Anatomie et physiologie : recherches en cours
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Does the Role of Angiogenesis Play a Role in Atherosclerosis and Plaque Instability?

Patel A

Atherosclerosis is an inflammatory vascular disease which begins as fatty streaks underlining the endothelium of large artery walls, usually coronary or carotid. It consists of endothelial dysfunction, the accumulation of lipid and cholesterol in the intima from a young age and the recruitment of inflammatory cells to sites of damage in the artery wall. The disease progresses through several stages, eventually resulting in the formation of a cholesterol rich plaque. The role of angiogenesis in atherosclerosis has been of growing interest over the last 20 years since experimental studies have not been able to support a causal relation. Angiogenesis involves hyperplasia of the vasa vasorum in the early stages of atherosclerosis which is thought to be angiogenesis independent, followed by intimal neovascularization in the late angiogenesis dependent stages of the disease. Angiogenesis increases the supply of oxygen and nutrients to the artery wall and supports initial plaque growth. Once the atherosclerotic plaque develops, intimal angiogenesis is thought to contribute to characteristics of an unstable plaque such as fibrous cap thinning, a cholesterol rich necrotic core, excess infiltration of inflammatory cells, plaque hemorrhage and the increased risk of plaque rupture. This account discusses the evidence behind the role of angiogenesis in atherosclerosis and plaque instability.