Application of Confocal Microscopy for 3D Assessment of Carotid Plaque Structure: Implications for Carotid Blood Flow and Stroke Research

Abstract

Background: Little information is available on how forces resulting from fluid flow interact
with structural stability of carotid atherosclerotic plaque and how such interactions may
impact on stroke prevention; investigation of the 3D structure of plaque could help in such
studies. The aim of thisstudy wasto investigate whether confocal microscopy can be used to
obtain 3D visualization of the structure of atherosclerotic carotid plaques.
Methods: Carotid plaque specimens were collected from routine end-arterectomy surgical
operations. Both bright-field microscopy and Laser Scanning Confocal Microscopy (LSCM)
were used to generate 3D image data-sets and visualizations of surgically removed carotid
plaques.
Results: Evidence of carotid plaque vulnerability was demonstrated by reduced fibrous cap
thickness and large lipid-necrotic core with evidence of cracking.
Conclusion: The generation of 3D images of carotid plaques could help in: (i) investigating
key features that affect plaque structural stability; (ii) comparing 3D microstructure of the
plaque with clinical imaging assessment and blood flow investigations; and (iii) developing
markers to identify patients requiring clinical intervention