中国脑血管病杂志2012，Vol.9Issue(5)：233-237,5.DOI:10.3969/j.issn.1672-5921.2012.05.003
颈动脉内膜切除术中转流管的应用及侧支代偿对其的影响
Effect of contralateral carotid occlusion on perioperative efficacy of carotid endarterectomy
摘要
Abstract
Objective To investigate the advantages and disadvantages of shunting during carotid endarte recto my as well as the impact of contralateral carotid occlusion and the patent of anterior and posterior communicating arteries on it. Methods A total of 308 patients who performed carotid endarte recto my from January 2000 to September 2011 were analyzed retrospectively. They were divided into shunting ( n = 63 ) and non-shunting ( n =245 ) groups. The intraoperative microemboli, postoperative stroke and mortality in both groups were compared. The degree of contralateral carotid stenosis, the opening ratios of anterior and posterior communicating arteries were compared in both groups. Its impact on shunting was analyzed. Results ①The median microemboli count was 25 in the shunting group and it was 10 in the non-shunting group. There was significant difference between the 2 groups ( P < 0. 05 ).②The incidence of ischemic events within one month after surgery: 1 patient ( 1.6% ) had stroke and 0 died in the shunting group; 6 patients ( 2. 4% ) had stroke and 4 ( 1. 6% ) died in the non-shunting group. There were no significant differences for stroke and mortality between both groups ( P > 0. 05 ). ③The degree of contralateral carotid artery stenosis before surgery: 8 patients had occlusion, 8 had severe stenosis, 47 had mild to moderate stenosis or without stenosis in the shunting group; 9 patients had occlusion, 36 had severe stenosis, and200 had mild to moderate stenosis or without stenosis in the non-shunting group. The rate of occlusion was significant differences between the 2 groups ( P <0. 05 ). Both preoperative anterior and posterior communicating arteries of 35 patients( 55. 6% ) did not open in the shunting group and 8l( 33. 1% ) did not open in the non-shunting group. There was significant difference between the 2 groups ( P <0. 05 ). Conclusion Although using shunting may increase the number of microemboli in carotid e ndarte recto my, but not increase the incidence of perioperative stroke and mortality. The patients with preoperative contralateral carotid artery occlusion or unpatented anterior and posterior communicating arteries, the proportion of using shunting is significantly higher than the other patients.关键词
颈动脉疾病/颈动脉内膜切除术/转流管Key words
Carotid artery diseases/ E ndarte recto my, carotid/ Shunting引用本文复制引用
郭锋,凌锋,张文彬,宋刚,华扬,蔡兵,谌燕飞,焦力群..颈动脉内膜切除术中转流管的应用及侧支代偿对其的影响[J].中国脑血管病杂志,2012,9(5):233-237,5.基金项目
"十二五"国家科技支撑计划(2011BAI08B04) （2011BAI08B04）
北京市科技新星计划(2007A078)100053 （2007A078）
