Determination of barometric criteria for rupture of atherosclerotic plaques in the brachiocephalic arteries

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The sequence of determining determination of the critical value of blood pressure for the occurrence of dissection of atherosclerotic intima of the internal carotid artery according to the experimental study. Atherosclerotic lesion of the brachiocephalic arteries was modeled on a vascular silicone phantom of the carotid arteries, in which the surgical material (intact annular area of atherosclerotic intima with plaque), obtained after eversion endarterectomy in a patient with atherosclerotic lesions, was placed and fixed in the region of the mouth of the internal carotid artery. A total of 30 models were created. To determine the critical values of the pressure on the intima with the plaque, at which it ruptures, balloon catheters were used, controlling the pressure with a manometer. The results were compared with the preoperative data of ultrasound and computed tomography examinations of patients. Dissection of the intima in the area of the plaque occurred in 6 cases at a pressure of 150–180 mm Hg; in 9 cases at 180–200 mm Hg, in 3 cases at a pressure of more than 200 mmHg, in 12 when exposed to more than 300 mm Hg. All patients, whose intima ruptured at a pressure of less than 200 mm Hg, had a fluid component of the plaque on preoperative examination, and in 6 patients, the critical pressure on the plaque was 150 mm Hg., there was also a thinned "cover" of the plaque. In the rest of the cases, the plaques were stable without a liquid component. Dissection of the intima in these cases did not occur when the exposure value was more than 300 mm Hg. The presence of a fluid component in an atherosclerotic plaque of the carotid artery in combination with a thinned «cover» of the plaque indicates the extreme danger of its destruction and embolism during a hypertensive crisis. The degree of stenosis of the carotid artery was found to be a less significant risk factor for unstable plaque rupture than the presence of a fluid component.

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作者简介

Dmitriy Maistrenko

A.M. Granov Russian research center for radiology and surgical technologies

编辑信件的主要联系方式.
Email: dn_maystrenko@rrcrst.ru
ORCID iD: 0000-0001-8174-7461
SPIN 代码: 7363-4840
Scopus 作者 ID: 57193120885
Researcher ID: AAA-9446-2020

doctor of medical sciences, Director

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Alexander Ivanov

A.M. Granov Russian research center for radiology and surgical technologies

Email: as_ivanov@rrcrst.ru
ORCID iD: 0000-0003-3357-5022

candidate of medical sciences

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Mikhail Generalov

A.M. Granov Russian research center for radiology and surgical technologies

Email: mi_generalov@rrcrst.ru
ORCID iD: 0000-0001-8980-5240

candidate of medical sciences

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Dmitry Nikolaev

A.M. Granov Russian research center for radiology and surgical technologies

Email: dn_nikolaev@rrcrst.ru
ORCID iD: 0000-0003-0501-7007

candidate of medical sciences

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Andrey Stanzhevsky

A.M. Granov Russian research center for radiology and surgical technologies

Email: aa_stangevsky@rrcrst.ru
ORCID iD: 0000-0002-1630-0564

doctor of medical sciences

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Oleg Molchanov

A.M. Granov Russian research center for radiology and surgical technologies

Email: oe_moltchanov@rrcrst.ru
ORCID iD: 0000-0003-3882-1720

doctor of medical science

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Anna Oleshuk

A.M. Granov Russian research center for radiology and surgical technologies

Email: an_oleschuk@rrcrst.ru
ORCID iD: 0000-0002-8437-1081

cardiovascular surgeon

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Denis Kokorin

A.M. Granov Russian research center for radiology and surgical technologies

Email: dm_kokorin@rrcrst.ru
ORCID iD: 0000-0002-4842-7711

doctor for X-ray endovascular diagnostics and treatment

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Alexey Maystrenko

A.M. Granov Russian research center for radiology and surgical technologies

Email: ad_maystrenko@rrcrst.ru
ORCID iD: 0000-0003-0335-4712

candidate of medical sciences

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Aleksey Soloviev

A.M. Granov Russian research center for radiology and surgical technologies

Email: av_soloviev@rrcrst.ru

candidate of medical sciences

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Arsen Chegemov

Vsevolozhsk Inter-District Clinical Hospital

Email: 4egemov@mail.ru
ORCID iD: 0000-0001-5074-1286

cardiovascular surgeon

俄罗斯联邦, Vsevolozhsk

Aleksandr Stepanov

A.M. Granov Russian research center for radiology and surgical technologies

Email: aa_stepanov@rrcrst.ru
ORCID iD: 0000-0003-1613-1892

leading engineer

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

Semyon Eshchik

A.M. Granov Russian research center for radiology and surgical technologies

Email: sm_eschik@rrcrst.ru
ORCID iD: 0000-0003-0945-3383

engineer

俄罗斯联邦, 197758, Saint Petersburg, Pesochnyi village, Leningradskaya street, 70

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版权所有 © Maistrenko D.N., Ivanov A.S., Generalov M.I., Nikolaev D.N., Stanzhevsky A.A., Molchanov O.E., Oleshuk A.N., Kokorin D.M., Maystrenko A.D., Soloviev A.V., Chegemov A.A., Stepanov A.A., Eshchik S.M., 2021

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