The Pathology Investigation Of Femoral Atherosclerosis

Following the increasing agedness population, the prevalence of peripheral atherosclerotic occlusive disease (PAOD) presented high trend every year. As study has shown, PAOD was the first reason which causes deformity of lower limbs. Meanwhile, the prevalence rate of hypertension, coronary heart disease, and diabetes were significantly higher in the population of PAOD than in the population of without PAOD. PAOD was named as coronary and cerebrovascular disease risk equivalents, and affect seriously the life of the patients. Low Extremity Arteriosclerosis Disease (LEASD) was the most prevalent in PAOD. Otherwise, the treatment on LEASD was not as effective as coronary and cerebrovascular disease. Some reasons were related with the unrepresentative complains of LEASD and ignore from clinical physician. At present, the rate of surgery is still up to 4.3% among the patient with intermittent claudication. The research of pathogenesis about LEASD has become one of conspicuous questions. Especially in pathology characteristic of low extremity atherosclerosis, whether it is consistent with coronary and carotid atherosclerosis, the literature was few.Objective:To investigate pathology characteristic of femoral atherosclerosis and provide theoretic support. The content includes questions as follows: 1. to investigate the relation among femoral, coronary and carotid atherosclerosis in the types, severity degree or range of atherosclerosis lesions.2. To investigate the difference in stability of plaque among femoral, carotid and coronary atherosclerosis and pathogenesis.3. To investigate the affect of diabetes on low extremity atherosclerosis. Methods:Experiment one: 15 autopsy cases were selected. Serial sections of femoral, carotid and left anterior descending artery of all cases were taken. The morphology, division and difference of atherosclerosis lesions were observed microscopically.Experiment two: parts of the segments were selected for immunohistochemica staining .Three markers against α-smooth muscle actin, CD68, and bax were performed . The number of smooth muscle cells and macrophages and expression of bax in plaques were observed.Experiment three: 8 elder diabetes autopsy cases and 8 control cases were selected respectively in our hospital. Serial sections of femoral artery of all cases were taken. With the same pathologic methods, the degree and caitify range were observed. The expression of a-smooth muscle actin, CD68, and bax in plaques were studied.Results:Experiment one: 1. the development of femoral atherosclerosis involve fatty streak, fibrous plaque, atheromatous plaque, and complicated lesion. Among the elder patients, most of atherosclerosis lesions were advanced plaques, especially complicated lesions in femoral atherosclerosis, similar with carotid and coronary atherosclerosis. 2. Compared with left anterior descending artery, atherosclerosis lesions were not so much widely, seriously in femoral and carotid.3. The correlations was absent among the three kinds of arteries either in the degree or range of atherosclerosis lesions.Experiment two: The division characteristic of smooth muscle cells and macrophages in femoral atherosclerotic plaques was similar with carotid atherosclerotic plaques. Expression of bax in all the three kinds of plaques was observed. The number of smooth muscle cells and macrophages in femoral atherosclerotic plaques was similar with carotid atherosclerotic plaques. Compared with coronary, there were more smooth muscle cells and less macrophage in femoral atherosclerotic plaques, and the expression of bax in macrophages was stronger, the expression of bax in smooth muscle cell was weaker.