颈动脉手术期间的颅外血流分布。

Extracranial blood flow distribution during carotid surgery.

作者信息

Aleksic M, Brunkwall J

机构信息

Department of Vascular Surgery, University Clinic of Cologne, Cologne, Germany.

出版信息

Eur J Vasc Endovasc Surg. 2009 Nov;38(5):552-5. doi: 10.1016/j.ejvs.2009.06.023. Epub 2009 Aug 12.

DOI:10.1016/j.ejvs.2009.06.023

PMID:19679497

Abstract

OBJECTIVE

The collateral function of the external carotid artery (ECA) for cerebral perfusion in cases of atherosclerotic occlusive disease of the internal carotid artery (ICA) is difficult to assess; for this reason, blood flow measurements were taken during carotid endarterectomy (CEA).

METHODS

Blood flow was measured before and after CEA using a transit-time flow meter at the carotid artery in 1000 patients who underwent CEA for high-degree (>70%) ICA stenosis. The data were collected prospectively and analysed retrospectively.

RESULTS

Median ICA blood flow increased significantly, up 46% from 160 ml min(-1) (IQR: 100-234 ml min(-1)) before CEA to 240 ml min(-1) (IQR: 187-309 ml min(1)) after CEA (P<0.001). Median ECA blood flow dropped by 4%, from 152 ml min(-1) (IQR: 108-220 ml min(-1)) to 150 ml min(-1) (IQR: 103-200 ml min(-1)) (P=0.001). Relative ICA blood flow volumes related to common carotid artery (CCA) flow increased from 58% before CEA to 73% after CEA, whereas relative ECA flow decreased from 54% to 44%.

CONCLUSIONS

Increased blood flow in the ICA after CEA is accompanied by decreased ECA flow whereupon the absolute amount of this redistribution is relatively limited. A more profound evaluation of these haemodynamic conditions demands further study.

摘要

目的

颈内动脉（ICA）发生动脉粥样硬化闭塞性疾病时，颈外动脉（ECA）对脑灌注的侧支功能难以评估；因此，在颈动脉内膜切除术（CEA）期间进行了血流测量。

方法

使用渡越时间流量计在1000例因高度（>70%）ICA狭窄而接受CEA的患者的颈动脉处测量CEA前后的血流。数据前瞻性收集并进行回顾性分析。

结果

CEA后ICA血流中位数显著增加，从CEA前的160 ml·min⁻¹（四分位间距：100 - 234 ml·min⁻¹）增加46%至240 ml·min⁻¹（四分位间距：187 - 309 ml·min⁻¹）（P<0.001）。ECA血流中位数下降4%，从152 ml·min⁻¹（四分位间距：108 - 220 ml·min⁻¹）降至150 ml·min⁻¹（四分位间距：103 - 200 ml·min⁻¹）（P = 0.001）。与颈总动脉（CCA）血流相关的ICA相对血流量从CEA前的58%增加到CEA后的73%，而ECA相对血流量从54%降至44%。