Cerebral microembolism and ischemic changes associated with carotid endarterectomy
Cerebral microembolism and ischemic changes associated with carotid endarterectomy
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DOI：
10.1016/s0741-5214(98)70005-9
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发表时间：
1998-06-01
影响因子：
4.3
通讯作者：
Winter, MR
中科院分区：
文献类型：
--
作者：
Cantelmo, NL;Babikian, VL;Winter, MR
目的：本研究的目的是表征颈动脉内膜切除术 (CEA) 不同阶段发生的微栓塞信号 (MS)，并考虑其与磁共振成像 (MRI) 术后变化的关系。方法：这是一项回顾性研究，对象为在转诊中心接受 78 例颈动脉内膜切除术的 76 名患者。 CEA前后均进行围手术期经颅多普勒监测和MRT。对手术阶段发生的 MS 类型进行分析，并与 MRI 变化进行比较。结果：我们在 7 项术后 MRI 研究中观察到一名患者 (1.3%) 出现临床卒中，并观察到同侧小区域无症状缺血性改变 (9.0%)。在 95% 的 CEA 中检测到 MS。只有在恢复室观察到每 15 分钟发生频率超过 5 次的 MS 才与术后 MRI 缺血性变化相关 (p < 0.0001)。 结论：CEA 后 MRI 缺血性变化与术后 MS 相关。
Purpose: The purpose of this study is to characterize microembolic signals (MS) that occur during the various phases of carotid endarterectomy (CEA) and to consider their relationship to postoperative changes on magnetic resonance imaging (MRI).Methods: This was a retrospective study of 76 patients who underwent 78 carotid endarterectomies at a referral center. Perioperative transcranial Doppler monitoring and MRT were performed before and after CEA. The types of MS that occurred during phases of surgery were analyzed and compared with MRI changes.Results: We observed a clinical stroke in one patient (1.3%) and ipsilateral small areas of silent ischemic change on seven postoperative MRI studies (9.0%). In 95% of CEAs, MS were detected. Only those MS observed in the recovery room that occurred at a rate of more than five per 15 minutes were associated with postoperative MRI ischemic changes (p < 0.0001).Conclusions: Ischemic changes on MRI after CEA are related to postoperative MS.