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Figure 1 Thrombus Propagation in Plaque Rupture

(A) Composite of a longitudinal section of proximal left anterior descending (LAD) and left diagonal (LD) coronary arteries with plaque rupture in the LAD. Note propagation of the thrombus upstream from the site of plaque rupture (arrowheads) extending up to the first major sidebranch (LD). (B) The same longitudinal section with Carstair’s stain for detection of fibrin (dark red) and platelets (blue-gray). The proximal and distal propagated thrombus consists predominantly of fibrin and red cells, whereas the rupture site has platelet-rich thrombus. Modified with permission from Virmani et al., editors. The Vulnerable Plaque: Strategies for Diagnosis and Management. Malden, MA: Blackwell Publishing, 2007.