Chakfe N, Beaufigeau M, Edah-Tally S, Steinmetz E, Popescu S, Hassani O, Clavert P, Suret-Canale M A, Kretz J G
Service de Chirurgie Cardio-Vasculaire, Les Hôpitaux Universitaires de Strasbourg.
J Mal Vasc. 1997 Jul;22(3):168-72.
Endarterectomy of the carotid bifurcation through a longitudinal arteriotomy of the common and internal carotid arteries followed by a direct closure is still accepted as the main surgical technique for carotid stenoses. However, this technique is complicated in about 10% of the cases by a restenosis. Mechanisms of myointimal hyperplasia leading to restenosis are not completely explained. The technique of eversion endarterectomy of the internal carotid artery has been said to be an alternate technique which could decrease the incidence of restenosis. We described the three main techniques of eversion endarterectomy and their results. The technique of eversion endarterectomy after proximal section of the internal carotid artery is the most frequently used. It allows to treat easily length excess of the internal carotid artery. Its results are good in terms of neurologic morbidity and mortality. However, randomized comparative studies are still required in order to determine its role on the incidence of restenosis despite the first encouraging results of first non comparative studies. The technique of eversion endarterectomy after distal section of the internal carotid artery has been proposed by Chevalier who reported also good short term results and no delayed restenosis.
通过对颈总动脉和颈内动脉进行纵行动脉切开术，然后直接缝合来实施颈动脉分叉处内膜切除术，仍然是治疗颈动脉狭窄的主要外科技术。然而，该技术在约10%的病例中会因再狭窄而变得复杂。导致再狭窄的肌内膜增生机制尚未完全阐明。据说颈内动脉外翻内膜切除术技术是一种可以降低再狭窄发生率的替代技术。我们描述了外翻内膜切除术的三种主要技术及其结果。颈内动脉近端离断后外翻内膜切除术技术是最常用的。它便于处理颈内动脉过长的情况。其在神经并发症和死亡率方面的结果良好。然而，尽管首批非对照研究取得了令人鼓舞的初步结果，但仍需要进行随机对照研究，以确定其在再狭窄发生率方面的作用。颈内动脉远端离断后外翻内膜切除术技术是由谢瓦利埃提出的，他也报告了良好的短期结果且无延迟性再狭窄。
