Eisner L, Müller F, Ammann J F
Chirurgische Klinik, Thurgauisches Kantonsspital, Münsterlingen.
Swiss Surg. 1996;2(5):212-4.
Elective operation of carotid stenosis over 70% is uncontested since publication of the interim results of NASCET and ECST [1,2] trials. Even though emergency carotid endarterectomy for rapidly progressing cerebral infarction (stroke in evolution) remains very controversial outcome depends on how fast cerebral perfusion is reestablished, complete recovery is possible if carotid thrombendarterectomy is successfully performed in between the first 6-8 hours. We report the case of a female patient developing a cerebral infarction on the first postoperative day after femoropopliteal bypass grafting. Diagnosis of an acute carotid occlusion was established by cerebral duplex sonography, intracerebral hemorrhage was excluded by emergency computed tomography. Emergency thrombendarterectomy successfully reverted all cerebral symptoms. Postoperative course was uneventful, the patient was dismissed on the 12th postoperative day without any neurological residual deficit.
自北美症状性颈动脉内膜切除术试验（NASCET）和欧洲颈动脉外科试验（ECST）[1,2]的中期结果公布以来，对于70%以上的颈动脉狭窄进行择期手术已无争议。尽管因快速进展性脑梗死（进展性卒中）而行急诊颈动脉内膜切除术仍极具争议，但结果取决于脑灌注重建的速度，如果在最初的6 - 8小时内行颈动脉血栓内膜切除术成功，则有可能完全恢复。我们报告一例女性患者，在股腘动脉旁路移植术后第一天发生脑梗死。通过脑双功超声确定为急性颈动脉闭塞，急诊计算机断层扫描排除了脑出血。急诊血栓内膜切除术成功逆转了所有脑部症状。术后过程顺利，患者在术后第12天出院，无任何神经功能残留缺损。
