Open AccessThe eccentric coronary atherosclerotic plaque: Morphologic observations and clinical relevance
Author(s) -
Waller B. F.
Publication year - 1989
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960120103
Subject(s) - medicine , eccentric , restenosis , cardiology , artery , coronary artery disease , angioplasty , angiography , anatomy , radiology , stent , physics , quantum mechanics
Five hundred consecutive coronary artery segments histologically narrowed 76 to 95% in cross‐sectional area by atherosclerotic plaque were classified into concentric and eccentric luminal types. Of the 500 segments, 365 (73%) were eccentric and 185 (27%) were concentric. Of the eccentric lesions, an are of disease‐free wall accounted for 2.3 to 32% (mean 16.6%) of the circumference of the internal elastic membrane. The average thickness of the coronary artery media was thinner in diseased segments (mean 88.4 μm) compared to disease‐free wall segments in the same vessel (mean 202.9 μm). The presence of disease‐free wall segments has clinical importance in at least three areas: (1) the accuracy with which angiography reflects the morphologic features of the diseased vessel, (2) coronary artery spasm, and (3) the mechanism of coronary balloon angioplasty and subsequent “restenosis” of previously dilated vessels.