Arapoglou B, Kondi-Pafiti A, Katsenis K, Dimakakos P
Vascular Surgery Department, Medical School, University of Athens, Areteion Hospital, Greece.
Int Angiol. 1994 Dec;13(4):323-6.
The clinical picture with the pathology findings of 89 atheromatic plaques which were removed following endarterectomy of the internal carotid artery, for the purpose of determining the clinical significance of the haemorrhagic atheromatic plaque were correlated. Intraplaque haemorrhage was determined in 44 of the 57 plaques (72.2%) of symptomatic patients while in the asymptomatic patients haemorrhage was noted in 12 of the 32 plaques (37.5%) p < 0.001. The extent of haemorrhage was > 25% of the plaque thickness in 21 of 44 symptomatic plaques (47.72%) and in the asymptomatic plaques in 3 out of 12 (25%) p > 0.05. The incidence of ulceration of the intima, with or without the presence of thrombus, was more frequent in the haemorrhagic plaques (68.42%) as compared with the non-haemorrhagic (31.57%), without any significant difference between the symptomatic and asymptomatic plaques. Communication of haemorrhage with the lumen was observed in 8 of 24 plaques (33.33%), 7 of which (29.16%) were symptomatic. The presence of haemorrhage in the atheromatic plaque of the internal carotid artery does not seem to play any direct role in the pathogenesis of the symptoms but, nevertheless, it constitutes a significant indication of instability of the atheromatic plaque.
为了确定出血性动脉粥样硬化斑块的临床意义，对89个在颈内动脉内膜切除术后被切除的动脉粥样硬化斑块的病理结果与临床表现进行了相关性分析。在有症状患者的57个斑块中，有44个（72.2%）发现斑块内出血，而在无症状患者的32个斑块中，有12个（37.5%）发现出血，p<0.001。在44个有症状斑块中的21个（47.72%）以及12个无症状斑块中的3个（25%）中，出血范围超过斑块厚度的25%，p>0.05。内膜溃疡（无论有无血栓形成）在出血性斑块中的发生率（68.42%）高于非出血性斑块（31.57%），有症状和无症状斑块之间无显著差异。在24个斑块中的8个（33.33%）观察到出血与管腔相通，其中7个（29.16%）有症状。颈内动脉粥样硬化斑块中的出血似乎在症状的发病机制中不发挥任何直接作用，然而，它是动脉粥样硬化斑块不稳定的一个重要指标。
