Kristensen Tatiana, Hovind Peter, Iversen Helle K, Andersen Ulrik B
Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Glostrup, Denmark.
Department of Diagnostic Imaging, Section of Clinical Physiology and Nuclear Medicine, North Zealand Hospital, Hillerod, Denmark.
Clin Physiol Funct Imaging. 2018 Jul;38(4):617-621. doi: 10.1111/cpf.12456. Epub 2017 Aug 7.
Carotid endarterectomy of symptomatic internal carotid artery stenosis in patients with stroke or transient ischaemic attack reduces the risk of recurrent stroke, particularly if performed within 2 weeks from the first event. We evaluated the efficiency of a screening programme based on Doppler ultrasound in patients hospitalized with stroke or transient ischaemic attack in the stroke centre at Rigshospitalet, Glostrup, Denmark, concerning timeliness of referral to the vascular surgeon and performance of carotid endarterectomy according to national recommendations.
Prospective study of a consecutive cohort of patients with transient ischaemic attack or stroke, referred for carotid Doppler ultrasound over a one-year period.
We examined 1390 patients (1048 with stroke, 342 with transient ischaemic attack), 71% within 24 h and 93% within 4 days after admission. Carotid stenosis or occlusion was found in 171 patients (12·3%) and was hemisphere related in 78 patients (5·6%). Among these, 68 (87%) were referred to the vascular department, 94% within 4 days of admission. Carotid endarterectomy was performed in 16 patients, all within 14 days from admission, and was not declined in any patient due to procedural delay.
In a major Danish stroke centre, the national recommended time limit of 4 days in patients with stroke or transient ischaemic attack for screening for carotid stenosis was met in almost all patients. No patients were excluded from surgery as a result of a time limit of 14 days from admission to surgery being exceeded. Of all patients screened, 1·2% underwent carotid endarterectomy.
对于患有中风或短暂性脑缺血发作的有症状颈内动脉狭窄患者，进行颈动脉内膜切除术可降低复发性中风的风险，尤其是在首次发病后2周内进行手术时。我们评估了一项基于多普勒超声的筛查计划在丹麦格罗斯楚普市里格霍斯医院卒中中心住院的中风或短暂性脑缺血发作患者中的效率，该计划涉及根据国家建议及时转诊至血管外科医生以及进行颈动脉内膜切除术的情况。
对一组连续的短暂性脑缺血发作或中风患者进行前瞻性研究，这些患者在一年时间内被转诊进行颈动脉多普勒超声检查。
我们检查了1390例患者（1048例中风患者，342例短暂性脑缺血发作患者），71%在入院后24小时内接受检查，93%在入院后4天内接受检查。171例患者（12.3%）发现有颈动脉狭窄或闭塞，其中78例（5.6%）与半球相关。在这些患者中，68例（87%）被转诊至血管科，94%在入院后4天内转诊。16例患者接受了颈动脉内膜切除术，均在入院后14天内进行，且没有任何患者因手术延迟而拒绝手术。
在丹麦的一个主要卒中中心，几乎所有中风或短暂性脑缺血发作患者都在国家建议的4天时间限制内完成了颈动脉狭窄筛查。没有患者因超过入院至手术14天的时间限制而被排除在手术之外。在所有接受筛查的患者中，1.2%接受了颈动脉内膜切除术。
