Iwasaki Motoyuki, Kuroda Satoshi, Yasuda Hiroshi, Nakayama Naoki, Saito Hisatoshi, Iwasaki Yoshinobu
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
No Shinkei Geka. 2008 Dec;36(12):1103-7.
There are few studies that describe long-term outcome of the carotid artery contralateral to carotid endarterectomy (CEA) in Japan. This study, therefore, was aimed at assessing the incidence and clinical features of patients whose contralateral carotid artery showed progression to significant stenosis (more than 70%). This study included 130 patients who underwent CEA for internal carotid artery stenosis between 1998 and 2007. During follow-up periods of a mean of 34.3 months, MR angiography or 3-dimenional CT angiography was performed every 6 or 12 months. Risk factors including hypertension, diabetes mellitus, hyperlipidemia, and coronary artery disease were also evaluated to clarify the significant predictors for disease progression of the carotid artery contralateral to CEA. The results were that, the carotid artery contralateral to CEA showed disease progression to significant stenosis (> 70%) in 12 of 130 patients (9.2%). The interval between CEA and disease progression of the carotid artery contralateral to CEA ranged from 13 to 103 months (mean, 50.7 months). Of these 9 patients underwent CEA for contralateral carotid artery stenosis to prevent ischemic stroke. Multiple logistic regression analysis revealed that there were no predictors for disease progression of the carotid artery contralateral to CEA during follow-up periods. This is the first report that has analyzed the incidence and clinical features of disease progression of the carotid artery contralateral to CEA in Japan. Its incidence is not low in Japan, and careful long-term follow-up would be essential to prevent additional stroke occurrence in patients who undergo CEA.
在日本，很少有研究描述颈动脉内膜切除术（CEA）对侧颈动脉的长期预后。因此，本研究旨在评估对侧颈动脉出现严重狭窄（超过70%）进展的患者的发病率和临床特征。本研究纳入了1998年至2007年间因颈内动脉狭窄接受CEA的130例患者。在平均34.3个月的随访期间，每6或12个月进行一次磁共振血管造影或三维CT血管造影。还评估了包括高血压、糖尿病、高脂血症和冠状动脉疾病在内的危险因素，以明确CEA对侧颈动脉疾病进展的重要预测因素。结果显示，130例患者中有12例（9.2%）CEA对侧颈动脉出现疾病进展至严重狭窄（>70%）。CEA与CEA对侧颈动脉疾病进展的间隔时间为13至103个月（平均50.7个月）。其中9例患者因对侧颈动脉狭窄接受了CEA，以预防缺血性卒中。多因素logistic回归分析显示，随访期间CEA对侧颈动脉疾病进展无预测因素。这是第一份分析日本CEA对侧颈动脉疾病进展的发病率和临床特征的报告。其发病率在日本并不低，对接受CEA的患者进行仔细的长期随访对于预防额外的卒中发生至关重要。
