中国脑血管病杂志Issue(8)：407-410,4.DOI:11.3969/j.issn.1672-5921.2014.08.004
颈动脉内膜切除术治疗颈动脉次全或完全闭塞的术后再通超声评估
Ultrasound assessment of recanalization after carotid endarterectomy for the treatment of subtotal or complete occlusion of carotid artery
摘要
Abstract
Objective To evaluate the short-term and long-term effects in patients of carotid artery subtotal or complete occlusion after carotid endarterectomy ( CEA) using vascular ultrasound. Methods A total of 107 consecutive patients were diagnosed as carotid artery occlusive disease with DSA and treated with CEA at Beijing Xuanwu Hospital,Capital Medical University from January 2005 to January 2014 were enrolled retrospectively. Sixty-three of them had subtotal occlusion ( the carotid artery stenosis rate 95% to 99%) and 44 had complete occlusion. The occurrence of perioperative complications of all patients was documented. The follow-up study used outpatient follow-up and telephone tracking. The patients of surgical recanalization were followed up with ultrasound at 1 week, 3, 6, 12, and 24 months after procedure. The clinical prognosis, restenosis, vascular structure and hemodynamic changes of the patients after CEA were documented. Results (1) Of the 107 patients,86 (80. 4%) achieved recanalization after procedure and 21 (19. 6%) did not. The incidence of stroke and death was 4. 7% (5 cases) within 30 days after procedure,among them the incidence of subtotal occlusion group was 4. 8% ( n=3 cases) and the complete occlusion group was 4. 5% (2 cases). (2) Within one week after procedure,the peak systolic velocity ( PSV) ,end diastolic velocity ( EDV) ,and pulsatility index ( PI) of the ipsilateral middle cerebral artery in the recanalization patients increased significantly (120 ± 39 cm/s vs 60 ± 17 cm/s,50 ± 18 cm/s vs 33±11cm/s,and0.96±0.20vs0.67±0.14,respectively).Thereweresignificantdifferences(allP<0. 01). Carotid artery ultrasound showed that the local vessel diameters of the original lesions in the recanalization patients were widened as compared with preoperation (4. 4 ± 1. 1 and 3. 6 ± 1. 0 mm). There was significant difference (P<0. 01). (3) Sixty-nine patients with recanalization were followed up for 1 to 60 months( the median time was 12 months) . One to six months after procedure,the patency rate of the patients was 95. 6%(n=66),>6 to 12 months was 94. 2%(n=65),>12 to 24 months was 94. 2%(n=65),and more than 2 years was 91. 3%(n=63). Conclusion Vascular ultrasound can conduct short-term and long-term follow-up for carotid artery occlusive disease after CEA. The degree of blood flow improvement should be identified and restenosis should be found in time after procedure.关键词
颈动脉疾病/颈动脉狭窄/颈动脉内膜切除术/术后随访Key words
Carotid artery disease/Carotid artery stenosis/Carotid endarterectomy/Post-operation follow-up引用本文复制引用
刘玉梅,王力力,凌晨,段春,周瑛华,贾凌云,焦力群,华扬..颈动脉内膜切除术治疗颈动脉次全或完全闭塞的术后再通超声评估[J].中国脑血管病杂志,2014,(8):407-410,4.基金项目
首发专项基金课题(303-01-005-0077) （303-01-005-0077）
