Murie J A, John T G, Morris P J
Department of Vascular Surgery, Royal Infirmary, Edinburgh, UK.
Br J Surg. 1994 Jun;81(6):827-31. doi: 10.1002/bjs.1800810612.
Of 356 questionnaires on carotid endarterectomy sent to all vascular surgeons in Great Britain and Ireland likely to undertake this procedure, 326 (92 per cent) were returned. Of those who replied 131 (40 per cent) performed at least one carotid endarterectomy in 1992; 57 (44 per cent) of these carried out ten or fewer operations and 74 (56 per cent) more than ten. The 131 surgeons were collectively responsible for 2628 operations in 1992, twice as many as were undertaken in either 1984 or 1989, years for which similar survey data are available. This sharp rise in the number of operations was accounted for by increased activity on the part of experienced operators, rather than any rise in the number of 'occasional' carotid surgeons. In 1992, although the neurologist remained a major source of patient referral, general practitioners (and others) were also referring patients in large numbers direct to the vascular surgeon; this represents a change in practice compared with previous years. Many of the technical aspects surrounding carotid endarterectomy remained unchanged over the years surveyed (1984, 1989, 1992) but by 1992 duplex scanning, intra-arterial (but not intravenous) digital subtraction angiography and transcranial Doppler ultrasonography had become established as clinically useful techniques.
在向英国和爱尔兰所有可能进行颈动脉内膜切除术的血管外科医生发放的356份调查问卷中，有326份（92%）被收回。在回复的医生中，131名（40%）在1992年至少进行了一次颈动脉内膜切除术；其中57名（44%）实施了10例或更少的手术，74名（56%）实施了超过10例的手术。131名外科医生在1992年总共进行了2628例手术，是1984年或1989年（可获取类似调查数据的年份）手术量的两倍。手术数量的急剧增加是由经验丰富的手术医生手术量的增加导致的，而非“偶尔进行”颈动脉手术的医生数量增加。1992年，尽管神经科医生仍是患者转诊的主要来源，但全科医生（及其他人员）也大量直接将患者转诊给血管外科医生；与前几年相比，这代表了一种实践上的变化。在调查的年份（1984年、1989年、1992年）中，围绕颈动脉内膜切除术的许多技术方面保持不变，但到1992年，双功超声扫描、动脉内（而非静脉内）数字减影血管造影和经颅多普勒超声检查已成为临床有用的技术。
