M.Ing. (Electrical and Electronic Engineering) / Shunt reactors are used in power system amongst other things, to suppress overvoltages in the network during network switching, auto reclosing of transmission lines and under low loading condition of the network. Traditionally, shunt reactors of fixed type have been used and these have been permanently connected to the system. This research work investigated the feasibility of replacing the fixed shunt line reactors with a reactor, whose parameters are automatically varied depending on the system reactive power requirements, in a mature power system overlaid with high voltage lines to improve amongst, other things voltage stability. However, in a mature system overlaid with parallel higher voltage lines, power tend to flow on the matured system rather than higher voltage system as predetermined by various impedances of the power system. It is therefore desirable that loading of higher voltage lines be increased because of their higher power transfer capability and fact that higher voltage networks generate capacitive power which is substantially more than for each line at the original voltage. However, replacing a large number of fixed line reactors, at low loadings of higher voltage lines, even when system collapse is averted by increasing the number of reactors inserted into the system, overvoltage problems may still be an issue, until a certain number of must-run reactors, operating at full reactance, are put into service. If too much inductive reactance is removed from the system when the loading levels are extremely low, the power system will collapse. Therefore, there was no economic benefit in replacing all the fixed shunt line reactors with controllable type when the loading was still relatively low. Thus, the majority of the converted reactors were operating in their full rating as there was still more reactive power to be absorbed. However, when the power was diverted to flow on the higher voltage system through the use of series compensation of the higher voltage system, there was a possibility of making some fixed shunt line reactors on the higher voltage network controllable. This also allowed more power to be transferred in the higher voltage system thus improving its utilisation. Also, a positive impact on active system losses was realised.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13465号 / 論医博第2252号 / 新制||医||1055(附属図書館) / (主査)教授 伊達 洋至, 教授 小西 靖彦, 教授 山下 潤 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Vibrações mecânicas oferecem grande limitação para a produtividade, qualidade ou mesmo viabilidade das operações de usinagem, especialmente quando se trata das autoexcitadas (chatter). Neste trabalho, foram desenvolvidas estratégias que tem como objetivo diminuir a intensidade de vibrações em processos de torneamento por meio do acoplamento de material piezelétrico ao suporte de ferramenta em conjunto com uso de shunts resistivo, indutivo e resistivo-indutivo em série ou em paralelo, criando assim estruturas eletromecânicas passivamente amortecidas. Para tanto, foram construídos modelos eletromecânicos de parâmetros distribuídos para mostrar a capacidade que tais estruturas eletromecânicas possuem em oferecer um maior amortecimento quando comparadas com estruturas mecânicas convencionais. Com os modelos construídos, foi possível verificar a influência causada pela espessura da camada de material piezelétrico bem como a influência dos shunts no comportamento da estrutura, sendo constatado que camadas mais espessas aumentam a capacidade de amortecimento da estrutura e que os shunts resistivo-indutivo, tanto em série quanto em paralelo, funcionam como um amortecedor dinâmico de vibrações amortecido e oferecem o melhor desempenho. A seguir, construiu-se o diagrama de lóbulos de estabilidade para comparar as estruturas com e sem shunts e observou-se que as estruturas com shunts resistivo-indutivo possuem um melhor desempenho. Também foram executados testes de impacto (tap tests) para a verificação experimental do comportamento da estrutura quando conectadas aos shunts e os resultados mostraram que há um maior amortecimento. Considerando os resultados obtidos, acredita-se que seja possível melhorar o desempenho de processos de torneamento usando material piezelétrico. / Mechanical vibrations offer great limitation for the productivity, quality or even feasibility of the machining operations when chatter is present. In this work it was developed strategies aiming to diminish the intensity of the vibration in turning processes. By coupling a piezoelectric material with a turning tool and by using different associations of resistive and inductive shunt (series or parallel) it was created electromechanical structures passively damped. Electromechanical models of distributed parameters were developed in order to show the capacity that these structures has to offer a greater dumping when compared with conventional mechanical structures. By using these constructed models it was possible to verify the influence of the thickness of the piezoelectric material as well as the influence of shunts in the behavior of structure. It was observed that thicker layers increase the damping capacity of the structure that resistive-inductive shunt (series or parallel) works as a damped dynamic vibration absorber which offer better performance. Latter was developed a stability lobes diagram in order to compare the structures with and without shunts and it was observed that structures connected to resistiveinductive shunt has a better performance. Tap tests were performed for the purpose of study the experimental behavior of the structure connected to shunt and results showed that there is a better damping in this situation. Considering the results obtained, is fair to believe that is possible to improve turning process by using piezoelectric materials.

