Cormier J M, Cormier F, Laurian C, Gigou F, Fichelle J M, Bokobza B
Service de Chirurgie Vasculaire, Hôpital Saint-Joseph, Paris, France.
Ann Vasc Surg. 1987 Dec;1(5):564-71. doi: 10.1016/S0890-5096(06)61441-6.
Between 1979 and 1986, 60 patients underwent a total of 62 revascularizations of the internal carotid artery with an expanded polytetrafluoroethylene (ePTFE) bypass. In 54 cases, the indication for surgery was the presence of extensive lesions in both the internal and common carotid arteries and, in 8 cases, a late complication of a previous surgical procedure. There were no early postoperative deaths (within 30 days). Three patients (5%) experienced postoperative neurologic complications. Two complications resolved completely whereas one left minimal residua. The bypasses remained patent in all three cases. All patients had early postoperative Doppler B-mode ultrasonography. Two early occlusions (3.2%) were disclosed but the patients remained symptom-free. Four neurologic complications were observed over long-term (average 23 months) follow-up. None were related to the operated carotid artery. There were no cases of infection or late occlusion. No hemodynamic or morphologic anomalies were observed on late follow-up ultrasound studies. These favorable results support the use of ePTFE as a reliable substitute when adequate autologous saphenous vein is not available for carotid bypass. Routine utilization might be indicated in cases of long bypasses, especially when it is necessary to implant the bypass on the ascending aorta, or when the proximal site of implantation is made on a thickened arterial wall.
1979年至1986年间，60例患者共接受了62次使用膨体聚四氟乙烯（ePTFE）旁路进行的颈内动脉血运重建术。54例患者的手术指征是颈内动脉和颈总动脉均存在广泛病变，8例患者的手术指征是既往手术的晚期并发症。术后无早期死亡（30天内）。3例患者（5%）出现术后神经并发症。2例并发症完全缓解，1例仅遗留轻微后遗症。所有3例患者的旁路均保持通畅。所有患者术后均早期进行了多普勒B型超声检查。发现2例早期闭塞（3.2%），但患者无症状。长期（平均23个月）随访观察到4例神经并发症。均与手术的颈动脉无关。无感染或晚期闭塞病例。晚期随访超声检查未发现血流动力学或形态学异常。这些良好结果支持在没有足够的自体大隐静脉用于颈动脉旁路手术时，使用ePTFE作为可靠的替代材料。对于长段旁路手术，特别是当需要将旁路植入升主动脉时，或者当植入的近端部位位于增厚的动脉壁上时，可能需要常规使用。
