The idiom “the straw that breaks the camel’s back” describes scenarios where seemingly minor incidents eventuate in a sudden, unexpected, and often detrimental downfall. In the case of atherosclerosis, over time multiple subclinical cellular events result in the development of unstable, vulnerable atherosclerotic lesions, which leads to the rupture of atherosclerotic plaques, culminating in the...

Atherosclerosis is the most frequent cause of ischemic heart disease and cerebrovascular disorders. The condition is the leading cause of death in Western societies. At the core of this condition is the atherosclerotic plaque. It is within the structure of this lesion that multiple biochemical and cellular processes interact influencing its vulnerability to rupture and as a result acute ischemi...

It is generally established that the unstable plaque is the major cause of acute clinical sequelae of atherosclerosis. Unfortunately, terms indicating lesions prone to plaque instability, such as “vulnerable plaque,” and the different phenotypes of unstable plaques, such as plaque rupture, plaque fissuring, intraplaque hemorrhage, and erosion, are often used interchangeably. Moreover, the diffe...

Intracranial atherosclerotic disease (ICAD) causes up to 10% of all ischemic strokes, and the rate of recurrent vascular ischemic events is very high. Important predictors of vulnerability in atherosclerotic plaques include the degree of stenosis and the underlying plaque morphology. Vascular wall MRI can provide information about wall structures and atherosclerotic plaque components. High-reso...

BACKGROUND Carotid atherosclerotic plaque is identified as one of the main sources of ischaemic stroke. However, the prevalence of carotid high-risk atherosclerotic plaque in Chinese patients with ischaemic cerebrovascular events has been inconsistently reported and needs to be investigated in a large population. OBJECTIVES The primary objective of CARE II study was to determine the prevalenc...

The arterial system is more than an intricate plumbing system for the transport of blood; it is a highly complex organ that interacts with its environment. The major function of the vessel wall, and more specifically the endothelial lining, is to maintain an adequate blood supply to the end organ that it is supplying. This is achieved by regulatory mechanisms that control vascular tone, inflamm...

Plaque Progression: Often Abrupt, Rarely Predictable Some facts are now certain. First, plaque progression and clinical outcome are not always closely related, and each is poorly predicted by clinical and angiographic variables.1–4 Second, many plaques progress episodically because of episodes of thrombosis triggered by rupture, erosion (denudation), or occasionally endothelial activation or in...

Increased plaque vascularization is causatively associated with the progression of unstable atherosclerotic vessel disease. We investigated the safety and efficacy of heat-generating radiofrequency ablation (RFA) in reducing the number of vessels in the plaque and adventitia and its effect on plaque size and composition. To this end, New Zealand White rabbits were fed a cholesterol-enriched die...