| Disease | THE AIM OF THIS STUDY WAS TO EVALUATE WHETHER TTFCA (TOTAL TRITERPENIC FRACTION OF CENTELLA ASIATICA), WAS EFFECTIVE, BY MODULATING COLLAGEN PRODUCTION, IN A PERIOD OF 12 MONTHS, INCREASING THE ECHOGENICITY OF ECHOLUCENT PLAQUES AT THE FEMORAL
BIFRUCATIO. HYPOECHOIC ATHEROSCLEROTIC PLAQUES HAVE BEEN FOUND TO BE ASSOCIATED WITH AN INCREASED EVIDENCE OF CEREBROVASCULAR EVENTS. IN THIS TYPE OF PLAQUES STROMAL COMPOSITION IS LIMITED AS THE COLLAGEN COMPONENT IS GENERALLY VERY LOW; THE
PLAQUES COMPOSITIONIS MAINLY DUE TO LIPID ACCUMULATION OR THROMOBOSIS. THE AIM OF THIS STUDY WAS THE EVALUATION OF ECHOGENICITY OF HYPERECHOIC PLQUES AND HOW IT COULD BE MODIFIED BY A DRUG ACTING ON THE MODULATION OF COLLAGEN SYNTHESIS.
ANTIPLATELET AGENTS WERE USED IN ALL PATIENTS; CHOLESTEROL-LOWERING AGENTS WERE USED IN 34% OF PATIENTS IN THE TREATMENT GROUP AND IN 36% IN THE PLACEBO GROUP. TTFCA WAS USED AT THE DOSE OF 60 MG THRICE DAILY (ORAL TABLETS). OF THE 60 INCLUDED
SUBJECTS 26 COMPLETED THE STUDY IN THE TREATMENT GOUP AND 24 IN THE PLACEBO GROUP. AT INCLUSION THE AVERAGE GMS IN THE TREATMENT GROUP WAS 14 (SD 3) AND 14.3 (SD3) IN CONTROLS. AT 12 MONTHS AT GMS WAS INCREASED UP TO 22.8 (SD.4) IN THE TREATMENT
GROUP AND IT WAS 15 (SD3) IN CONTROLS CONSIDERING TEXTURE NO SIGNIFICANT CHANGES WERE OBSERVED IN CONTROLS WHILE A QUALITATIVE INCREASE IN HOMOGENICITY WAS OBSERVED IN THE TTFCA GROUP. PLAQUE SIZE MEASURED AT THE BEGINNING AND AT THE END OF THE
STUDY SHOWED A MEDIAN INCREASE IN SIZE, IN CONTROLS (23%; RANGE 0%-44%); IT WAS UNCHANGED IN THE TTFCA GROUP (VARIATION 7%, 4%-26%). IN CONCULSION IN THE TREATMENT GROUP PLAQUES INCREASED IN ECHOGENICITY AND IN HOMOGENICITY; SIZE AND STENOSIS
REMAINED UNCHANGED. MODULATING THE SCARRING PROCESS WITHIN ECHOLUCENT PLAQUES (LOW ECHOGENICITY, HIGH ECHOLUENCY, WITH A VERY LOW COLLAGEN/STROMA COMPONENT), POSSIBLY BY COLLAGEN MODULATION, MAKES PLAQUES MORE STABLE. THIS AS BEEN ACHIEVED AND
DOCUMENTED IN THE PRESENT STUDY BY AN INCRREAS IN THE GRAY-SCALE MEDIAN (PLAUES BECOMES MORE ECHOGENIC, MORE 'WHITE'). THE VARIATION IN GSM IS GENERALLY ASSOCIATED WITH A LOW RISK OF WALL THROMBOSIS, RUPTURE AND EMBOLIZATION. THESE OBSERVATIONS
INDICATE A POSITIVE ACTION OF TTFCA ON THE STABILIZATION OF HYPOECHOIC, LOW-DENSITY FEMORAL PLAUES. |