Vibrações mecânicas oferecem grande limitação para a produtividade, qualidade ou mesmo viabilidade das operações de usinagem, especialmente quando se trata das autoexcitadas (chatter). Neste trabalho, foram desenvolvidas estratégias que tem como objetivo diminuir a intensidade de vibrações em processos de torneamento por meio do acoplamento de material piezelétrico ao suporte de ferramenta em conjunto com uso de shunts resistivo, indutivo e resistivo-indutivo em série ou em paralelo, criando assim estruturas eletromecânicas passivamente amortecidas. Para tanto, foram construídos modelos eletromecânicos de parâmetros distribuídos para mostrar a capacidade que tais estruturas eletromecânicas possuem em oferecer um maior amortecimento quando comparadas com estruturas mecânicas convencionais. Com os modelos construídos, foi possível verificar a influência causada pela espessura da camada de material piezelétrico bem como a influência dos shunts no comportamento da estrutura, sendo constatado que camadas mais espessas aumentam a capacidade de amortecimento da estrutura e que os shunts resistivo-indutivo, tanto em série quanto em paralelo, funcionam como um amortecedor dinâmico de vibrações amortecido e oferecem o melhor desempenho. A seguir, construiu-se o diagrama de lóbulos de estabilidade para comparar as estruturas com e sem shunts e observou-se que as estruturas com shunts resistivo-indutivo possuem um melhor desempenho. Também foram executados testes de impacto (tap tests) para a verificação experimental do comportamento da estrutura quando conectadas aos shunts e os resultados mostraram que há um maior amortecimento. Considerando os resultados obtidos, acredita-se que seja possível melhorar o desempenho de processos de torneamento usando material piezelétrico. / Mechanical vibrations offer great limitation for the productivity, quality or even feasibility of the machining operations when chatter is present. In this work it was developed strategies aiming to diminish the intensity of the vibration in turning processes. By coupling a piezoelectric material with a turning tool and by using different associations of resistive and inductive shunt (series or parallel) it was created electromechanical structures passively damped. Electromechanical models of distributed parameters were developed in order to show the capacity that these structures has to offer a greater dumping when compared with conventional mechanical structures. By using these constructed models it was possible to verify the influence of the thickness of the piezoelectric material as well as the influence of shunts in the behavior of structure. It was observed that thicker layers increase the damping capacity of the structure that resistive-inductive shunt (series or parallel) works as a damped dynamic vibration absorber which offer better performance. Latter was developed a stability lobes diagram in order to compare the structures with and without shunts and it was observed that structures connected to resistiveinductive shunt has a better performance. Tap tests were performed for the purpose of study the experimental behavior of the structure connected to shunt and results showed that there is a better damping in this situation. Considering the results obtained, is fair to believe that is possible to improve turning process by using piezoelectric materials.

L’échoendoscopie thérapeutique occupe une place croissante et incontournable de l’activité médico-chirurgicale en pathologie digestive depuis le développement des sondes sectorielles. Les domaines d’application de cette technique interventionnelle mini-invasive sont de plus en plus nombreux, d’une part en pathologie biliopancréatique et entérale permettant la réalisation d’anastomoses évitant un recours à la chirurgie traditionnelle, et d’autre part en cancérologie digestive car elle permet de délivrer un agent thérapeutique, une source de rayonnement ou des cellules liées au système immunitaire dans une lésion ciblée. L’abord vasculaire est une voie récente et prometteuse de l’échoendoscopie interventionnelle offrant des perspectives thérapeutiques en hépatologie notamment dans le domaine de l’hypertension portale. Ce travail se décompose en trois parties décrivant successivement l’état de l'art des applications de l’échoendoscopie interventionnelle, puis deux travaux originaux expérimentaux : dans un premier temps, le transfert de la technique d’anastomose biliodigestive (réalisée régulièrement dans notre centre) à l’abord vasculaire portosystémique sur animal sain, puis dans un deuxième temps la validité de la technique sur modèle animal de fibrose hépatique. La première série d’expérimentations a permis de mettre au point la technique de création d’un shunt intrahépatique portosystémique par échoendoscopie chez 23 cochons sains, en collaboration avec l’équipe de radiologie vasculaire. Ces procédures ont été réalisées dans une salle de cathétérisme vasculaire expérimentale (laboratoire Caviti) dans le cadre du laboratoire d’accueil ISIT (Image Science for Interventional Techniques, Pr. L. Boyer, Pr. J.