THE USE OF ULTRASOUND TECHNOLOGIES IN THE ASSESSMENT OF ATHEROSCLEROTIC LESIONS OF THE VESSEL WALL

Retrospective analysis of data of histological and ultrasound examination of 199 fragments of arterial wall of internal carotid artery obtained during reconstructive operations was conducted. A retrospective analysis of ultrasound data and histological examination of 199 fragments of the wall of the internal carotid artery obtained during reconstructive operations has been performed. Hypoechoic area, diagnosed by ultrasound in the structure or on the surface of the plaque was shown to correspond to hemorrhage, thrombosis and/or atheromatous masses. Hyperechoic inclusions in the plaque structure morphologically correspond to calcinosis and/or cholesterol crystals. A comparison of the structural features of the atherosclerotic lesion of arterial wall with a degree of cerebral ischemia in 121 patients showed that in patients with focal neurological symptoms (IV degree of cerebral ischemia) plaques with a predominance of hypoechoic area without damaging the caps and with the prevalence of hypoechoic area in conjunction with the disintegration of the cap were revealed in 92,2% and 91% of cases , respectively, while in patients with I and III degrees of cerebral ischemia – in 44,8% and 50% of cases, that is an indication for carotid endarterectomy in the first group of patients for the prevention of the development of focal neurological symptoms. In 230 patients with atherosclerotic stenoses of the peripheral arteries (including 115 patients in the preparation, implementation and evaluation of the results of iliac artery stenting, 70 patients after endovascular intervention on the superficial femoral arteries and 45 patients before and after stenting of the mouth of the renal artery) along with angiography techniques methods of non-invasive and intravascular ultrasound scan have been used. It is shown that for the challenge of treatment there is needed precise information concerning the hemodynamic significance of the stenosis, the structure and form of the atherosclerotic plaque, the configuration of the vessel lumen. Therefore, a comprehensive intraoperative assessment of the area of stenosis, obtained by intravascular ultrasound - the presence of calcifications, lipid inclusions, the prevalence of fibrous structures, etc., helps to make the right decision on the need and choice of method of endovascular treatment, especially in the case of the development of restenosis.