Treiman R L, Foran R F, Cohen J L, Levin P M, Cossman D V
Arch Surg. 1979 Oct;114(10):1138-40. doi: 10.1001/archsurg.1979.01370340044007.
The records of 516 patients who underwent an elective abdominal aortic operation for aneurysmal or occlusive disease are reviewed. Four patients operated on twice are considered an individual patient for each operation. Excluding 27 patients who had a prior carotid endarterectomy, there were 84 with a carotid bruit. Thirty-six patients without a carotid bruit had experienced an episode of cerebral ischemia. Four patients had a postoperative stroke. There was no correlation between the stroke and presence of a carotid bruit or history of cerebral ischemic symptoms. We do not challenge the validity of prophylactic carotid endarterectomy but question if the need for an abdominal aortic operation should be considered indication for carotid angiography and surgery in patients with a carotid bruit.
回顾了516例因动脉瘤或闭塞性疾病接受择期腹主动脉手术患者的记录。4例接受了两次手术的患者,每次手术视为单独个体。排除27例曾接受过颈动脉内膜切除术的患者后,有84例存在颈动脉杂音。36例无颈动脉杂音的患者曾经历过脑缺血发作。4例患者术后发生中风。中风与颈动脉杂音的存在或脑缺血症状史之间无相关性。我们并不质疑预防性颈动脉内膜切除术的有效性,但质疑对于有颈动脉杂音的患者,腹主动脉手术的需求是否应被视为颈动脉血管造影和手术的指征。