Bone formation in carotid plaques: A clinicopathological study

Bone formation and dystrophic calcification are present in carotid endarterectomy plaques. The clinical significance of these findings is unknown. The purpose of this study was to determine whether bone formation and extensive dystrophic calcification are associated with stable plaques and protectiv...

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Veröffentlicht in:Stroke (1970) 2002-05, Vol.33 (5), p.1214-1219
Hauptverfasser: HUNT, Jennifer L, FAIRMAN, Ronald, CUSACK, Anita, MOHLER, Emile R, MITCHELL, Marc E, CARPENTER, Jeffrey P, GOLDEN, Michael, KHALAPYAN, Tigran, WOLFE, Megan, NESCHIS, David, MILNER, Ross, SCOLL, Benjamin
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container_end_page 1219
container_issue 5
container_start_page 1214
container_title Stroke (1970)
container_volume 33
creator HUNT, Jennifer L
FAIRMAN, Ronald
CUSACK, Anita
MOHLER, Emile R
MITCHELL, Marc E
CARPENTER, Jeffrey P
GOLDEN, Michael
KHALAPYAN, Tigran
WOLFE, Megan
NESCHIS, David
MILNER, Ross
SCOLL, Benjamin
description Bone formation and dystrophic calcification are present in carotid endarterectomy plaques. The clinical significance of these findings is unknown. The purpose of this study was to determine whether bone formation and extensive dystrophic calcification are associated with stable plaques and protective against ischemic vascular events. Carotid endarterectomy plaques were collected from 142 patients (94 men) with carotid stenosis. The specimens were evaluated for lamellar bone formation, dystrophic calcifications, inflammatory infiltrates, neovascularization, and histological type or grade of plaque according to a standard AHA grading system. Immunohistochemical staining was performed to identify vascular endothelial cells in neovascularization (factor VIII) and lymphocytes. Clinical data, including history of cerebrovascular and cardiovascular events, were recorded at the time of surgery. Patients with calcification of carotid plaques had fewer symptoms of stroke and transient ischemic attack (P=0.042) than those without calcification. Stroke and transient ischemic attack occurred less frequently in patients with plaques with large calcific granules (P=0.021). Of the patients, 13% had lamellar bone formation, which directly correlated with the presence of sheetlike calcifications (P=0.0001) and inversely correlated with ulcerated lesions (P=0.048). The presence of bone also correlated with diabetes (P
doi_str_mv 10.1161/01.STR.0000013741.41309.67
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The clinical significance of these findings is unknown. The purpose of this study was to determine whether bone formation and extensive dystrophic calcification are associated with stable plaques and protective against ischemic vascular events. Carotid endarterectomy plaques were collected from 142 patients (94 men) with carotid stenosis. The specimens were evaluated for lamellar bone formation, dystrophic calcifications, inflammatory infiltrates, neovascularization, and histological type or grade of plaque according to a standard AHA grading system. Immunohistochemical staining was performed to identify vascular endothelial cells in neovascularization (factor VIII) and lymphocytes. Clinical data, including history of cerebrovascular and cardiovascular events, were recorded at the time of surgery. Patients with calcification of carotid plaques had fewer symptoms of stroke and transient ischemic attack (P=0.042) than those without calcification. Stroke and transient ischemic attack occurred less frequently in patients with plaques with large calcific granules (P=0.021). Of the patients, 13% had lamellar bone formation, which directly correlated with the presence of sheetlike calcifications (P=0.0001) and inversely correlated with ulcerated lesions (P=0.048). The presence of bone also correlated with diabetes (P&lt;0.01) and coronary artery disease (P&lt;0.01). Of the 20 patients with bone, 6 had a history of stoke and transient ischemic attack (P=0.5). The results indicate that bone formation tends to occur in heavily calcified carotid lesions devoid of ulceration and hemorrhage. 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Stroke and transient ischemic attack occurred less frequently in patients with plaques with large calcific granules (P=0.021). Of the patients, 13% had lamellar bone formation, which directly correlated with the presence of sheetlike calcifications (P=0.0001) and inversely correlated with ulcerated lesions (P=0.048). The presence of bone also correlated with diabetes (P&lt;0.01) and coronary artery disease (P&lt;0.01). Of the 20 patients with bone, 6 had a history of stoke and transient ischemic attack (P=0.5). The results indicate that bone formation tends to occur in heavily calcified carotid lesions devoid of ulceration and hemorrhage. 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The clinical significance of these findings is unknown. The purpose of this study was to determine whether bone formation and extensive dystrophic calcification are associated with stable plaques and protective against ischemic vascular events. Carotid endarterectomy plaques were collected from 142 patients (94 men) with carotid stenosis. The specimens were evaluated for lamellar bone formation, dystrophic calcifications, inflammatory infiltrates, neovascularization, and histological type or grade of plaque according to a standard AHA grading system. Immunohistochemical staining was performed to identify vascular endothelial cells in neovascularization (factor VIII) and lymphocytes. Clinical data, including history of cerebrovascular and cardiovascular events, were recorded at the time of surgery. Patients with calcification of carotid plaques had fewer symptoms of stroke and transient ischemic attack (P=0.042) than those without calcification. 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subjects Adult
Aged
Aged, 80 and over
Arteriosclerosis - complications
Arteriosclerosis - pathology
Biological and medical sciences
Calcinosis - complications
Calcinosis - pathology
Carotid Stenosis - complications
Carotid Stenosis - pathology
Carotid Stenosis - surgery
Demography
Endarterectomy, Carotid
Female
Humans
Immunohistochemistry
Ischemic Attack, Transient - complications
Male
Medical sciences
Middle Aged
Neurology
Osteogenesis
Prospective Studies
Risk Factors
Stroke - complications
Vascular diseases and vascular malformations of the nervous system
title Bone formation in carotid plaques: A clinicopathological study
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