Perkins J M, Hands L J, Morris P J
Nuffield Department of Surgery, University of Oxford, John Radcliffe, UK.
J R Coll Surg Edinb. 1996 Jun;41(3):170-3.
Carotid bifurcation advancement uses the in situ external carotid artery to patch the internal carotid after carotid endarterectomy. This avoids the potential complications of patch rupture and pseudo-aneurysm formation seen with vein and synthetic patches. In 25 cases a Dacron patch was used to close and nine bifurcation advancement closures were compared retrospectively with 30 cases using simple primary closure and 13 using a saphenous vein patch. Follow-up with carotid duplex scanning revealed six restenoses > 50% in the primary closure group, whereas the patch angioplasty and bifurcation advancement groups had no restenoses (P = 0.002). No significant difference in post-endarterectomy flow increase was shown between the patch angioplasty groups and the bifurcation advancement group. Operation times did not differ significantly between the patch closure and the bifurcation advancement groups. Carotid bifurcation advancement is an alternative method of vessel closure with comparable rates of restenosis, post-endarterectomy flow increase, and operation time as compared with conventional patch angioplasty closure techniques.
颈动脉分叉推进术在颈动脉内膜切除术后利用原位颈外动脉修补颈内动脉。这避免了使用静脉和合成补片时出现的补片破裂和假性动脉瘤形成等潜在并发症。在25例患者中使用了涤纶补片进行闭合，回顾性比较了9例采用分叉推进闭合术的患者与30例采用单纯一期闭合术以及13例采用大隐静脉补片的患者。通过颈动脉双功超声扫描随访发现，一期闭合组有6例再狭窄超过50%，而补片血管成形术组和分叉推进术组均无再狭窄（P = 0.002）。补片血管成形术组和分叉推进术组在动脉内膜切除术后血流增加方面无显著差异。补片闭合组和分叉推进术组的手术时间无显著差异。与传统补片血管成形术闭合技术相比，颈动脉分叉推进术是一种血管闭合的替代方法，在再狭窄率、动脉内膜切除术后血流增加以及手术时间方面具有可比性。
