PMC5733059_01
The two-dimensional ultrasonography of right carotid artery shows that the floating carotid plaques in the medial wall of the bifurcation of the distal carotid artery, moving with the cardiac cycle [(A,B) arrows]. The floating material with pedicel can be found in the bifurcation of carotid artery during operation [arrows (C)]. The floating material [arrow (E)] was stripped off from the base of the desquamated plaque [arrow (D)].
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F1
The carotid ultrasound (GE LOGIQ9 duplex sonography with a 10L transducer) showed the endomembrane of bilateral carotid arteries thickening with multiple plaques formation; multiple plaques with heterogeneous echotexture in the distal segment of right common carotid artery with about 90% reduction in diameter; and the about 0.7 cm x 0.3 cm pedicle substances with homogeneous echotexture in the medial wall of the bifurcation of the distal carotid artery, moving with cardiac cycle (free-floating plaques) (Figures 1A,B). During operation, we found atherosclerotic plaques in common carotid artery and the bifurcation of carotid artery which caused stenosis, a white, fragile, and brittle floating plaque with pedicel could be found in the bifurcation of carotid artery, with a size of about 0.7 cm x 0.3 cm (Figures 1C-E).
Pathological examination: the fibrous cap in the base of floating plaque was incomplete, in which lipid necrosis and calcification can be found, and tissue cells which ingested the lipids were protrudes from the fibrous cap [HE staining; original magnification 2x for (A), and 4x for (B)]. The floating plaque was consisted of tissue cells ingesting the lipids and cholesterol clefts, there was lipid necrosis inside it [HE staining; original magnification 2x for (C), and 10x for (D)].
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F2
Pathological examination revealed that the fibrous cap in the base of floating plaque was incomplete, in which lipid necrosis and calcification could be found, and tissue cells ingesting the lipids protruded from the fibrous cap (Figures 2A,B). The floating plaque consisted of tissue cells ingesting the lipids and cholesterol clefts, inside of lipid necrosis (Figures 2C,D).