Berni A, Cavaiola S, Mele R, Tombesi T, Custureri F, D'Andrea V, Marchesi M, Tromba L
Istituto III Clinica Chirurgica, Università degli Studi di Roma, La Sapienza.
Minerva Cardioangiol. 1996 May;44(5):247-55.
The authors briefly report their experience regarding the opportunities offered by the use of current ultrasound methods in carotid surgery. They describe: a system for the quantification of athcromasic plaque used to monitor non-operated patients over time; ultrasound methods used to analyse the carotid wall to establish whether it can be utilised as an index of vascular aggression in hypertension, diabetes and atherosclerosis; the use of transcranial Doppler; criteria for the definition of high risk plaque; the applications of eco-color Doppler. The paper also illustrates a new pathology identified by the authors, defined as primary intimal fibrous hyperplasia, and the evolution of the carotid wall after endarterectomy. The structural characteristics of primary hyperplasia can only be shown using ultrasound given that arteriography cannot distinguish it from atheromatic stenosis. After endarterectomy the carotid wall is subject to hematic and hemodynamic stimuli which determine the type of evolution of the wall itself. The authors therefore examine the myointimal reaction, myointimal hyperplasia, early restenosis and late restenosis as different facets of the same phenomenon.
作者简要报告了他们在颈动脉手术中使用当前超声方法所带来的机遇方面的经验。他们描述了：一种用于量化动脉粥样硬化斑块的系统，用于长期监测未接受手术的患者；用于分析颈动脉壁以确定其是否可作为高血压、糖尿病和动脉粥样硬化中血管侵袭指标的超声方法；经颅多普勒的使用；高危斑块的定义标准；彩色多普勒超声的应用。该论文还阐述了作者发现的一种新病理，定义为原发性内膜纤维增生，以及内膜切除术后颈动脉壁的演变。原发性增生的结构特征只能通过超声显示，因为动脉造影无法将其与动脉粥样硬化狭窄区分开来。内膜切除术后，颈动脉壁受到血液和血流动力学刺激，这些刺激决定了壁本身的演变类型。因此，作者将肌内膜反应、肌内膜增生、早期再狭窄和晚期再狭窄视为同一现象的不同方面进行研究。
