The endarterectomy involved excision of plaque intima through natural dissection plane within the tunica media. The excised tissues were approximately 3 cm in length, which contained plaque as well as intima and media layers extending from the common carotid artery into and along the internal and external carotid arteries tailing off to normal intima. The arteriotomy in the patients was closed with a patch sutured to the outer layer of the media and adventitia.
Tissue specimens were examined and compartmentalized according to the severity of atherosclerosis lesions using the American Heart Association classification (16 (link)). Segmented tissues were freshly embedded in O.C.T and stored at −80°C as previously described. Segmented tissue sections were stained for ORO as described above to detect lipids and the presence of elastin fibers. Tissues were scanned using 3DHISTECH slide scanner and viewed using Slide Viewer as described above.