Iversen T, Vea H, Sørlie D, Joakimsen O
Ortopedisk avdeling, Regionsykehuset i Tromsø.
Tidsskr Nor Laegeforen. 1991 Aug 10;111(18):2253-5.
227 patients underwent 259 carotid endarterectomies because of transitory ischemic attacks (TIA). All had a 50% or more carotid lumen reduction as revealed by angiography, and symptoms from the arteriosclerotic lesion. Surgical mortality/morbidity at 30 days was 2.6%. 5.3 years after the operation (1 month-13 years) the probability of stroke was 4.9%, which corresponds to a postendarerectomy stroke rate of 1% per year. The procedure may be of value if the rate of surgical complication is very low, but the net effect still depends upon the occurrence of other vascular complications during the follow-up period. The incidence of vascular diseases in this series of seriously affected arteriosclerotics was higher than in a matched normal population, and mortality was much higher. At present a somewhat restrictive indication for surgery seems justified.
227例患者因短暂性脑缺血发作（TIA）接受了259次颈动脉内膜切除术。血管造影显示，所有患者的颈动脉管腔狭窄均达50%或以上，且均有动脉硬化病变引起的症状。30天的手术死亡率/发病率为2.6%。术后5.3年（1个月至13年），中风概率为4.9%，相当于每年颈动脉内膜切除术后中风发生率为1%。如果手术并发症发生率非常低，该手术可能具有价值，但最终效果仍取决于随访期间其他血管并发症的发生情况。在这组严重动脉硬化患者中，血管疾病的发生率高于匹配的正常人群，死亡率也高得多。目前，手术指征似乎应有所限制。
