Staniloae Cezar S, Ambrose John A
Comprehensive Cardiovascular Center, Department of Medicine, Saint Vincent Catholic Medical Centers of New York, 170 West 12th Street, NY 10011, USA.
Expert Rev Cardiovasc Ther. 2003 Sep;1(3):353-65. doi: 10.1586/14779072.1.3.353.
There has been great interest in the possibility of identifying plaques that might be the site of future acute coronary events. These plaques are termed vulnerable and the majority are lipid-rich with an abundance of inflammatory cells and a thin fibrous cap. Several techniques developed to identify these plaques are in various stages of development and in the near future, one might employ a strategy to potentially identify and therapeutically modify such lesions during percutaneous intervention to avoid future acute events. Although this approach of identifying the vulnerable plaque seems promising, there are significant potential limitations. The natural history of a vulnerable plaque is unknown and clinical trials utilizing this strategy of identification and therapeutic intervention are lacking. Moreover, in any given patient, multiple vulnerable plaques are likely to be present. This article reviews some of the techniques for identifying a vulnerable plaque and discusses the potential advantages and limitations of this strategy.
人们对识别可能成为未来急性冠状动脉事件发生部位的斑块的可能性产生了浓厚兴趣。这些斑块被称为易损斑块，大多数富含脂质，有大量炎症细胞且纤维帽较薄。为识别这些斑块而开发的几种技术正处于不同的发展阶段，在不久的将来，人们可能会采用一种策略，在经皮介入治疗期间潜在地识别并对这类病变进行治疗性干预，以避免未来发生急性事件。尽管这种识别易损斑块的方法看起来很有前景，但存在重大的潜在局限性。易损斑块的自然病程尚不清楚，且缺乏利用这种识别和治疗干预策略的临床试验。此外，在任何给定患者中，可能存在多个易损斑块。本文回顾了一些识别易损斑块的技术，并讨论了该策略的潜在优势和局限性。
