Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan.
Cerebrovasc Dis. 2010;29(5):468-75. doi: 10.1159/000297962. Epub 2010 Mar 19.
This study aimed to evaluate the relationship between the amount of aspirated debris during distal balloon-protected carotid artery stenting (CAS) and the pre-intervention plaque composition, as assessed by Virtual Histology (VH) intravascular ultrasound (IVUS).
The study subjects were 25 consecutive patients (mean age, 73.0 +/- 5.2 years; 20 males and 5 females) who underwent CAS under distal balloon protection. The average rate of carotid stenosis was 74.6 +/- 12.9% by North American Symptomatic Carotid Endarterectomy Trial criteria. We assessed culprit plaque components by VH-IVUS before CAS. Aspirated debris was filtered, stained with HE and mounted onto glass slides. The quantity of debris was evaluated by measuring its surface area. We evaluated the relationship between the quantity of aspirated debris and VH-IVUS measurements before CAS.
The amount of debris during CAS was positively correlated with the total plaque volume in grayscale IVUS (Rs = 0.480, p = 0.015) and fibro-fatty volumes over the entire lesion length in VH-IVUS (Rs = 0.561, p = 0.001).
Culprit lesions with large plaque volumes, especially larger fibro-fatty volumes, as imaged by VH-IVUS, are associated with large amounts of debris during balloon-protected CAS.
本研究旨在评估在球囊保护下远端颈动脉支架置入术（CAS）过程中抽吸的碎片量与虚拟组织学（VH）血管内超声（IVUS）评估的术前斑块成分之间的关系。
本研究纳入了 25 例连续接受球囊保护下 CAS 的患者（平均年龄 73.0 +/- 5.2 岁；男性 20 例，女性 5 例）。根据北美症状性颈动脉内膜切除术试验标准，颈动脉狭窄的平均率为 74.6 +/- 12.9%。我们在 CAS 前通过 VH-IVUS 评估罪犯斑块成分。抽吸的碎片经过过滤、HE 染色并安装在载玻片上。通过测量其表面积来评估碎片的数量。我们评估了 CAS 过程中抽吸的碎片量与 VH-IVUS 测量值之间的关系。
CAS 过程中产生的碎片量与灰阶 IVUS 中的总斑块体积呈正相关（Rs = 0.480，p = 0.015），与 VH-IVUS 中整个病变长度的纤维脂肪体积呈正相关（Rs = 0.561，p = 0.001）。
VH-IVUS 成像显示的斑块体积较大的罪犯病变，特别是纤维脂肪体积较大的病变，与球囊保护下 CAS 过程中产生的大量碎片有关。
