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腔内血管成形术:实验模型中形态学与血管造影结果的相关性

Transluminal angioplasty: correlation of morphologic and angiographic findings in an experimental model.

作者信息

Block P C, Baughman K L, Pasternak R C, Fallon J T

出版信息

Circulation. 1980 Apr;61(4):778-85. doi: 10.1161/01.cir.61.4.778.

Abstract

The morphologic consequences of transluminal angioplasty of stenotic atherosclerotic coronary arteries are unknown. This study describes the production of aortoiliac atherosclerosis in rabbits and reports the morphologic changes after transluminal angioplasty of stenotic arterial lesions. Atherosclerotic lesions were evaluated angiographically before and after transluminal angioplasty and were studied histologically and by electron microscopy after angioplasty. Moderatley stenotic aortic segments showed denudation of endothelial cells and deposition of a carpet of platelets enmeshed in fibrin. Medial and intimal compression were not seen. Intimal plaque disruption and splitting of atheromatous plaques were observed in more stenotic vessels where dilatation during angioplasty is relatively greater. Transluminal angioplasty, therefore, acutely causes desquamation of endothelial cells and superficial plaque elements, splitting of atheroma and subsequent deposition of platelets and fibrin in the area of angioplasty. This experimental model may be useful to evaluate the morphologic changes after angioplasty and might be used in further studies to determine the long-term pathophysiologic changes after transluminal angioplasty.

摘要

狭窄性动脉粥样硬化冠状动脉腔内血管成形术的形态学后果尚不清楚。本研究描述了兔腹主动脉髂动脉粥样硬化的形成,并报告了狭窄性动脉病变腔内血管成形术后的形态学变化。在腔内血管成形术前和术后通过血管造影评估动脉粥样硬化病变,并在血管成形术后进行组织学和电子显微镜研究。中度狭窄的主动脉段显示内皮细胞剥脱和由纤维蛋白包绕的血小板毯状沉积。未见中膜和内膜受压。在血管成形术中扩张相对较大的更狭窄血管中观察到内膜斑块破裂和动脉粥样硬化斑块裂开。因此,腔内血管成形术可急性导致内皮细胞和浅表斑块成分剥脱、动脉粥样硬化裂开以及随后血小板和纤维蛋白在血管成形术区域沉积。该实验模型可能有助于评估血管成形术后的形态学变化,并可用于进一步研究以确定腔内血管成形术后的长期病理生理变化。

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