Michael Mecley, MD; Kenneth Rosenfield, MD; Jenifer Kaufman, BS; R. Eugene Langevin Jr., MD; Syed Razvi, MD; Jeffrey M. Isner, MD
Unstable atherosclerotic plaque morphology has been established as the major factor responsible for escalating symptoms of myocardial ischemia and extracranial vascular disease. Previous histopathologic (1-5) and ultrasound (6) studies have suggested that plaque hemorrhage, plaque rupture, and intraluminal thrombosis characterize the sequence of pathologic findings in such cases. Surprisingly, however, this same sequence of unstable plaque morphology has not been previously recognized as a basis for accelerated symptoms of arterial insufficiency in patients with peripheral vascular disease. The evidence we obtained by directional atherectomy and intravascular ultrasound suggests that unstable plaque morphology should be considered as a pathogenetic mechanism for
Mecley M, Rosenfield K, Kaufman J, Langevin RE, Razvi S, Isner JM. Atherosclerotic Plaque Hemorrhage and Rupture Associated with Crescendo Claudication. Ann Intern Med. ;117:663–666. doi: 10.7326/0003-4819-117-8-663
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Published: Ann Intern Med. 1992;117(8):663-666.
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