Neurologic sequelae of unilateral carotid artery occlusion: immediate and late.
Neurologic sequelae of unilateral carotid artery occlusion: immediate and late.
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单侧颈动脉闭塞的神经系统后遗症：立即和晚期。
DOI：
10.1067/mva.1989.15723
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发表时间：
1989
影响因子：
4.3
通讯作者：
Strandness,DE
中科院分区：
文献类型：
--
作者：
Nicholls,SC;Bergelin,R;Strandness,DE
在7年的时间内（1980年至1987年），24例患者（18例男性：平均年龄67岁;范围，52至78岁，6例女性：平均年龄67岁;范围，46至82岁）接受连续颈动脉多普勒扫描，观察到进展为单侧颈动脉闭塞。闭塞与6例（25%）同侧卒中、4例（16%）同侧短暂性脑缺血发作和1例（5%）非半球症状发作相关。13例患者无症状。随访4 ~ 96个月，平均39.4个月。晚期神经系统事件包括两次中风，三次短暂性脑缺血发作和六次非半球症状的发作，其中一些是致残的。13例患者无症状。发生3例死亡（1例与卒中相关）。对于晚期事件，通过生命表分析，前2年卒中的平均年发生率为10%，短暂性脑缺血发作为13%。短暂性脑缺血发作和卒中的合并发生率为每年20%。对于非半球症状，第一年的发病率为31%。它的结论是，单侧颈动脉闭塞与不可接受的发生率立即神经系统后遗症，这些患者继续有一个高比例的晚期神经功能缺损在后续。因此，观察到进展为高度狭窄并因此有立即闭塞风险的患者应接受预防性颈动脉内膜切除术似乎是合适的。（J Vasc Surg1989;10：542-8.）
Over a 7-year period (1980 to 1987) 24 patients (18 men: mean age 67 years; range, 52 to 78 years, and six women: mean age 67 years; range, 46 to 82 years) undergoing serial carotid artery duplex scans were observed to progress to unilateral carotid artery occlusion. The occlusions were associated with ipsilateral strokes in six (25%), ipsilateral transient ischemic attacks in four (16%), and the onset of nonhemispheric symptoms in one (5%). Thirteen patients had no symptoms. Follow-up ranged from 4 months to 96 months (mean 39.4 months). Late neurologic events comprised two strokes, three transient ischemic attacks and the onset of nonhemispheric symptoms in six, which in some were disabling. Thirteen patients had no symptoms. Three deaths occurred (one was stroke related). For late events by life-table analysis, the average annual rate over the first 2 years for stroke was 10% and for transient ischemic attack 13%. The combined rate for transient ischemic attack and stroke was 20% per annum. For nonhemispheric symptoms the rate for the first year was 31%. It is concluded that unilateral carotid artery occlusion is associated with an unacceptable incidence of immediate neurologic sequelae and that such patients continue to have a high rate of late neurologic deficits at follow-up. Therefore it seems appropriate that patients who are observed to progress to high-grade stenosis and are therefore at risk for immediate occlusion should undergo prophylactic carotid endarterectomy. (J Vasc Surg1989;10:542–8.)
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