Hugenholtz H, Elgie R G
J Neurosurg. 1980 Dec;53(6):776-83. doi: 10.3171/jns.1980.53.6.0776.
Thromboendarterectomy performed in 35 patients with symptoms distal and ipsilateral to an occluded internal carotid artery resulted in patency in 19 cases (53%). Two factors that influence successful operation are early intervention following occlusion and good collateral circulation. In only 12 patients (34%) could the interval from occlusion to surgery be confidently determined. Four of these vessels, occluded for up to 7 days (100%), and five of eight vessels (63%), occluded for up to 4 weeks, were reopended. In the remaining patients, where the duration of occlusion was indefinite, greater reliance was placed on the evaluation and grading of angiographic collateral supply distal to the occlusion. Patients with Grade 1 to 3 collateral supply should not be explored unless occlusion occurred very recently. Patients with Grades 4 and 5 collateral supply are considered for carotid exploration regardless of the duration of the occlusion, as an alternative to other methods of revascularization.
对35例颈内动脉闭塞且有同侧远端症状的患者进行了血栓内膜切除术，19例（53%）实现了血管通畅。影响手术成功的两个因素是闭塞后早期干预和良好的侧支循环。只有12例患者（34%）能够确切确定从闭塞到手术的时间间隔。其中，4条闭塞长达7天的血管（100%）以及8条闭塞长达4周的血管中的5条（63%）重新开通。在其余闭塞时间不确定的患者中，更多地依赖于对闭塞远端血管造影侧支供应的评估和分级。除非闭塞发生在近期，否则不应探查侧支供应为1至3级的患者。侧支供应为4级和5级的患者，无论闭塞时间长短，均考虑进行颈动脉探查，作为其他血管重建方法的替代方案。
