Pintér László, Cagiannos Catherine, Bakoyiannis Chris N, Kolvenbach Ralf
Department of Vascular Surgery and Endovascular Interventions, Augusta Hospital, Amalien Strasse 9, 40472 Düsseldorf, Germany.
J Vasc Surg. 2007 Jul;46(1):135-9. doi: 10.1016/j.jvs.2007.01.062.
Symptomatic occlusion of the common carotid artery with preserved circulation in the internal carotid artery is an uncommon occurrence. We describe a hybrid technique whereby a patient was treated with eversion carotid bifurcation endarterectomy, fluoroscopically guided retrograde ring-stripper common carotid endarterectomy, and stenting of residual stenosis in the disobliterated artery. Successful recanalization was achieved without adverse anatomic or neurologic sequelae. The patient remains asymptomatic with a radiographically patent reconstruction at 1 year. This combination of endovascular and open surgery enables the surgeon to address long occlusions of the common carotid arteries with control of the distal and proximal endarterectomy margins and obviates the need for general anesthesia or sternotomy.
颈总动脉出现症状性闭塞但颈内动脉循环保留的情况并不常见。我们描述了一种混合技术，通过该技术对一名患者进行了外翻式颈动脉分叉内膜切除术、透视引导下逆行环形剥脱器颈总动脉内膜切除术以及对未再通动脉的残余狭窄进行支架置入术。成功实现了再通，且未出现不良的解剖或神经后遗症。患者在1年时仍无症状，影像学检查显示重建血管通畅。这种血管内手术与开放手术相结合的方式使外科医生能够处理颈总动脉的长段闭塞，同时控制远端和近端内膜切除术边缘，并且无需全身麻醉或开胸手术。
