Atherosclerosis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Niloofarsadaat Eshaghhosseiny, MD [3]

Overview

Atherosclerosis may be classified according to histological classification into 6 types: Type1,Type2,Type3,Type4,Type5 and Type6.

Classification

Atherosclerosis may be classified according to histological classification into 6 types: Type1,Type2,Type3,Type4,Type5 and Type6.^[1]

TYPE 1:

Adaptive intimal thickening in constant locations since birthday which doesnt obstruct the lumen.

TYPE 2:

Macrophage foam cells and lipid-laden smooth muscle cells(fatty streaks)

TYPE 3:

Atheroma,this stage is intermediate phase between type2 and type 4.In this stage we have symptoms.

TYPE 4:

In this stage we have lipid core.

TYPE 5:

In this phase we have calcification and lipid core contain thick layers of fibrous.^[1]

TYPE6:

May have fissure,hematoma,thrombus.^[1]

Adapted from AHA (american heart association)
0	Normal artery with or without adaptive intimal thickening;no hold	normal tissue
AHA GRADE	Criteria	Comments and corresponding gross calcification
1	Isolated MFCs containing lipid;no extracellular lipid;variable adaptive intimal thickening grossly with lipid staining	initial atherosclerosis lesion ;somtimes visible grossly with lipid staining
2	Numerous MFCs ,often in layers,with fine particles of extracellular lipid;no distinct pools of extracellular lipid:variable adaptive intimal thickening	Fatty streak,visible grossly with 3 staining
3	Numerous MFCswith >pools of extracellular lipid ;no well-defined core of extracellular lipid	Fatty plaque,raised fatty streak,intermediate lesion,or transitional leison
4	Numerous MFGs plus well-defined core of extracellular but with luminal surface covered by relatively normal intima	Atheroma,fibrous plaque,or raised lesion
5	Numerous MFCs,well-defined core or multiple cores of extracellular lipid,plus reactive fibrotic cap,vascularization,or calcium	Fibroatherema,fibrous plaque,or raised lesion
6	All of the above plus surface defect,hematoma,hemorrhage,thrombosis	Complicated lesion

The following terms are similar, yet distinct, in both spelling and meaning, and can be easily confused:

Arteriosclerosis is a general term describing any hardening (and loss of elasticity) of medium or large arteries (in Greek, “Arterio” meaning artery and “sclerosis” meaning hardening), arteriolosclerosis is atherosclerosis mainly affecting the arterioles (small arteries), atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque. Therefore, atherosclerosis is a form of arteriosclerosis.

References

↑ ^1.0 ^1.1 ^1.2 Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W; et al. (1995). “A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association”. Circulation. 92 (5): 1355–74. doi:10.1161/01.cir.92.5.1355. PMID 7648691.

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[pmid7648691-1] 1.0 ^1.1 ^1.2 Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W; et al. (1995). “A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association”. Circulation. 92 (5): 1355–74. doi:10.1161/01.cir.92.5.1355. PMID 7648691.

[1]