Zuccarello M, Yeh H S, Tew J M
Department of Neurosurgery, University of Cincinnati, Ohio.
Neurosurgery. 1988 Oct;23(4):445-50. doi: 10.1227/00006123-198810000-00007.
It has been shown that carotid endarterectomy reduces the incidence of stroke in patients with symptomatic extracranial occlusive vascular disease in the absence of major perioperative complications such as stroke or death. We present a retrospective study of 106 carotid endarterectomies performed under local anesthesia in 100 patients in whom transient ischemic attack (TIA) or minor stroke had occurred. Nonfatal stroke occurred in 2%, and TIA occurred in 1%. There was no perioperative mortality. Our study suggests that, under local anesthesia, even high risk patients can be operated safely and the majority of carotid endarterectomies can be performed without the use of an indwelling shunt. Meticulous surgical technique is of great importance for achieving low perioperative complications.
研究表明，对于有症状的颅外闭塞性血管疾病患者，在没有中风或死亡等主要围手术期并发症的情况下，颈动脉内膜切除术可降低中风发生率。我们对100例发生短暂性脑缺血发作（TIA）或轻度中风的患者在局部麻醉下进行的106例颈动脉内膜切除术进行了回顾性研究。非致命性中风发生率为2%，TIA发生率为1%。围手术期无死亡病例。我们的研究表明，在局部麻醉下，即使是高危患者也能安全地进行手术，并且大多数颈动脉内膜切除术无需使用留置分流管即可完成。细致的手术技术对于降低围手术期并发症至关重要。