-Y. Boire, UMR CNRS/UDA 6284). Les résultats ont été concluants puisque le shunt est apparu faisable dans 91% des cas, fonctionnel dans 81% des cas avec une morbidité de 14,2%. La deuxième série d’expérimentations a permis de valider cette technique d’échoendoscopie chez un modèle porcin de fibrose hépatique par embolisation radiologique, en collaboration avec l’Institut National de Recherche Agroalimentaire de Theix pour la stabulation des animaux. Ce travail multidisciplinaire a permis une collaboration étroite entre endoscopistes, radiologues, chirurgiens viscéraux et anatomopathologistes, s’inscrivant dans une démarche de recherche transversale. Les résultats sont encourageants puisqu’un shunt intrahépatique porto-systémique par échoendoscopie s’est révélé techniquement faisable et fonctionnel sur modèle de fibrose hépatique avec une survie à 7 jours des animaux dans deux tiers des cas. Avant d’envisager une étude princeps chez l’homme, des études complémentaires sont néanmoins nécessaires sur des modèles porcins présentant une fibrose hépatique associée à une hypertension portale en augmentant la durée de stabulation, en homogénéisant la procédure de squelettisation de l’artère hépatique et en adaptant la dose de solution injectée. Cette technique pourrait constituer à terme une alternative en cas d’échec de la technique standard pour complications de l’hypertension portale (shunt intrahépatique portosystémique par voie transjugulaire) chez des patients alors en situation d’impasse thérapeutique. / Therapeutic endoscopic ultrasonography is a growing and essential part of the medical and surgical activity in digestive pathology since the development of sectoral probes. The fields of application of this minimally invasive interventional technique are more and more numerous, on the one hand in biliopancreatic and enteral pathology, allowing the realization of anastomoses without traditional surgery, and on the other hand in digestive oncology, because it makes it possible to deliver a therapeutic agent, a source of radiation or cells linked to the immune system in a targeted lesion. The vascular approach is a recent and promising way of interventional endoscopic ultrasound offering therapeutic perspectives in hepatology, especially in the field of portal hypertension.This work is divided into three parts successively describing the state of the art of the applications of interventional ultrasonoscopy, then two original experimental works: initially, the transfer of the technique of biliodigestive anastomosis (performed regularly in our center ) at the portosystemic vascular approach on healthy animal, then in a second time the validity of the animal model technique of liver fibrosis.The first series of experiments led to the development of the technique for the creation of an intrahepatic shunt portosystemic by echoendoscopy in 23 healthy pigs, in collaboration with the vascular radiology team. These procedures were performed in an experimental vascular catheterization room (Caviti laboratory) as part of the ISIT host laboratory (Image Science for Interventional Techniques, Prof. L. Boyer, Pr. J.-Y.Boire, UMR CNRS / UDA 6284). The results were conclusive since the shunt appeared feasible in 91% of cases, functional in 81% of cases with a morbidity of 14.2%. The second series of experiments validated this endoscopic ultrasound technique in a porcine model of liver fibrosis by X-ray embolization, in collaboration with Theix National Institute for Food Research for Animal Stabling. This multidisciplinary work has allowed close collaboration between endoscopists, radiologists, visceral surgeons and anatomopathologists, as part of a transversal research approach. The results are encouraging since a porto-systemic intrahepatic shunt by endoscopic ultrasonography proved to be technically feasible and functional on a hepatic fibrosis model with a 7-day survival of the animals in two-thirds of the cases. Before considering a primary study in humans, additional studies are nevertheless necessary on porcine models presenting hepatic fibrosis associated with portal hypertension by increasing the duration of stabulation, by homogenizing the procedure of skeletonization of the hepatic artery and by adjusting the dose of injected solution. This technique could eventually be an alternative in case of failure of the standard technique for complications of portal hypertension (intrahepatic portosystemic shunt transjugular) in patients then in a situation of therapeutic impasse.

