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使用可吸收缝合材料进行颈内动脉重建的短期结果。

The short-term results of internal carotid reconstructions by absorbable suture material.

作者信息

Beloiartsev D F, Timina I E

机构信息

Department of Vascular Surgery, A. V. Vishnevsky Institute of Surgery, Russian Academy of Medical Sciences, Moscow, Russia.

出版信息

Angiol Sosud Khir. 2003;9(4):79-88.

Abstract

Analysis was made of the results of 11 internal carotid reconstructions using polydioxanone (PDS) sutures 6 months after intervention performed in 10 patients. All operations on the carotid bifurcation were accomplished using 5/0 PDS continuous suture. Nine eversion carotid endarterectomies and 2 internal carotid reconstructions were performed for Kinkiking. There were no neurologic complications, thromboses, bleedings or repeated operations after interventions on the brachiocephalic arteries. Six months later the patients were examined under ambulatory conditions and were provided color duplex scanning (CDS) of the reconstructed area. Measurements were made of the diameter of the common carotid artery (CCA) right beneath the anastomosis between the CCA and the internal carotid artery (ICA), of the maximal diameter of the anastomosis between the CCA and the ICA, and of the size of the proximal ICA segment right the anastomosis. During the 6-month period following surgical intervention, all 10 patients did not demonstrate any ischemic attacks (TIA) or strokes. No cases of anastomotic aneurysms were recorded. After 9 reconstructions no ICA restenoses were marked. In one case, restenosis accounted for 40% because of atherosclerosis progression and after one operation there developed asymptomatic thrombosis of the ICA. The study has demonstrated that the use of PBS absorbable suture for autoarterial ICA reconstruction provides for anastomosis integrity minimally over the period as long as 6 months.

摘要

对10例患者进行干预6个月后使用聚对二氧环己酮(PDS)缝线进行的11例颈内动脉重建结果进行了分析。所有颈动脉分叉手术均使用5/0 PDS连续缝线完成。针对扭结样病变进行了9例外翻式颈动脉内膜切除术和2例颈内动脉重建术。对头臂动脉进行干预后,未出现神经并发症、血栓形成、出血或再次手术情况。6个月后,在门诊条件下对患者进行检查,并对重建区域进行彩色双功超声扫描(CDS)。测量了颈总动脉(CCA)与颈内动脉(ICA)吻合口正下方的颈总动脉直径、颈总动脉与颈内动脉吻合口的最大直径以及吻合口近端颈内动脉段的大小。在手术干预后的6个月期间,所有10例患者均未出现任何缺血性发作(短暂性脑缺血发作)或中风。未记录到吻合口动脉瘤病例。9例重建术后未发现颈内动脉再狭窄。1例因动脉粥样硬化进展出现40%的再狭窄,1例手术后出现无症状性颈内动脉血栓形成。该研究表明,使用PBS可吸收缝线进行自体动脉颈内动脉重建,在长达6个月的时间内可使吻合口完整性达到最低限度。

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