Schuler J J, Flanigan D P, DeBord J R, Ryan T J, Castronuovo J J, Lim L T
Arch Surg. 1983 May;118(5):567-72. doi: 10.1001/archsurg.1983.01390050043008.
Thirteen patients with internal carotid artery occlusion and symptomatic external carotid artery stenosis underwent external carotid artery revascularization by means of endarterectomy (n = 10) or subclavian artery--external carotid artery bypass (n = 3). All patients but one were followed up, for five to 46 months (mean, 20 months). There were no operative deaths or complications and no late strokes. One patient (7.7%) required early extracranial-intracranial (EC-IC) bypass for failure of the external carotid artery endarterectomy to relieve the initial symptoms. All remaining patients were completely (n = 9) or partially (n = 2) relieved of symptoms, and EC-IC bypass was not required. There were no criteria identified by either oculopneumoplethysmography or angiography that could reliably predict the need for subsequent EC-IC bypass. Ninety-two percent of the patients were adequately treated with external carotid artery revascularization alone, suggesting that subsequent EC-IC bypass is seldom required in patients with ipsilateral internal carotid artery occlusion and external carotid artery stenosis.
13例颈内动脉闭塞且伴有症状性颈外动脉狭窄的患者接受了颈外动脉血运重建术，其中10例行内膜切除术，3例行锁骨下动脉-颈外动脉搭桥术。除1例患者外，所有患者均获随访，随访时间为5至46个月（平均20个月）。无手术死亡或并发症，也无迟发性卒中。1例患者（7.7%）因颈外动脉内膜切除术未能缓解初始症状，需早期行颅外-颅内（EC-IC）搭桥术。其余所有患者症状完全（9例）或部分（2例）缓解，无需行EC-IC搭桥术。眼体积描记法或血管造影均未发现可可靠预测后续是否需要行EC-IC搭桥术的标准。92%的患者仅通过颈外动脉血运重建术即得到充分治疗，这表明同侧颈内动脉闭塞和颈外动脉狭窄的患者很少需要后续行EC-IC搭桥术。
