In vitro dissolution of carotid atherosclerotic plaques with bile

Incidence of carotid occlusive disease has increased gradually, creating a healthcare burden. This study aimed to evaluate the effectiveness of in vitro dissolution of carotid atherosclerotic plaques with bile to provide a new method for treating carotid atherosclerosis. We obtained vulnerable and stable plaques by carotid endarterectomy. Three plaque groups were formed in which fresh bile, dilute hydrochloric acid, or saline was added. Dissolution status was observed in each group and dissolution times were measured. Significant dissolution was observed in vulnerable plaque and poorer dissolution in stable plaque, both with added bile. No dissolution was observed in vulnerable and stable plaque groups with added dilute hydrochloric acid or normal saline. The lipid-rich necrotic core within vulnerable or stable plaques is dissolved quickly by bile, while other components, including the fibrous cap, cannot be dissolved. The large lipid-rich core of vulnerable plaque accounts for more significant dissolution than in stable plaque.