Marshall W G, Kouchoukos N T, Murphy S F, Pelate C
Division of Cardiovascular and Thoracic Surgery, Jewish Hospital, Washington University Medical Center, St. Louis, MO 63110.
Circulation. 1988 Sep;78(3 Pt 2):I1-5.
Between July 1985 and September 1987, 25 patients underwent 26 carotid endarterectomies based on an abnormal duplex scan (B-mode ultrasonography and pulsed-Doppler sound spectral analysis) indicative of severe stenosis or ulceration. Arteriography was not performed because of severe unstable angina requiring coronary artery bypass grafting (23 patients) or patient preference (two). Twelve patients were symptomatic, and 13 were asymptomatic but had severe (greater than or equal to 75%) bilateral or unilateral carotid artery stenosis. Operative and pathological analyses confirmed the duplex-scan findings in all 25 cases. All 25 patients survived the operation. One patient had a transient ipsilateral neurological deficit, and one had a permanent contralateral neurological deficit. Five patients died of ventricular arrhythmias within 30 days of operation. Duplex scanning is an accurate method for determining the presence of clinically and hemodynamically significant carotid arterial occlusive disease. Duplex scanning also serves as an alternative method for evaluating patients for whom carotid arteriography may be associated with significant risk.
1985年7月至1987年9月期间，25例患者接受了26次颈动脉内膜切除术，这些手术基于异常的双功扫描（B型超声和脉冲多普勒声谱分析），提示严重狭窄或溃疡形成。由于严重不稳定型心绞痛需要冠状动脉搭桥术（23例患者）或患者意愿（2例），未进行动脉造影。12例患者有症状，13例无症状但有严重（大于或等于75%）双侧或单侧颈动脉狭窄。手术和病理分析证实了所有25例患者的双功扫描结果。所有25例患者均手术存活。1例患者出现短暂性同侧神经功能缺损，1例出现永久性对侧神经功能缺损。5例患者在术后30天内死于室性心律失常。双功扫描是确定临床上和血流动力学上有意义的颈动脉闭塞性疾病存在的一种准确方法。双功扫描也是评估颈动脉造影可能有重大风险的患者的一种替代方法。
