Relationship Between The Properties Of Carotid Plaques And The Common Risk Factors Of Its Community High-risk Population And Its Influence On Carotid Stent Implantation

PartⅠRelationship between the properties of carotid plaques and thecommon risk factors of its community high-risk populationObjectiveTo investigate the relationship between the properties of carotid plaques and thecommon risk factors of its community high-risk population.MethodsFrom January2008to August2010,277subjects from atherosclerotic high-riskpopulation in native communities underwent carotid color ultrasound examination.Univariate and multivariate analyses were used to identify the relationship between theproperities of carotid plaques (flat, soft, hard and ulcer plaque) and the common riskfactors.ResultsUnivariate analyses showed that the detection rates of flat and ulcer plaques had aincreasing trend with age. Flat plaques were detected more in the subjects more than80years old than those less than65years old (P<0.01), and ulcer plaques more in thesubjects more than80years old than in those less than80years old (P<0.05). Furthermore, the detection rates of flat plaques were decreased significantly in femalepopulation (P<0.01) as well as in hypertensive group (P<0.05). Multivariate analysesdiscovered that age was the key risk factor increasing not only carotid plaqueformation (OR=1.098, P=0.000) but also the properties of flat plaques (ORulcer=1.048, P=0.011)(ORflat=1.034, P=0.012) and. ulcer plaquesConclusionsThe properties of carotid plaques were related to the age, gender and hypertensionof the high-risk population; there are less soft plaques in female and hypertensivesubjects, more flat and ulcer plaques in the elder ones. PartⅡInfluence of the properties of carotid plaques on carotid stentimplantationObjectiveTo investigate the influence of the properties of carotid plaques on carotid stentimplantation.MethodsFrom January,2012to January,2014in our hospital,48inpatients who wererevealed up to the indication of carotid stenting by neuroimage and DSA examinationwere collected. According to the results of carotid ultrasound, the patients were dividedinto3groups: soft plaque (n=23), hard plaque (n=16) and ulcer plaque group (n=9).The changes of systolic blood pressure (SBP), diastolic blood pressur (DBP), heart rate(HR), blood oxygen saturation (BOS) and lesions on head DWI were investigatedbefore and after operation of carotid stent implantation; and both the BP and HR wereobserved as well during operationResultsWithin soft plaque group after compared with before balloon expansion, both SBP(147.03±8.78vs.133.53±10.92, t=9.98, p=0.000) and HR (81.09±7.08vs.73.55±6.81, t=7.15, p=0.000) were decreased significantly respectively, while BOS was notfound significant difference (t=1.73, p=0.09); compared with before carotid stenting,both SBP and HR were similar.Within hard plaque group after compared with before balloon expansion, SBP（152.67±9.67vs126.88±13.41, t=14.16, P=0.000）and DBP （80.01±8.61vs69.78±8.85, t=3.03, P=0.008）were respectively significantly lower; HR was alsostatistically dicreased; while BOS was similar (t=1.89, p=0.07); after compared withbefore carotid stenting. both SBP and DBP were not significantly different, while HRwas significantly decreased (84.52±6.69vs79.23±7.21, t=3.95, P=0.001). Within ulcer plaque group after balloon expansion compared with that before, HRwas significantly lower (77.75±7.01vs74.51±8.73, t=5.8, P=0.001); while theparameters of SBP, SBP and BOS were all similar, after carotid stenting compared withbefore, they were all simila.Comparison between groups, higher pressure (χ2＝27.25, P=0.000) and moretimes (χ2＝18.504，P=0.003) of balloon expansion were used in hard plaque groupthan those in both soft and ulcer plaque groups. SBP（F=35.86，P=0.000）, DBP(F=22.835，P=0.000) and HR were significantly higher in hard plaque group before andafter the balloon than those of soft and ulcer plaque group After carotid stentimplantation, the penetrating infarction accounted for11.1%, and cortical infarction was89.8%in soft plaque group, while in hard plaque group, the penetrating infarctionaccounted for66.7%, and cortical infarction was33.3%, which showed a statisticaldifference between the2groups (χ2=6.417，P=0.011).ConclusionsIn soft plaque group, the pressure and times of balloon expansion were both lessthan those in hard plaque group during balloon expansion; SBP and HR（F=14.45，P=0.001）were also significantly different between before and after balloon expansion, butno significant difference between before and after carotid stenting.In hard plaque group, the highest pressure and most times of balloon expansionwere used among3groups; BP and HR were both significantly different between beforeand after balloon expansion, but they were both similar between before and after carotidstenting.In ulcer plaque group, the lowest pressure and lest times of balloon expansion wereused among3groups during balloon expansion; and BP was similar, but HR wassignificantly different between before and after balloon expansion; and between beforeand after carotid stenting, BP and HR were both similar.After carotid stent implantation, more cortex infarction were revealed in softplaque group, and more penetrating infarction in hard plaque group.