Long Anne, Lepoutre Agnès, Corbillon Emmanuel, Branchereau Alain, Kretz Jean-Georges
Service de Radiologie Cardiovasculaire, Hôpital Européen George Pompidou, Paris, France.
Ann Vasc Surg. 2002 May;16(3):261-5. doi: 10.1007/s10016-001-0228-z. Epub 2002 May 23.
A survey of the 382 members of the Société de Chirurgie Vasculaire de Langue Française was conducted to determine preferred imaging techniques for preoperative assessment of the proximal internal carotid artery. A total of 180 questionnaires were returned concerning 9390 carotid stenoses treated in the year 2000. Doppler ultrasound (DUS), angiography, magnetic resonance angiography (MRA), and computed tomography angiography (CTA) were routinely used in 99%, 51.5%, 4%, and 3% of cases. Usual work-up methods involved DUS and angiography in 64% of cases, DUS and MRA in 7%, and DUS and CTA in 4% of cases. Indications for endarterectomy were based on DUS and angiography findings in 69% of cases, on DUS and MRA findings in 14%, on DUS and CTA findings in 9%, and on DUS findings alone in 8%. In-house access to CTA or MRA was more frequent at state-run institutions (p = 0.00001). Indication of endarterectomy based on DUS and MRA was more common at institutions equipped with technical facilities for MRA (21% vs. 8%; p = 0.001). An inverse correlation was observed between the number of carotid artery procedures performed and use of DUS and angiography work-up. The number of carotid endarterectomies without angiography is increasing in France. Preoperative DUS is still routinely used. Combined DUS and MRA is the preferred work-up for endarterectomy without angiography. Lack of access to MRA is still a limiting factor. Further study will be needed to evaluate the benefits and risks of endarterectomy without angiography.
对法国血管外科学会的382名成员进行了一项调查，以确定用于颈内动脉近端术前评估的首选成像技术。共收回了180份问卷，涉及2000年治疗的9390例颈动脉狭窄。在99%、51.5%、4%和3%的病例中，常规使用多普勒超声（DUS）、血管造影、磁共振血管造影（MRA）和计算机断层血管造影（CTA）。64%的病例中常用的检查方法包括DUS和血管造影，7%的病例中是DUS和MRA，4%的病例中是DUS和CTA。69%的病例中，内膜切除术的指征基于DUS和血管造影结果，14%基于DUS和MRA结果，9%基于DUS和CTA结果，8%仅基于DUS结果。国立机构更常能内部使用CTA或MRA（p = 0.00001）。在配备了MRA技术设备的机构中，基于DUS和MRA的内膜切除术指征更为常见（21%对8%；p = 0.001）。观察到颈动脉手术的数量与DUS和血管造影检查的使用之间存在负相关。在法国，不进行血管造影的颈动脉内膜切除术数量正在增加。术前仍常规使用DUS。联合DUS和MRA是无血管造影内膜切除术的首选检查方法。无法使用MRA仍然是一个限制因素。需要进一步研究来评估无血管造影内膜切除术的益处和风险。
