed.2016.01.019
    Keyword
    carotid endarterectomy; calcification; image analysis; carotid bifurcation; fibrous layer
    Type
    Journal article
    Publisher
    Elsevier
    Citable link to this page
    https://hdl.handle.net/1911/94217
    Rights
    This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier.
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    • Bioengineering Publications [632]
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    Home | FAQ | Contact Us | Privacy Notice | Accessibility Statement
    Managed by the Digital Scholarship Services at Fondren Library, Rice University
    Physical Address: 6100 Main Street, Houston, Texas 77005
    Mailing Address: MS-44, P.O.BOX 1892, Houston, Texas 77251-1892
    Site Map