Es wurden 44 Hunde mit einem kongenitalen Portosystemischen Shunt präoperativ hinsichtlich ihrer Leberzellintegrität (ALT, AP, GLDH, GGT) und ihrer hepatischen Synthese- (Harnstoff, Cholesterin, Albumin) bzw. Metabolisierungsrate (Ammoniak) untersucht. Die hepatische Durchblutungs- und Resorptionsrate wurde anhand des Verlaufs der Serumgallensäuren im Gallensäuren-Stimulationstest mit Ceruletid (0,3µg/kg KM i.v.)vor und 30 min nach Stimulation (FSBA; PSBA) beurteilt. Eine Verlaufsuntersuchung erfolgte bei den Hunden, bei denen das Shuntgefäß in zwei Operationen verschlossen worden war. Die Untersuchungen wurden jeweils prae operationem, am zweiten, vierten und siebten Tag post operationem sowie abschließend mindestens 120 Tage nach vollständigem Verschluss des Shuntgefäßes durchgeführt. Es wurden die Ergebnisse der einzelnen Untersuchungstage untereinander mit Hilfe des gepaarten t-Tests sowie mit einer Kontrollgruppe (63 lebergesunde Hunde)unter Anwendung des unpaaren t-Tests verglichen. / The hepatic enzymes: alanine aminotransferase (ALT), alkaline phosphatase (AP), glutamat dehydrogenase (GLDH), gamma-glutamyl transferase (GGT); the hepatic synthetic (urea, cholesterol, albumin) and metabolic activity (ammonia) and the hepatic blood flow (serum bile acid stimulation test) were determined in 44 dogs with congeintal portosystemic shunt and in 63 healthy dogs. After determination of fasting serum bile acids (FSBA), the gallbladder contraction was induced by administration of 0,3µg/kg iv ceruletide (Takus). Blood samples of the poststimulatin serum bile acids (PSBA) were taken 30 minutes post administration. The portosystemic shunt was first attenuated (surgery 1) and 4 weeks later completely ligated (surgery 2). All dogs treated with this surgical procedure were examined with the described laboratory design before surgery, the second, the fourth, the seventh day after surgery and approxiamtely 120 days after complete ligation in a follow up study. To compare the developmentof the biochemical and hepatic alterations the paired and unpaired t-test were used.

Submitted by Kilvya Braga (kilvyabraga@hotmail.com) on 2018-04-26T13:55:49Z No. of bitstreams: 1 ALAN GONÇALVES PAULO E SILVA - DISSERTAÇÃO (PPGEM) 2016.pdf: 4036442 bytes, checksum: 66c4a790f1155d8ce09ccc484d739542 (MD5) / Made available in DSpace on 2018-04-26T13:55:49Z (GMT). No. of bitstreams: 1 ALAN GONÇALVES PAULO E SILVA - DISSERTAÇÃO (PPGEM) 2016.pdf: 4036442 bytes, checksum: 66c4a790f1155d8ce09ccc484d739542 (MD5) Previous issue date: 2016-02-04 / Capes / A necessidade de controle ou supressão das vibrações surgiu devido aos seus efeitos danosos causados as pessoas, estruturas e elementos de máquinas. Com o passar dos anos, várias técnicas de controle foram criadas e se desenvolvem à medida que a tecnologia avança. Hoje, a utilização de materiais funcionais ou inteligentes, já é utilizada em larga escala em aplicações práticas e nas pesquisas acadêmicas dos maiores centros de tecnologia do mundo. Neste trabalho, temos como objetivo, realizar o controle de vibrações de uma estrutura com dois graus de liberdade do tipo pórtico, utilizando transdutores piezoelétricos associados a circuitos do tipo shunt de capacitância negativa com resistência elétrica em série. Para tal, utilizamos um circuito eletroeletrônico com componentes passivos (resistores, capacitores, indutores) associados a transdutores piezoelétricos QP10W, para produzirmos o circuito shunt de capacitância negativa, implementado através de Conversores de Impedância Negativa (NIC), utilizando amplificadores operacionais. As amplitudes de resposta do sistema nos domínios do tempo e frequência foram analisadas em vibração livre e em vibração forçada, utilizando os resistores que obtiveram o melhor desempenho na dissipação de energia da estrutura, que foram os de 100 Ω e de 150 kΩ. Obtivemos uma redução de 9,01 dB para o primeiro pico de frequência e de 6,95 dB para o segundo pico, em vibração livre. Para o caso de vibração forçada, obtivemos uma redução de 1,5 dB para o primeiro pico de frequência e de 2,19 dB para o segundo pico de frequência, cumprindo assim o objetivo do trabalho pretendido. / The need for control or suppression of vibrations arose due to its harmful effects caused at people, structures and machine elements. With the passage of years, various control techniques were created and develop as technology advance. Today, the use of functional or smart materials is already used on a large scale in practical applications and in academic research of the world's largest technology centers. In this work, our goal is to perform vibration control of a structure with two degrees of freedom portico type using piezoelectric transducers associated with the negative capacitance shunt circuits with electric resistance in series. To do this, we use an electroelectronics circuit with passive components (resistors, capacitors, inductors) associated with piezoelectric transducers QP10W, to produce the negative capacitance shunt circuit, implemented through Negative Impedance Converters (NIC) using operational amplifiers. Response amplitudes of the system in the domains of time and frequency were analyzed in free vibration and forced vibration using the resistors that had the best performance in energy dissipation structure, which were the 100 Ω and 150 kΩ. We obtained a reduction of 9.01 dB for the first peak frequency and 6.95 dB for the second peak in vibration free. In the case of forced vibration, we obtained a reduction of 1.5 dB for the first peak frequency and 2.19 dB for the second peak frequency, thus fulfilling the purpose of the intended work.

