Farb A, Virmani R, Atkinson J B, Kolodgie F D
Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
J Am Coll Cardiol. 1990 Nov;16(6):1421-9. doi: 10.1016/0735-1097(90)90386-4.
Morphologic correlates of pathologic success or failure were studied at autopsy in 28 patients with 40 coronary arteries that had been subjected to balloon angioplasty. The presence of the following histologic features was evaluated: plaque concentricity or eccentricity, calcification, fibrous or fibropultaceous plaque, medial disruption, luminal thrombus and inflammation. Angioplasty was considered successful (residual cross-sectional luminal area greater than 25%) on pathologic examination in 14 arteries and unsuccessful in 26 arteries. Eccentric plaques were more likely to be successfully dilated than were concentric lesions (p less than 0.05). Six (50%) of 12 fibropultaceous plaques were successfully dilated compared with only 8 (29%) of 28 fibrous plaques. Moderate to severe calcification did not preclude morphologic success. Medial stretching or dissection, or both, was more often associated with a successful result. Thus, plaque morphology may be an important determinant of pathologic outcome after coronary angioplasty.
对28例患者的40条接受球囊血管成形术的冠状动脉进行尸检，研究病理成功或失败的形态学相关因素。评估以下组织学特征的存在情况：斑块同心性或偏心性、钙化、纤维或纤维粥样斑块、中膜破坏、管腔内血栓和炎症。在病理检查中，14条动脉血管成形术被认为成功（残余横断面管腔面积大于25%），26条动脉不成功。偏心斑块比同心病变更有可能成功扩张（p<0.05）。12个纤维粥样斑块中有6个（50%）成功扩张，而28个纤维斑块中只有8个（29%）成功扩张。中度至重度钙化并不排除形态学上的成功。中膜伸展或剥离，或两者兼而有之，更常与成功结果相关。因此，斑块形态可能是冠状动脉血管成形术后病理结果的重要决定因素。
