Carotid Plaque Mast Cells Associate with Atherogenic Serum Lipids, High Grade Carotid Stenosis and Symptomatic Carotid Artery Disease

Background and Purpose: The red blood cell fatty acid composition objectively reflects the long-term dietary intake of several fatty acids. In patients undergoing carotid endarterectomy, we explored whether red blood cell status of selected fatty acids related to symptomatic carotid artery disease. Methods: We included patients with symptomatic (n=22) and asymptomatic (n=23) carotid artery disease. We determined all-C18:1 trans, linoleic acid (LA, C18:2n6), alpha-linolenic acid (C18:3n3), and the omega-3 index (sum of eicosapentaenoic [C20:5n3] and docosahexaenoic [C22:6n3] acids) in both red blood cells and carotid plaque phospholipids by gas-chromatography. Results: In a multivariate logistic regression analysis, we only observed a significant association for LA, whose red blood cell status was inversely related to symptomatic carotid artery disease (odds ratio, 0.116 [95% CI, 0.022–0.607], P =0.011, for each 1-SD increase). A similar result was observed for LA in carotid plaque phospholipids. Conclusions: Cell membrane enrichment in LA, which reflects its intake, was inversely related to symptomatic carotid disease. This increases evidence supporting a favorable role of dietary LA in vascular health.

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I. Impaired dark adaptation in symptomatic carotid artery disease

Neurology ◽

10.1212/wnl.49.5.1353 ◽

1997 ◽

Vol 49 (5) ◽

pp. 1353-1359 ◽

Cited By ~ 12

Author(s):

Ult Havelius ◽

David Bergqvist ◽

Pia Falke ◽

Bengt Hindfelt ◽

Torsten Krakau

Keyword(s):

Carotid Artery ◽

Carotid Stenosis ◽

Dark Adaptation ◽

Carotid Artery Disease ◽

Contralateral Side ◽

Symptomatic Carotid ◽

Control Subjects ◽

Artery Disease ◽

First Time ◽

Pupillary Size

It has been known for more than a century that even slight hypoxemia reduces dark adaptation. We studied dark adaptation in symptomatic carotid artery disease. Twenty-one consecutive patients scheduled for first-time carotid endarterectomy and 31 age-matched control subjects with normal carotid arteries were examined by dark adaptometry monocularly and were tested repeatedly on consecutive days. The average degree of internal carotid stenosis on the symptomatic side was much greater than that on the contralateral side. Dark adaptation was markedly impaired in the patients as compared with the control subjects. In the patients there was no difference in dark adaptation between the symptomatic and nonsymptomatic sides. The existence of carotid stenosis correlated to the level of dark adaptation. Pupillary size and age correlated to the dark adaptational level but did not affect the effect of carotid stenosis on dark adaptation. The decreased dark adaptation may be due to insufficient blood supply or repeated subclinical microembolization to the retinae, the brain, or both.

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Evaluation of haemodynamic impairment and collateral flow in symptomatic carotid artery disease using arterial spin labelling MRI

Aktuelle Neurologie ◽

10.1055/s-2005-919686 ◽

2005 ◽

Vol 32 (S 4) ◽

Author(s):

R Kern ◽

M Günther ◽

F Sallustio ◽

K Szabo ◽

M Griebe ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Artery Disease ◽

Arterial Spin Labelling ◽

Collateral Flow ◽

Symptomatic Carotid ◽

Artery Disease ◽

Spin Labelling

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Concomitant Surgical Treatment of Symptomatic Carotid Artery Disease With a Coexisting Shamblin I Carotid Body Tumor

Vascular and Endovascular Surgery ◽

10.1177/1538574416689430 ◽

2017 ◽

Vol 51 (2) ◽

pp. 103-107 ◽

Cited By ~ 2

Author(s):

