Szabo A, Brazda E, Dosa E, Apor A, Szabolcs Z, Entz L
Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary.
Eur J Vasc Endovasc Surg. 2004 May;27(5):537-9. doi: 10.1016/j.ejvs.2004.02.017.
The eversion endarterectomy of the internal carotid artery was introduced in Hungary in 1991. The aim of this study was to define the long-term restenosis rate of this procedure.
Between 1991 and 1993, 171 operations, on 151 patients, were performed by single surgeon: with long-term follow up of 109 patients, which included annual physical and ultrasound examinations. Restenosis rate and plaque morphology were defined. Survival and patency rate were analysed by life-tables.
The combined perioperative stroke morbidity and mortality rate was 0.8%. The 5-year patient survival rate was 85%, the recurrent stenosis free rate was 88% at 5 years. Only 9% of the patients had carotid restenosis of more than 70% during this period. Ultrasound plaque morphology showed calcification in one case. Two patients had re-operations, with plaque histology showed myointimal hyperplasia in each case.
Our results for restenosis are compare favourably with the 2-34% restenosis rate reported in the literature. Ultrasound and histological findings suggest that atherosclerosis does not play a significant role in the development of restenosis after the eversion carotid endarterectomy.
1991年匈牙利引入了颈内动脉外翻内膜切除术。本研究的目的是确定该手术的长期再狭窄率。
1991年至1993年间，由一名外科医生对151例患者进行了171例手术；对109例患者进行了长期随访，包括每年的体格检查和超声检查。确定再狭窄率和斑块形态。通过生命表分析生存率和通畅率。
围手术期合并卒中发病率和死亡率为0.8%。5年患者生存率为85%，5年无复发性狭窄率为88%。在此期间，只有9%的患者颈动脉再狭窄超过70%。超声斑块形态显示1例有钙化。2例患者进行了再次手术，斑块组织学检查显示每例均有肌内膜增生。
我们的再狭窄结果与文献报道的2%-34%的再狭窄率相比具有优势。超声和组织学结果表明，动脉粥样硬化在颈外翻内膜切除术后再狭窄的发生中不起重要作用。