Esta dissertação apresenta uma análise numérica do controle de vibrações estruturais através de cerâmicas piezoelétricas em extensão e em cisalhamento conectadas a circuitos ativo-passivos compostos por resistência, indutância e fonte de tensão. Para tal, um modelo de elementos finitos de vigas sanduíche com três camadas elásticas e/ou piezoelétricas foi desenvolvido. Realizou-se também uma modelagem dos componentes do circuito elétrico e seu acoplamento à estrutura gerando assim uma equação de movimento acoplada para a estrutura com elementos piezoelétricos conectados aos circuitos elétricos. Uma análise harmônica das equações obtidas foi realizada para se obter uma avaliação preliminar dos efeitos causados pelos componentes elétricos do circuito na estrutura. Observou-se que os elementos passivos do circuito, resistência e indutância, tem não somente um efeito de absorvedor dinâmico de vibrações mas, também, promovem uma amplificação da autoridade de controle no caso de se atuar através da fonte de tensão. Usando a metodologia tradicional de projeto de absorvedores dinâmicos de vibrações, derivou-se expressões para os valores de resistência e indutância de modo a maximizar o desempenho passivo do sistema. Uma análise numérica do desempenho na redução das amplitudes de vibração em um viga engastada-livre com uma cerâmica piezoelétrica em extensão ou cisalhamento foi realizada mostrando bons resultados. Em seguida, uma análise da autoridade de controle para estas estruturas foi realizada visando a implementação de um controle híbrido ativo-passivo. A parcela ativa do controle foi obtida usando-se uma estratégia de controle por retroalimentação ótima do tipo linear quadratic regulator para calcular a tensão aplicada ao circuito. Uma comparação entre os resultados mostra que o controle híbrido ativo-passivo é sempre superior aos controles puramente ativos ou passivo para os dois casos estudados, com cerâmicas piezoelétricas em extensão e cisalhamento. / This work presents a numerical analysis of the structural vibration control using piezoelectric materials in extension and shear mode connected to active-passive electric circuits composed of the resistance, inductance and voltage source. For that, a finite element model for sandwich beams with three elastic or piezoelectric layers was developed. A modeling of the electric circuit dynamics and its coupling to the structure with piezoelectric elements was also done. A harmonic analysis of the resulting equations was performed to yield a preliminary evaluation of the effects caused by the electric circuit components on the structure. It was observed that the passive circuit components not only lead to a dynamic vibration absorber effect but also to an amplification of the control authority in case of actuation using the voltage source. Using the standard methodology for the design of dynamic vibration absorbers, expressions were derived for the resistance and inductance values that optimize the passive vibration control performance of the system. A numerical analysis of the passive vibration control was performed for cantilever beams with extension and shear piezoelectric ceramics showing satisfactory results. Then, an analysis of the control authority was carried out for the same structures aiming at an active-passive vibration control. The active control was achieved using a linear quadratic regulator optimal feedback strategy to evaluate the voltage applied to the circuit. A comparison between the obtained results show that hybrid active-passive control is always superior to the purely active or purely passive control for both cases studied, with extension and shear piezoelectric ceramics.

