Waller B F
Indiana University Medical Center, Indianapolis 46223.
Clin Cardiol. 1989 Jan;12(1):14-20. doi: 10.1002/clc.4960120103.
Five hundred consecutive coronary artery segments histologically narrowed 76 to 95% in cross-sectional area by atherosclerotic plaque were classified into concentric and eccentric luminal types. Of the 500 segments, 365 (73%) were eccentric and 185 (27%) were concentric. Of the eccentric lesions, an arc of disease-free wall accounted for 2.3 to 32% (mean 16.6%) of the circumference of the internal elastic membrane. The average thickness of the coronary artery media was thinner in diseased segments (mean 88.4 micron) compared to disease-free wall segments in the same vessel (mean 202.9 micron). The presence of disease-free wall segments has clinical importance in at least three areas: (1) the accuracy with which angiography reflects the morphologic features of the diseased vessel, (2) coronary artery spasm, and (3) the mechanism of coronary balloon angioplasty and subsequent "restenosis" of previously dilated vessels.
500个连续的冠状动脉节段，经组织学检查发现其横截面积因动脉粥样硬化斑块而狭窄76%至95%，这些节段被分为同心腔型和偏心腔型。在这500个节段中，365个（73%）为偏心型，185个（27%）为同心型。在偏心病变中，无病变壁的弧长占内弹性膜周长的2.3%至32%（平均16.6%）。与同一血管中的无病变壁节段（平均202.9微米）相比，病变节段的冠状动脉中膜平均厚度更薄（平均88.4微米）。无病变壁节段的存在至少在三个方面具有临床意义：（1）血管造影反映病变血管形态特征的准确性；（2）冠状动脉痉挛；（3）冠状动脉球囊血管成形术的机制以及先前扩张血管随后的“再狭窄”。
