Читать книгу Interventional Cardiology - Группа авторов - Страница 26

Improvement in anti‐atherosclerotic therapy reduces the risk of plaque rupture [7]. Atherosclerotic plaques have become less inflamed and more fibrous, minimising the risk of rupture due to fissure of the fibrous cap [96]. Plaque erosions tend to have a rich extracellular matrix without a thin, friable fibrous cap, with less foam cells and lipid accumulation [97]. It typically shows endothelial denudation with intact internal and external elastic laminas and a well‐developed media with contractile SMCs unlike ruptured plaque where internal lamina is disrupted and the underlying media is thin and disorganised [98]. Interestingly, plaque erosions sometimes found in up‐ or downstream of a plaque rupture with a fatal superimposed thrombus, which might suggest that loss of endothelium can occur secondarily to thrombus formation assuming that the ruptured plaque nearby is the sole precipitating cause.