Thomas G I, Jones T W, Stavney L S, Manhas D R, Spencer M P
Am J Surg. 1986 May;151(5):616-9. doi: 10.1016/0002-9610(86)90570-2.
We prospectively reviewed our experience with 32 carotid endarterectomies in 30 patients performed without angiography in a 7 year period. Although this represents 6.7 percent of our total experience with carotid endarterectomy in this period, carotid endarterectomy without angiography is increasing and comprises 17 percent of the last 2 years' total. We have adhered to strict criteria for patient selection that identifies circumstances for a safe operative experience in seven broad categories. Evidence is also presented to reduce an overriding concern for intracranial aneurysms and siphon stenosis if either one exists unrecognized. We are hopeful that in the future, the latter will be identified by intracranial Doppler studies currently being performed. Our experience in this small series has been favorable, with intraoperatively measured lesions equal to the preoperative noninvasive predictions. We suggest that Doppler ultrasonography in its current form can be effectively used in place of conventional angiography or digital subtraction angiography in selected patients.
我们前瞻性地回顾了7年间30例患者接受32次未行血管造影的颈动脉内膜切除术的经验。尽管这占我们同期颈动脉内膜切除术总经验的6.7%，但未行血管造影的颈动脉内膜切除术正在增加，占过去两年总数的17%。我们坚持严格的患者选择标准，确定了七大类安全手术经验的情况。同时也提供了证据，以减少对未被识别的颅内动脉瘤和虹吸部狭窄的过度担忧。我们希望，未来后者将通过目前正在进行的颅内多普勒研究得以识别。我们在这个小系列中的经验是良好的，术中测量的病变与术前无创预测结果相当。我们建议，当前形式的多普勒超声检查可有效用于替代部分患者的传统血管造影或数字减影血管造影。
