Davidovic Lazar B, Tomic Ivan Z
School of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
J Korean Neurosurg Soc. 2020 May;63(3):373-379. doi: 10.3340/jkns.2019.0201. Epub 2020 Mar 2.
Carotid endarterectomy (CEA) is the main procedure in carotid surgery, as well as the most frequent vascular procedure. Two techniques of CEA are available : eversion and conventional plus patch angioplasty. Eversion CEA is anatomic procedure that reduces ischemic and total operative time. Simultaneous correction of the joined carotid kinking and coiling is possible, easy and safe, while the usage of patch is excluded. Thanks to oblique shape of anastomosis, eversion CEA is associated with low risk of long-term restenosis. The false anastomotic aneurysms occurrence is very rare, almost impossible after eversion CEA. However, the usage of carotid shunt during eversion CEA is not always simple, while proximal or distal extension of the carotid plaque can make eversion CEA more difficult and risky. Eversion CEA should be the first choice in carotid surgery. Conventional CEA is indicated in cases when carotid plaque is extended more than usual, as well as, if the usage of carotid shunt is necessary.
颈动脉内膜切除术（CEA）是颈动脉手术中的主要术式，也是最常见的血管手术。CEA有两种技术：外翻式和传统加补片血管成形术。外翻式CEA是一种解剖学术式，可减少缺血时间和总手术时间。同时矫正合并的颈动脉扭结和盘绕是可行的、简便且安全的，同时无需使用补片。由于吻合口呈斜形，外翻式CEA与长期再狭窄风险较低相关。假性吻合口动脉瘤的发生率非常低，外翻式CEA术后几乎不可能发生。然而，外翻式CEA术中使用颈动脉分流器并不总是简单的，而颈动脉斑块的近端或远端延伸会使外翻式CEA更困难且风险更高。外翻式CEA应是颈动脉手术的首选。传统CEA适用于颈动脉斑块延伸超过正常情况以及需要使用颈动脉分流器的病例。
