Cormier J M, Fermand M, Massoni J M
Service de Chirurgie Vasculaire de l'Hôpital Saint-Joseph, Paris.
J Chir (Paris). 1987 Nov;124(11):585-92.
A retrospective study of 150 consecutive patients undergoing revascularization of internal carotid artery for atheromatous lesion of carotid bifurcation, included analysis of collaterals being compressed by common carotid artery simulating clamping. Two exploratory procedures had been applied routinely: global suprasigmoid digital subtraction angiography and Doppler velocimetry. Two groups of patients could be defined: clamping without risk (95.4%) and clamping at risk (4.6%). For the group of clamping at risk a surgical strategy is proposed allowing clamping without shunt by bypass between subclavian and internal carotid arteries of by bypass between common and internal carotid arteries because of the external carotid artery collaterals left untouched. A shunt is only necessary when the latter artery is occluded. Results of this series of patients explored in this way and operated upon confirmed these data: no clamping accident in the 1st group, one transient ischemic accident in the 2nd.
对150例因颈动脉分叉处动脉粥样硬化病变而接受颈内动脉血运重建的连续患者进行了一项回顾性研究，其中包括对模拟夹闭时被颈总动脉压迫的侧支循环进行分析。常规应用了两种探查方法：全乙状窦上数字减影血管造影和多普勒测速。可将患者分为两组：无风险夹闭组（95.4%）和有风险夹闭组（4.6%）。对于有风险夹闭组，由于未触及颈外动脉侧支循环，提出了一种手术策略，即通过锁骨下动脉与颈内动脉之间的旁路或颈总动脉与颈内动脉之间的旁路实现无分流夹闭。只有在后者动脉闭塞时才需要分流。以这种方式探查并接受手术的这一系列患者的结果证实了这些数据：第一组无夹闭意外，第二组有一次短暂性缺血意外。
