中国脑血管病杂志2012，Vol.9Issue(5)：238-242,5.DOI:10.3969/j.issn.1672-5921.2012.05.004
对侧颈动脉闭塞对颈动脉内膜切除术围手术期疗效的影响
Effect of contralateral carotid occlusion on perioperative efficacy of carotid endarterectomy
摘要
Abstract
Objective To investigate the effect of contralateral carotid occlusion on perioperative efficacy of carotid endarterectomy ( CEA ). Methods The clinical data of 296 patients with carotid stenosis performed unilateral CEA in Xuanwu Hospital from January 2000 to September 2011 were analyzed retrospectively. They were divided into either a contralateral occlusion group ( n = 17 ) or a non-occlusion group ( n =279 ) according to whether they had contralateral carotid occlusion or not. The intraoperative shunting application and the efficacy within 30 days after surgery in both groups were analyzed. Results ①The intraoperative shunting application rate in the contralateral occlusion group was 47. 1% ( 8/17 ), and it was higher than 18.3% ( 51/279 ) in the non-contralateral occlusion group ( P =0. 010 ). ②Among the 8 patients who used shunting in the contralateral occlusion group, 4 ( 4/8 ) had anterior communicating artery patent; among the 9 patients without using shunting, 2 ( 2/9 ) had anterior communicating artery patent ( P = 0.335 ). Among the patients who used shunting, 3 ( 3/8 ) had posterior communicating artery patent, and among the patients who did not use shunting, 9 ( 9/9 ) had posterior communicating artery patent ( P = 0. 009 ). ③Of the 279 patients in the contralateral non-occlusion group, the postoperative stroke rate at day30 was 3.2% ( 9/279 ); the mortality was 1. 4%( 4/279 ). Brain nerve damage and cardiac complications were 3.6% ( 10/279 ) respectively; in addition to 2 ( 11.8% ) had cardiac complications, no other complications occurred in the contralateral occlusion group, but there were no significant differences in complications and mortality in both groups. Conclusion In patients complicating with contralateral carotid occlusion, CEA may increase the rate of shunting application, especially in patients with patent posterior communicating artery, however, it does not increase the risks of perioperative complications and mortality.关键词
颈动脉狭窄/颈动脉内膜切除术/对侧颈动脉闭塞/治疗结果Key words
Carotid stenosis/ E nd art e recto my, carotid/ Contralateral carotid occlusion/ Treatment outcome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..对侧颈动脉闭塞对颈动脉内膜切除术围手术期疗效的影响[J].中国脑血管病杂志,2012,9(5):238-242,5.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) （2007A078）
