O'Holleran L W, Kennelly M M, McClurken M, Johnson J M
Vascular Laboratory, Good Samaritan Medical Center, Phoenix, Arizona 85006.
Am J Surg. 1987 Dec;154(6):659-62. doi: 10.1016/0002-9610(87)90238-8.
A prospective analysis of 296 carotid arteries in 293 asymptomatic patients was undertaken using real-time B-mode ultrasonography. All patients had carotid bifurcation disease and were followed for an average of 46 months. The endpoint for follow-up was a transient ischemic attack or stroke. Patients were categorized according to degree of stenosis (greater or less than 75 percent) and morphologic plaque characteristics (calcified, dense, or soft). Patients with hemodynamically significant stenosis were at greater risk of transient ischemic attack or stroke than their counterparts with less than 75 percent stenosis. However, even patients with less than 75 percent stenosis were at risk if the plaque was less organized (dense or soft). Patients with hemodynamically significant stenosis and morphologically soft plaque were at the greatest risk of transient ischemic attack or stroke. Those patients with calcified plaque and less than 75 percent stenosis had the lowest risk of transient ischemic attack or stroke. Morphologic plaque characteristics, as well as degree of stenosis, is important in determining which patients are candidates for carotid endarterectomy.
对293例无症状患者的296条颈动脉进行了前瞻性分析，采用实时B型超声检查。所有患者均有颈动脉分叉病变，平均随访46个月。随访终点为短暂性脑缺血发作或中风。患者根据狭窄程度（大于或小于75%）和形态学斑块特征（钙化、致密或柔软）进行分类。血流动力学显著狭窄的患者比狭窄程度小于75%的患者发生短暂性脑缺血发作或中风的风险更高。然而，如果斑块组织性较差（致密或柔软），即使狭窄程度小于75%的患者也有风险。血流动力学显著狭窄且形态学上为柔软斑块的患者发生短暂性脑缺血发作或中风的风险最大。那些有钙化斑块且狭窄程度小于75%的患者发生短暂性脑缺血发作或中风的风险最低。形态学斑块特征以及狭窄程度在确定哪些患者适合进行颈动脉内膜切除术方面很重要。
