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

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Chinese Medical Journal 2002年第3期115卷 405-408页

作者：郭大乔王玉琦符伟国叶建荣陈福真陈斌复旦大学附属中山医院血管外科上海200032

OBJECTIVE: To determine the perioperative and late outcomes for carotid endarterectomy (CEA) in treatmen. 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.

关键词： Carotid Artery, Internal Endarterectomy, Carotid Aged Carotid Stenosis Female Humans Male Middle Aged Research Support, Non-U.S. Gov't Treatmen. Outcome

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