Carlos A. Hinojosa ◽

Javier E. Anaya-Ayala ◽

Hugo Laparra-Escareno ◽

Adriana Torres-Machorro ◽

Rene Lizola ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Body ◽

Carotid Artery Disease ◽

Duplex Ultrasound ◽

Neurological Deficits ◽

Symptomatic Carotid ◽

Carotid Body Tumors ◽

Carotid Artery Endarterectomy ◽

Artery Disease ◽

Dissection Technique

Symptomatic carotid artery atherosclerotic disease is an indication for carotid artery endarterectomy. The coexistence of carotid body tumors (CBTs) with symptomatic carotid disease is rarely encountered and adds significant challenges to vascular surgeons, with a reported overall mortality for patients who undergo endarterectomy and tumor excision of 8.8%, as opposed to the 2% for those who had CBT excision only. We describe the case of a 79-year-old female who experienced an acute cerebrovascular accident in the left hemisphere; duplex ultrasound revealed high-grade carotid stenosis in the left side and the presence of a Shamblin I CBT. The risks and benefits of the planned operation were reviewed, and the decision was made to proceed with early carotid endarterectomy and concomitant surgical resection of the tumor using the retrocarotid dissection technique. The patient recovered well, and at 11 months from the combined procedure, her neurological deficits improved significantly.

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Carotid Endarterectomy for Symptomatic Carotid Artery Disease Demonstrated by Duplex Ultrasound With Minimal Arteriographic Findings

Annals of Vascular Surgery ◽

10.1007/bf02286785 ◽

1996 ◽

Vol 10 (4) ◽

pp. 385-389 ◽

Cited By ~ 6

Author(s):

Ali F. AbuRahma ◽

John F. White ◽

James P. Boland

Keyword(s):

Carotid Artery ◽

Carotid Endarterectomy ◽

Carotid Artery Disease ◽

Duplex Ultrasound ◽

Symptomatic Carotid ◽

Artery Disease

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170 Vasa Vasorum Activities in Human Carotid Atherosclerosis is Associated with Plaque Development and Vulnerability

Neurosurgery ◽

10.1093/neuros/nyx417.170 ◽

2017 ◽

Vol 64 (CN_suppl_1) ◽

pp. 243-244

Author(s):

Sungpil Joo

Keyword(s):

T Cell ◽

Mast Cells ◽

Carotid Artery ◽

Carotid Plaque ◽

Vasa Vasorum ◽

Plaque Vulnerability ◽

Unstable Plaque ◽

Symptomatic Carotid ◽

Before And After ◽

Stable Plaque

Abstract INTRODUCTION Carotid endarterectomy (CEA) has been shown to be beneficial in patients with high-grade symptomatic carotid artery stenosis. Subintimal and intraplaque hemorrhages are frequently seen during CEA in the absence of any visible breach in the intima, as these changes are derived from the vasa vasorum system rather than from blood in the vessel lumen. Imaging modalities to characterize unstable, vulnerable plaques are strongly needed for better risk stratification in these patients. The aim of this study was to investigate the correlation between the activities of the carotid vasa vasorum and carotid plaque vulnerability using indocyanine green-video angiography (ICG-VA) during CEA, focusing on how the carotid artery vasa vasorum is depicted. METHODS Sixty-nine patients (mean age, 68.5 ± 2.5 years; mean degree of stenosis, 78.9 ± 3.8) who underwent CEA were enrolled prospectively from September 2013 to December 2014. ICG was injected intravenously as a bolus before and after resecting the atheroma during CEA. We also performed immunohistochemistry using CD68 (macrophage), CD117 (mast cell), CD4 (T-cell), and CD8 (T-cell) antibodies for resected plaque specimens. RESULTS >Active vasa vasorum density was observed in all patients on ICG-VA (n = 69). The vasa vasorum externa (VVE) and interna (VVI) were seen in 11 (16%) and 57 patients (82.6%), respectively. The types of VVE were strongly associated with preoperative angiographic instability (90.0%, P = 0.005) and carotid plaque vulnerability (100%, P = 0.007) macroscopically. In contrast, the types of VVI were less associated with angiographic instability (36.1%) and plaque vulnerability (49.1%, P = 0.003). CD86- and CD117-stained macrophages and mast cells were observed more frequently in unstable plaque, compared to those in stable plaque (P < 0.0001, P = 0.002, respectively). CONCLUSION The early appearance of VVE on ICG-VA was strongly associated with unstable carotid plaque and many microvessel channels that provided nutrients to the developing and expanding intima and potentially created an unstable hemorrhagic environment prone to rupture. Macrophages and mast cells were involved in the formation of microvessels in the atherogenic plaque and accelerated plaque progression into an unstable plaque phenotype.

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