Murie J A, Morris P J
Br J Surg. 1986 Nov;73(11):867-70. doi: 10.1002/bjs.1800731103.
A survey of the practice of carotid surgery by 245 vascular and neurological surgeons in Great Britain and Ireland was conducted with a 96 per cent response. Ninety-six surgeons (41 per cent) performed at least one carotid endarterectomy in 1984 and a total of 1374 such operations were carried out in that year. The indications for carotid endarterectomy in order of frequency were transient ischaemic attack, minor stroke and stroke. Operation was hardly ever undertaken for asymptomatic carotid bruit. Eighty-six per cent of surgeons who performed carotid endarterectomy generally assessed patients in the first instance using techniques less invasive than conventional angiography, principally Doppler ultrasonography or digital subtraction angiography. Nevertheless, conventional angiograms were usually performed before surgery by 89 per cent of surgeons. Almost all surgeons operated only under general anaesthesia, while opinion on the use of an intraluminal shunt during carotid endarterectomy was divided. Despite an increase in the number of carotid endarterectomies in recent years, this operation is currently performed nineteen times less frequently in Great Britain and Ireland than in the USA. The reasons for this are explored and certain controversies surrounding carotid endarterectomy are discussed.
对英国和爱尔兰的245名血管外科医生和神经外科医生的颈动脉手术实践进行了一项调查，回应率为96%。96名外科医生（41%）在1984年至少进行了一次颈动脉内膜切除术，当年共进行了1374例此类手术。颈动脉内膜切除术的适应证按频率依次为短暂性脑缺血发作、轻度中风和中风。几乎从未因无症状颈动脉杂音而进行手术。进行颈动脉内膜切除术的外科医生中，86%通常首先使用比传统血管造影侵入性小的技术评估患者，主要是多普勒超声或数字减影血管造影。然而，89%的外科医生通常在手术前进行传统血管造影。几乎所有外科医生仅在全身麻醉下进行手术，而对于在颈动脉内膜切除术中使用腔内分流器的意见存在分歧。尽管近年来颈动脉内膜切除术的数量有所增加，但目前在英国和爱尔兰进行该手术的频率比美国低19倍。探讨了其原因，并讨论了围绕颈动脉内膜切除术的某些争议。
