Magee T R, Earnshaw J J, Cole S E, Hayward J K, Baird R N, Horrocks M
Vascular Studies Unit, Bristol Royal Infirmary.
Ann R Coll Surg Engl. 1992 Nov;74(6):430-3.
BIPAS, a computerised vascular audit has been used to analyse the results of 203 carotid endarterectomies performed over a 5-year period in a vascular unit. In addition, all but two patients have been followed up with regular duplex scans. The indications and surgical techniques have remained similar over the study period though preoperative carotid arteriography is no longer considered essential and intraoperative monitoring with transcranial Doppler insonation is becoming routine. There were six perioperative deaths and 20 postoperative neurological defects. However, only three survivors had any long-term disability. It was not possible to identify any particular patients at high risk of perioperative stroke, although simultaneous major surgery and significant bilateral carotid endarterectomy seemed to be more hazardous. Routine follow-up using duplex scanning identified patients with late occlusion (5%) and restenosis (8%), but only three patients (1.5%) suffered a late stroke. Once the perioperative hazards of death and permanent stroke (4.4% in this series) have been overcome, carotid endarterectomy provides good protection against subsequent stroke.
BIPAS是一种计算机化血管审计工具，已用于分析在一个血管科5年期间进行的203例颈动脉内膜切除术的结果。此外，除两名患者外，所有患者均接受了定期双功扫描随访。在研究期间，手术适应症和技术保持相似，尽管术前颈动脉造影不再被认为是必不可少的，并且术中经颅多普勒超声监测正变得常规化。围手术期有6例死亡和20例术后神经功能缺损。然而，只有3名幸存者有任何长期残疾。虽然同期进行大手术和双侧颈动脉内膜切除术似乎更具危险性，但无法确定任何围手术期中风高危的特定患者。使用双功扫描进行的常规随访发现了晚期闭塞（5%）和再狭窄（8%）的患者，但只有3名患者（1.5%）发生了晚期中风。一旦克服了围手术期死亡和永久性中风的风险（本系列中为4.4%），颈动脉内膜切除术可为后续中风提供良好的预防作用。
