Atherosclerotic plaque healing: mechanisms and clinical relevance.

Healed atherosclerotic plaques show layered morphology in vivo on optical coherence tomography, and are linked to chronic coronary syndromes in patients.

• Why it matters: Plaque healing was long known mainly from post-mortem histology, leaving uncertainty about its real-time clinical relevance and how it relates to disease course.
• What they did: The review synthesizes evidence that plaque healing proceeds through endogenous thrombus lysis, granulation tissue formation, and re-endothelialization, and highlights high-resolution intracoronary imaging for in vivo identification.
• The result: Healed plaques are more frequently observed in chronic coronary syndrome patients, and repeated disruption–repair cycles may contribute to progressive luminal narrowing and long-term coronary atherosclerosis progression.

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