Ammar A D, Mullins J R
Department of Surgery, University of Kansas School of Medicine, Wichita.
Cardiovasc Surg. 1993 Dec;1(6):717-9.
Stroke is an important source of morbidity and mortality in the USA. Carotid occlusive disease is associated with most cerebrovascular accidents, and carotid artery intraplaque hemorrhage is particularly important in the pathogenesis of cerebral ischemic symptoms. The authors' experience with intraplaque hemorrhage in patients undergoing bilateral carotid endarterectomy was reviewed to determine whether unilateral intraplaque hemorrhage is predictive of the condition occurring on the contralateral side. Forty-seven patients underwent staged bilateral carotid endarterectomy performed by one vascular surgeon. Each plaque was reviewed by a pathologist for the presence of intraplaque hemorrhage. Of these patients, 33 demonstrated intraplaque hemorrhage on the side of initial endarterectomy; 27 of these 33 (82%) had bilateral hemorrhage. It was concluded that intraplaque hemorrhage in the initially operated carotid atheroma is highly predictive of the condition occurring in the contralateral atheroma. Furthermore, aggressive follow-up in this patient population may be warranted.
在美国，中风是发病和死亡的重要原因。颈动脉闭塞性疾病与大多数脑血管意外相关，而颈动脉斑块内出血在脑缺血症状的发病机制中尤为重要。回顾了作者对接受双侧颈动脉内膜切除术患者的斑块内出血情况的经验，以确定单侧斑块内出血是否可预测对侧发生同样情况。47例患者由一位血管外科医生分阶段进行双侧颈动脉内膜切除术。每位病理学家对每个斑块进行检查，以确定是否存在斑块内出血。在这些患者中，33例在初次内膜切除术一侧出现斑块内出血；这33例中的27例（82%）双侧都有出血。得出的结论是，初次手术的颈动脉粥样硬化斑块内出血高度可预测对侧粥样硬化斑块出现同样情况。此外，对这一患者群体进行积极随访可能是必要的。
