Bredenberg C E, Iannettoni M, Rosenbloom M, Hodge C J, Litvin G K, Aust J C, Cacayorin E
Department of Surgery, State University of New York Health Science Center, Syracuse 13210.
J Vasc Surg. 1989 Apr;9(4):530-4. doi: 10.1067/mva.1989.vs0090530.
Fifty patients who had carotid bifurcation endarterectomy as their sole surgical procedure underwent intraoperative completion angiography by means of portable intraarterial digital subtraction angiography. All had subsequent intravenous digital subtraction angiography or duplex scanning during early follow-up. After the endarterectomy site was closed and before the wound was closed, 6 to 8 ml of contrast was injected through a 21-gauge needle while fluoroscopy was performed with a conventional C-arm. The C-arm was coupled to a Quantel IDIS Mobile Digital Subtraction Angiogram Unit (Quantel Medical Products Group, Clemmons, N.C.) for image enhancement and immediate playback. There were no postoperative deaths or neurologic complications. Abnormal radiographic results led to reopening of endarterectomy sites in eight patients, which resulted in successful correction of the defects. There was a single asymptomatic occlusion of the internal carotid artery at 3 weeks in the patient with the only false-negative result on the completion study. Intraarterial digital subtraction angiography is a safe and useful technique for intraoperative quality control of carotid endarterectomy. It provides visual images that can be easily repeated in several projections, uses small volumes of contrast, and has no timing requirements for filming and injecting.
五十名仅接受颈动脉分叉内膜切除术这一外科手术的患者，通过便携式动脉内数字减影血管造影术进行了术中造影检查。所有患者在早期随访期间均接受了后续的静脉数字减影血管造影术或双功超声扫描。在完成内膜切除部位的缝合但伤口尚未缝合时，通过一根21号针头注入6至8毫升造影剂，同时使用传统的C型臂进行荧光透视检查。C型臂与Quantel IDIS移动数字减影血管造影装置（Quantel医疗产品集团，北卡罗来纳州克莱蒙斯）相连，用于图像增强和即时回放。术后无死亡病例或神经并发症。影像学检查结果异常导致八名患者的内膜切除部位重新打开，从而成功纠正了缺陷。在完成检查中唯一出现假阴性结果的患者中，术后3周出现了一例无症状的颈内动脉闭塞。动脉内数字减影血管造影术是一种用于颈动脉内膜切除术术中质量控制的安全且有用的技术。它提供的可视图像可以在多个投影中轻松重复，使用少量造影剂，并且对拍摄和注射没有时间要求。
