I. Introduction and Historical Background
II. Pathology
III. Pathogenesis
IV. Vulnerable Atheromatous Plaques
V. Clinical Studies
VI. Perspective and Research Implications

GLOSSARY
angiogenesis functional new blood vessel growth.
atheroma same as atherosclerosis, raised plaques filled with cholesterol, calcium, and other substances on the inner wall of arteries that obstruct the lumen and the flow of blood; the plaque of atheroma hardens the artery, hence the term atherosclerosis (sclerosis ¼ hardening).
atherothrombosis when a plaque of atheroma is fissured or ruptures, the contents of the plaque are highly thrombogenic and a clot (thrombus) forms rapidly causing complete occlus¬ion of arteries leading to myocardial infarction, stroke, or other cardiovascular events (atheroma plus thrombosis ¼ atherothrombosis).
diapedese the passage of blood cells through intact vessel walls.
endothelium the innermost part of the intima that comes in contact with circulating blood, a silky smooth layer of epithe¬lial cells.
hemodynamics the study of the movement of blood and the forces involved in the circulation of the blood.
hydrodynamics a branch of the science of mechanics which treats liquids.

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• I. INTRODUCTION AND HISTORICAL BACKGROUND
  A. Incidence
• II. PATHOLOGY A. Definition of Atheroma and Atherosclerosis
  The word atheroma is derived from the Greek ‘‘athere’’ meaning porridge or gruel. When a plaque of atheroma is cut open one sees a gelatinous, porridge-like material which contains globules of cholesterol fat, neutral fat, saturated sterols, protein granules, crystals of cholesterol, fatty acids, calcium, and other cells. The amount of calcium in the lesion (calcification) is extremely variable. Fortunately, the porridge-like material does not touch the blood that flows through the artery, because nature covers the fatty material with a protective hard layer of cells called fibrous tissue. The atheromatous material forms a plaque, an opaque yellowish-white patch of thickening, that juts into the lumen of the artery. An atheromatous plaque therefore consists of a central fatty core that has a variable amount of lipids and calcium covered by a fibrous cap. Because the cap is hard and the medical word for hardness is ‘‘sclerosis,’’ the disease is commonly called atherosclerosis. The fibrous cap, however, may be quite thin and fragile and prone to fracture and rupture or show erosion in some individuals. The exposed material is highly thrombogenic. Figure 2 gives a simplified representation of an atheromatous plaque and the subsequent rupture and blood clot that completely obstructs the artery.
• III. PATHOGENESIS
  The precise cause and pathogenesis of atheroma formation remains unknown.
• IV. VULNERABLE ATHEROMATOUS PLAQUES
  A. Rupture of the Plaque
• V. CLINICAL STUDIES
  A. Maehara et al.
• BIBLIOGRAPHY
  Agmon, Y., Khandheria, B. K., Meissner, I. et al. The association between

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