Figure 4. Mechanism of plaque hemorrhage, rupture and/or erosion induced by cholesterol crystallization with volume expansion of the necrotic core.
In the case of a large necrotic core, the plaque cap is torn leading to rupture, whereas in the case of a small necrotic core, it leads to erosion. Furthermore, trauma to the vasa vasorum by expanding cholesterol crystals within the plaque causes intraplaque hemorrhage.
Modified with permission from [18].