Osman H Y, Gibbons C P
Department of Surgery, Morriston Hospital, Swansea SA6 6NL, UK.
Ann R Coll Surg Engl. 2001 May;83(3):149-53.
Technical defects are a potential cause of peri-operative strokes following carotid endarterectomy (CEA) by either the eversion technique or the standard method of longitudinal arteriotomy with or without patch closure.
A non-randomised retrospective study was undertaken to assess the value of angioscopy for the identification of technical errors following CEA and to compare those detected following eversion and standard endarterectomy with patch closure.
Intra-operative completion angioscopy was performed following 110 CEAs (56 eversion, 54 standard). Angioscopy was omitted in 5 patients because of technical problems (2) or extreme shunt dependency (3).
Significant technical defects were identified and corrected in 10 cases (9%) and were equally distributed between the eversion and standard procedures. There was no peri-operative stroke or death in this series.
Significant residual defects may occur after CEA by either technique. Angioscopy allows their correction peri-operatively and has the potential to reduce peri-operative stroke.
技术缺陷是采用外翻技术或标准纵向动脉切开术（有无补片修补）进行颈动脉内膜切除术（CEA）后围手术期卒中的一个潜在原因。
开展一项非随机回顾性研究，以评估血管内镜检查在识别CEA术后技术错误方面的价值，并比较外翻术和标准补片修补内膜切除术后检测到的技术错误。
对110例CEA手术（56例外翻术，54例标准术）进行术中完成血管内镜检查。5例患者因技术问题（2例）或严重依赖分流（3例）未进行血管内镜检查。
10例（9%）发现并纠正了明显的技术缺陷，外翻术和标准术之间分布均匀。本系列中无围手术期卒中或死亡病例。
两种技术行CEA术后均可能出现明显的残余缺陷。血管内镜检查可在围手术期进行纠正，有可能减少围手术期卒中。
