Abstract
By Jeffrey M. Isner and Marianne Kearney, 128 pp, with illus, London, England, WB Saunders Co, 1999.This beautifully illustrated book fills a rather large void in the available literature on the pathology of atherosclerosis. Practically all of the current knowledge on this disease process is based on the study of tissues obtained at autopsy or from experimental animals.Isner and Kearney describe in this book the pathology of atherosclerosis as seen in specimens obtained from patients at the time of atherectomy performed for a variety of clinical events. They encompass stenosis occurring during primary atherosclerosis in coronary arteries, saphenous vein graphs, peripheral arteries, and dialysis fistulas; all tissues were obtained by direct atherectomy. The authors also studied specimens obtained from simple and multiple restenosing lesions. The lesions were examined utilizing the latest technologies, including immunohistochemistry and molecular biology. Thus, the cell composition and proliferative activity of atherosclerotic plaques was carefully mapped; the rate of apoptosis and the matrix proteins were also analyzed. Gene expression and angiogenesis, the most recent targets of investigators, were examined by in situ hybridization and the use of immunohistochemistry to detect the expression of vascular endothelial growth factor.The color illustrations are of excellent quality and the pathology is carefully detailed. If a picture is indeed worth a thousand words, this is a very eloquent textbook. It should be a welcome addition to the reference texts of pathologists and all physicians involved in the care of patients with vascular diseases.
Published Version
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