Seifert K B, Blackshear W M
J Vasc Surg. 1985 Nov;2(6):817-20. doi: 10.1067/mva.1985.avs0020817.
A sterile 8.5 MHz continuous-wave Doppler probe was used intraoperatively to evaluate the technical result of 229 consecutive carotid endarterectomies. Primary areas of evaluation included the proximal point of plaque transection and the internal and external carotid arteries at and distal to the termination of the endarterectomy. Subjective interpretation was made of the Doppler audio signal. Signs associated with inadequate technical results were a high-frequency signal indicative of luminal narrowing with a reduction in frequency distal to the area of stenosis, absence of a Doppler signal indicating occlusion, and a weak monophasic flow signal indicating poor distal perfusion. Abnormal signals were identified in 10 internal carotid arteries (4.3%) which prompted intraoperative angiography in eight and immediate reopening of the artery in an additional two. Significant lesions were identified in seven arteries (70%). Twenty external carotid lesions (8.7%) were detected by Doppler and in 19 cases (95%) a significant stenosis or obstruction was found when the vessel was reopened. Auscultation of a continuous-wave Doppler signal with a sterile probe at operation appears to have a high positive predictive value in the identification of both internal and external carotid stenoses. It is rapid, safe, relatively inexpensive, and avoids the problems associated with routine intraoperative angiography.
术中使用无菌8.5兆赫连续波多普勒探头评估229例连续颈动脉内膜切除术的技术效果。主要评估区域包括斑块横断的近端点以及内膜切除术终点处及远端的颈内动脉和颈外动脉。对多普勒音频信号进行主观解读。与技术效果不佳相关的迹象包括：高频信号提示管腔狭窄，狭窄区域远端频率降低；无多普勒信号提示闭塞；以及微弱的单相血流信号提示远端灌注不良。在10条颈内动脉（4.3%）中发现异常信号，其中8例促使术中进行血管造影，另外2例立即重新开放动脉。在7条动脉（70%）中发现显著病变。通过多普勒检测到20条颈外动脉病变（8.7%），在19例（95%）中，当血管重新开放时发现显著狭窄或阻塞。术中使用无菌探头听诊连续波多普勒信号在识别颈内和颈外动脉狭窄方面似乎具有较高的阳性预测价值。它快速、安全、相对便宜，并且避免了与常规术中血管造影相关的问题。
