Kawaguchi S, Sakaki T, Tsunoda S, Morimoto T, Hoshida T, Hiramatsu K, Iwanaga H, Nikaido Y
Department of Neurosurgery, Nara Medical University.
Neurol Med Chir (Tokyo). 1994 Feb;34(2):86-90. doi: 10.2176/nmc.34.86.
The outcomes of carotid endarterectomy (CEA) including long-term results in 121 patients (126 procedures) were retrospectively analyzed to identify the causes of operative morbidity. The angiographic internal carotid artery (ICA) stenosis was severe (> 70%) in 62 patients and moderate (50-70%) with ulceration in 64. The arterial wall was sutured primarily in 91 patients and with patch graft in 35. The outcomes 3 months after operation were good recovery in 86 patients, moderately disabled in 20, severely disabled in 11, and death in four. Three patients suffered operative morbidity (2.5%). During follow-up, three patients (2.6%) suffered transient ischemic attack on the operative side due to middle cerebral artery stenosis (50%) or ICA occlusion at the origin, and recurrent stenosis (40%) of the common carotid artery and ICA (1 each). In the latter two cases, the artery was primarily sutured. Improved therapeutic results require use of patch vein graft for the arterial wall suture, checking of the CEA patency, and prevention of intracranial ischemic events and hemorrhage due to associated lesions.
对121例患者（126例手术）进行颈动脉内膜切除术（CEA）的结果（包括长期结果）进行回顾性分析，以确定手术并发症的原因。62例患者的血管造影显示颈内动脉（ICA）重度狭窄（>70%），64例为中度狭窄（50-70%）伴溃疡形成。91例患者动脉壁采用直接缝合，35例采用补片移植。术后3个月时，86例患者恢复良好，20例中度残疾，11例重度残疾，4例死亡。3例患者发生手术并发症（2.5%）。随访期间，3例患者（2.6%）因大脑中动脉狭窄（50%）或ICA起始部闭塞，在手术侧发生短暂性脑缺血发作，另有2例（各占1例）颈总动脉和ICA出现再狭窄（40%）。后两例患者动脉采用直接缝合。改善治疗效果需要在动脉壁缝合时使用补片静脉移植，检查CEA通畅情况，预防因相关病变导致的颅内缺血事件和出血。
