Zierler R E, Bandyk D F, Thiele B L, Strandness D E
Arch Surg. 1982 Nov;117(11):1408-15. doi: 10.1001/archsurg.1982.01380350016003.
Duplex scanning and spectral analysis were used to detect carotid artery stenosis following 89 endarterectomies in 76 patients with a mean postoperative follow-up interval of 16 months. Operative arteriography was used in all cases to verify the technical result. Spectral changes indicating greater than 50%-diameter internal carotid stenosis were observed postoperatively in 32 of the 89 sides. Serial follow-up of 22 stenotic sides showed persistent stenosis in 12, regression of stenosis in nine, and internal carotid occlusion in one. The estimated overall incidence of persistent high-grade stenosis was 19%. Recurrent neurologic symptoms occurred in eight patients. This incidence of postoperative carotid stenosis is higher than estimates based on clinical criteria. The transient nature of some early postoperative stenosis is consistent with proliferation and regression of myointimal lesions in response to arterial injury.
对76例患者进行了89次颈动脉内膜切除术，术后平均随访16个月，采用双功扫描和频谱分析检测颈动脉狭窄情况。所有病例均采用术中动脉造影来验证手术效果。89侧中，术后观察到频谱变化提示颈内动脉直径狭窄超过50%的有32侧。对22侧狭窄部位进行连续随访，结果显示12侧持续狭窄，9侧狭窄程度减轻，1侧颈内动脉闭塞。持续性重度狭窄的总体发生率估计为19%。8例患者出现复发性神经症状。术后颈动脉狭窄的发生率高于基于临床标准的估计值。术后早期一些狭窄的短暂性与肌内膜病变因动脉损伤而增殖和消退相一致。
