Carotid endarterectomy. Relationship of outcome to early restenosis.
Carotid endarterectomy. Relationship of outcome to early restenosis.
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颈动脉内膜切除术。
DOI：
10.1067/mva.1985.avs0020375
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发表时间：
1985
影响因子：
4.3
通讯作者：
StrandnessJr,DE
中科院分区：
文献类型：
--
作者：
Nicholls,SC;Phillips,DJ;Bergelin,RO;Beach,KW;Primozich,JF;StrandnessJr,DE
对134例(145侧)颈动脉内膜剥脱术患者进行超声双功重复扫描和4年临床评价，对术后结果进行前瞻性评价。研究组中有107名男性和27名女性。围手术期卒中发生率为1.3%，死亡率为0.7%。晚期死亡9例，其中卒中相关死亡2例(1.4%)。12例患侧出现局灶性症状，其中6例为卒中(1例腔隙)。其余症状发生在中度颈动脉狭窄(<；50%)。有7名患者有与手术侧相关的短暂性脑缺血发作(TIA)，但只有2名患者与复发的高度狭窄有关。在随访期间，32例(22%)患者出现了复发的重度狭窄。7例再狭窄消退，持续率为17.1%。女性再狭窄发生率显著高于女性(P<；0.01)。按寿命表分析，再狭窄发生较早，多数发生在24个月内。症状的发展与再狭窄的发生之间没有一致的联系。因此，根据观察到的狭窄程度来预防随后的TIA和卒中，没有理由重新手术。(J VASCSURG1985；2：375-81.)
The results following carotid endarterectomy were prospectively evaluated in 134 patients (145 sides) by repeat ultrasonic duplex scanning and clinical evaluation extending for a period of 4 years. There were 107 men and 27 women in the study group. The perioperative stroke rate was 1.3% and the mortality rate, 0.7%. There were 9 late deaths, of which two were stroke related (1.4%). Focal symptoms occurred in 12 patients on the ipsilateral side, six of which were strokes (one lacunar). The remaining symptoms developed in the presence of moderate degrees of carotid stenosis (< 50%). There were seven patients who had transient ischemic attacks (TIAs) referable to the operated side, but only two of these were associated with a recurrent high-grade stenosis. During follow-up 32 (22%) patients had recurrent high-grade stenosis. Restenosis regressed in seven, giving a persistent rate of 17.1%. The incidence of restenosis was significantly higher in women (p < 0.01). By life-table analysis, restenosis occurred early, the majority within 24 months. There was no consistent association between the development of symptoms and the occurrence of restenosis. Therefore, it is concluded that there is no justification for reoperation based on the degree of narrowing observed to prevent subsequent TIAs and strokes. (J VASCSURG1985;2:375-81.)
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