Early and late outcomes in patients with severe extracranial internal carotid stenosis undergoing carotid endarterectomy

作     者：郭大乔 王玉琦 符伟国 叶建荣 陈福真 陈斌 GUO Daqiao;WANG Yuqi;FU Weiguo;Ye Jianrong;CHEN Fuzhen;CHEN Bin

作者机构：复旦大学附属中山医院血管外科上海200032 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2002年第115卷第3期

页      面：405-408页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：This study was sponsored by the Scientific Research Fund of the Ministry of Health of China (No. 961171) 

主　　题：Carotid Artery, Internal Endarterectomy, Carotid Aged Carotid Stenosis Female Humans Male Middle Aged Research Support, Non-U.S. Gov't Treatment Outcome 

摘      要：OBJECTIVE: To determine the perioperative and late outcomes for carotid endarterectomy (CEA) in treatment of patients with high-grade stenotic lesions of the extracranial internal carotid artery. METHODS: Twenty patients underwent 21 CEAs at the Zhongshan Hospital between May 1993 and June 2000. They were 19 men and 1 woman, with a mean age of 64 +/- 9 years. Seven patients were performed for stroke, 11 for transient ischaemic attacks (TIAs) and 2 for asymptomatic disease. Duplex scan was the primary tool of evaluation prior to surgery. Perioperative digital subtraction angiography and magnetic resonance angiography were done for 19 and 18 patients, respectively. The percentage of stenosis was calculated using NASCET criteria. Of the 21 lesions operated, 19 had a stenosis of 70% or greater, 2 had ulcerative lesions with a stenosis ranging from 60% to 69%. All CEAs were performed under cervical block anaesthesia with selective intraoperative shunting and patch angioplasty. The patients were followed up regularly with duplex scan surveillance. RESULTS: There was no mortality or stroke during 30 days postoperatively. A TIA occurred in one patient and cranial nerve injury in 2 patients perioperatively. All patients were followed up for a mean interval of 31 +/- 20 months (range: 1 - 63 months). The 2-year survival rate and risk of stroke were 92.3% and 0%, respectively, and the 5-year survival rate and risk of stroke were 79.1% and 12.5%, respectively. Two asymptomatic recurrent stenoses ranging from 50% to 60% were detected on follow-up duplex scan. CONCLUSIONS: For the patients in this study, CEA is associated with an acceptable perioperative outcome as well as a satisfactory long-term beneficial effect in stroke prevention.