术中双功扫描作为颈动脉内膜切除术质量控制的一种手段。
Intraoperative duplex scanning as a means of quality control during carotid endarterectomy.
作者信息
Walker R A, Fox A D, Magee T R, Horrocks M
机构信息
Vascular Studies Unit, University Department of Surgery, Royal United Hospital, Bath, U.K.
出版信息
Eur J Vasc Endovasc Surg. 1996 Apr;11(3):364-7. doi: 10.1016/s1078-5884(96)80087-6.
OBJECTIVES
To identify correctable technical errors following carotid endarterectomy using intraoperative colour duplex sonography (ATL, UM9, HDI). Results were compared with intraoperative flow measurements using an operative flow meter and with middle cerebral artery velocity measured by trans-cranial Doppler (TCD).
DESIGN
Prospective study.
MATERIALS AND METHODS
50 consecutive patients undergoing carotid endarterectomy were investigated. Follow-up was performed at 6 weeks using duplex scanning and clinical evaluation.
RESULTS
Significant intraoperative technical errors were detected in three patients and were re-explored. Two scans demonstrated kinking or pinching at the distal endarterectomy site requiring patch-plasty and the third revealed a large mass of intramural thrombus. A further 18 endarterectomies yielded 21 additional minor abnormalities.
CONCLUSIONS
Duplex sonography provides a sensitive intraoperative technique for detecting thrombus and technical errors. It yields both anatomic and hemodynamic details and is superior to intraoperative flow measurements and transcranial doppler.
目的
使用术中彩色双功超声（ATL、UM9、HDI）识别颈动脉内膜切除术后可纠正的技术错误。将结果与使用手术流量计进行的术中血流测量以及经颅多普勒（TCD）测量的大脑中动脉速度进行比较。
设计
前瞻性研究。
材料与方法
对50例连续接受颈动脉内膜切除术的患者进行研究。在6周时使用双功扫描和临床评估进行随访。
结果
在3例患者中检测到明显的术中技术错误，并进行了再次探查。两次扫描显示在远端内膜切除部位有扭结或压迫，需要进行补片成形术，第三次扫描显示有大量壁内血栓。另外18例内膜切除术又发现了21处其他轻微异常。
结论
双功超声为检测血栓和技术错误提供了一种敏感的术中技术。它能提供解剖和血流动力学细节，优于术中血流测量和经颅多普勒检查。
Zotero 插件