Mughal Majid M, Khan Mohsin K, DeMarco J Kevin, Majid Arshad, Shamoun Fadi, Abela George S
Department of Medicine, Division of Cardiology, Michigan State University, 138 Service Road, B208 Clinical Center, East Lansing, MI 48824, USA.
Expert Rev Cardiovasc Ther. 2011 Oct;9(10):1315-30. doi: 10.1586/erc.11.120.
Carotid atherosclerotic plaques represent both stable and unstable atheromatous lesions. Atherosclerotic plaques that are prone to rupture owing to their intrinsic composition such as a large lipid core, thin fibrous cap and intraplaque hemorrhage are associated with subsequent thromboembolic ischemic events. At least 15-20% of all ischemic strokes are attributable to carotid artery atherosclerosis. Characterization of plaques may enhance the understanding of natural history and ultimately the treatment of atherosclerotic disease. MRI of carotid plaque and embolic signals during transcranial Doppler have identified features beyond luminal stenosis that are predictive of future transient ischemic attacks and stroke. The value of specific therapies to prevent stroke in symptomatic and asymptomatic patients with severe carotid artery stenosis are the subject of current research and analysis of recently published clinical trials that are discussed in this article.
颈动脉粥样硬化斑块包括稳定和不稳定的动脉粥样病变。由于其内在成分，如大脂质核心、薄纤维帽和斑块内出血而易于破裂的动脉粥样硬化斑块与随后的血栓栓塞性缺血事件相关。所有缺血性卒中中至少15%-20%归因于颈动脉粥样硬化。斑块的特征描述可能会增进对自然病史的理解，并最终促进动脉粥样硬化疾病的治疗。颈动脉斑块的磁共振成像以及经颅多普勒检查期间的栓子信号已识别出管腔狭窄以外的特征，这些特征可预测未来的短暂性脑缺血发作和卒中。针对有症状和无症状的重度颈动脉狭窄患者预防卒中的特定疗法的价值是当前研究的主题，本文将讨论对最近发表的临床试验的分析。
