Shoĭkhet Ya N, Khorev N G, Kulikova N I, Beller A V, Kulikov V P, Miller V E
Faculty Surgery, Altai State Medical University, Russia.
Angiol Sosud Khir. 2010;16(1):89-98.
The present study enrolling a total of eighty-eight 4-to-16-year-old children and adolescents was aimed at detailed elaboration and formalization of clinical signs of the internal carotid artery pathological kinking syndrome. To achieve these objectives, the authors carried out a comparative analysis of clinical manifestations of the disease in the surgically treated subjects (constituting the Surgery Group comprising 43 children and adolescents) and non-operated patients (making up the Comparison Group consisting of 45 age- and gender-matched subjects). There were no baseline differences in the incidence rate of clinical syndromes and symptoms between the groups of the would-be operated and conservatively treated patients. Also studied were the remote outcomes (1-to-12-year follow up) of surgical correction for pathological tortuosity of the internal carotid artery. The incidence rate of regression of neurological symptomatology along different clinical signs after surgery was shown to vary within a wide range from 11.6% to 96.3%. Resection of the proximal portion of the internal carotid artery with re-implantation into the old ostium turned out to be clinically effective in 90.0% of cases, with the haemodynamic efficacy amounting to 83.3%. Arteriolysis of the internal carotid artery rendered a clinical effect in 75% of cases, with a haemodynamical effect thereof equalling 25.0%. The decision as to the type of a surgical intervention to perform was primarily made based on the findings of angiography of the internal carotid artery. The operation of arteriolysis did not lead to deterioration of the child's condition.
本研究共纳入88名4至16岁的儿童和青少年，旨在详细阐述和规范颈内动脉病理性扭曲综合征的临床体征。为实现这些目标，作者对接受手术治疗的受试者（组成手术组，共43名儿童和青少年）和未接受手术的患者（组成对照组，共45名年龄和性别匹配的受试者）的疾病临床表现进行了对比分析。拟接受手术治疗和保守治疗的患者组之间，临床综合征和症状的发生率在基线时并无差异。作者还研究了颈内动脉病理性迂曲手术矫正的远期疗效（随访1至12年）。术后不同临床体征的神经症状消退发生率在11.6%至96.3%的广泛范围内变化。颈内动脉近端部分切除并重新植入原开口在90.0%的病例中显示出临床疗效，血流动力学疗效为83.3%。颈内动脉动脉松解术在75%的病例中产生了临床效果，其血流动力学效果为25.0%。关于进行何种手术干预的决定主要基于颈内动脉血管造影的结果。动脉松解术并未导致患儿病情恶化。