Este trabalho apresenta uma modelagem de placas laminadas com sensores/atuadores piezoelétricos integrados e conectados a circuitos tipo shunt resistivo-indutivo (RL). O modelo faz uso de duas teorias de placa, FSDT (First-order Shear Deformatíon Theory) e TSDT (Third-order Shear Deformatíon Theory), e considera a possibilidade de inserção de pastilhas piezoelétricas trabalhando nos modos de extensão e cisalhamento. Um modelo de elementos finitos para placas laminadas piezoelétricas, em camada equivalente (Equivalent Single Layer), foi desenvolvido usando como graus de liberdade os deslocamentos mecânicos generalizados e a carga elétrica gerada nos circuitos acoplados. Após, uma implementação computacional foi realizada e validada através de comparações com resultados encontrados na literatura. Então, foram realizados estudos para configurações de placa laminada com diferentes quantidades de pastilhas piezoelétricas através de uma análise paramétrica para obtenção das posições de maior acoplamento entre pastilhas e estrutura para os primeiros modos de vibração da placa. Estes resultados possibilitaram a otimização da eficiência do acoplamento eletromecânico através da distribuição das pastilhas piezoelétricas para uma placa com maior quantidade de pastilhas bem como a comparação dos resultados obtidos entre as duas teorias utilizadas. / This work presents the modeling of laminate plates with embedded piezoelectric sensors and actuators connected to resistive-inductive (RL) shunt circuits. The model considers two plate theories, FSDT (First-order Shear Deformation Theory) and TSDT (Third-order Shear Deformation Theory) and allows embedded piezoelectric patches in extension and thickness-shear modes. A finite element model for piezoelectric laminate plates, using equivalent single layer (ESL), was developed considering the generalized mechanical displacements and the electric charges induced in the coupled electric circuits as degrees of freedom. Then, the model was implemented and validated by means of comparisons with results found in the literature. Thereafter, some laminate plate configurations with different numbers of piezoelectric patches were studied through a parametric analysis to obtain the positions that maximize the electromechanical coupling between patches and structure for the first vibration modes. These results allowed the optimization of the electromechanical coupling efficiency through piezoelectric patches distribution for a plate with a larger number of patches and the comparison between the results obtained with the two plate theories considered.

Le traitement de référence des lésions sténosantes carotidiennes de haut grade est la chirurgie associée à un traitement médical. Nous avons mis en place depuis 2003 une base de données prospective colligeant l’ensemble des patients hospitalisés dans notre service pour prise en charge d’une lésion sténosante carotidienne d’indication chirurgicale. Depuis 2012, cette base de données cliniques s’est vue complétée par la mise en place d’une tissuthèque et d’une plasmathèque. Nous présentons ici la méthode de mise en place d’une telle base, puis les résultats de quatre études originales sur la thématique du « patient à risque » en chirurgie carotidienne, portant sur l’influence de la fonction rénale, du délai entre les symptômes et la chirurgie et du statut de l’artère carotide controlatérale sur les résultats de cette chirurgie, ainsi que la proposition d’un score pronostic d’intolérance au clampage carotidien. Nous avons montré que l’insuffisance rénale influait sur les résultats de la chirurgie carotidienne de manière différente en fonction de la méthode d’appréciation de la fonction rénale (créatinine plasmatique, clearance de la créatinine calculée selon Cockcroft-Gault ou selon la formule MDRD) ; que le statut hémodynamique de la carotide controlatérale influait sur le taux de shunt sans modifier la morbidité ; que la chirurgie précoce des sténoses carotidiennes symptomatiques n’était pas grevée d’une surmortalité ; et qu’il était possible dans une certaine mesure de prédire la nécessité de mise en place d’un shunt carotidien. Nous abordons enfin les projets à venir utilisant la collection biologique pour tenter d’identifier les plaques athéromateuses à risque / The treatment of high-grade carotid stenosis is surgery combined with best medical treatment. We established since 2003, a prospective database including all patients hospitalized in our vascular surgery department for management of carotid stenosis. Since 2012, the clinical database was completed for the establishment of a biological database. We present here the method of setting up such a database, and the results of four original studies on the theme of "high-risk patient" for carotid surgery: the influence of renal function, of the delay between symptoms and surgery and of the contralateral carotid artery on outcome and the proposal of a prognostic score of intolerance to carotid clamping. We have shown that renal failure influenced outcome of carotid surgery in different ways depending on the method of assessment of renal function (serum creatinine, creatinine clearance calculated by Cockcroft-Gault or MDRD formula) ; the hemodynamic status of the contralateral carotid affected the rate of shunt without changing morbidity; that early surgery for symptomatic carotid stenosis was not burdened with excess mortality; and that it is possible to predict the need for establishment of a carotid shunt. Finally, we discuss future projects using biological collection to try to identify atherosclerotic plaques at risk