Reducing the risk of intraoperative neurological complications during carotid endarterectomy with early distal control of the internal carotid artery.
Reducing the risk of intraoperative neurological complications during carotid endarterectomy with early distal control of the internal carotid artery.
复制标题
通过早期远端控制颈内动脉，降低颈动脉内膜切除术术中神经系统并发症的风险。
DOI：
10.1016/j.ejvs.2004.09.015
复制
发表时间：
2004
影响因子：
5.7
通讯作者：
R. Pulli
中科院分区：
文献类型：
--
作者：
C. Pratesi;W. Dorigo;A. Innocenti;L. Azas;E. Barbanti;R. Lombardi;G. Pratesi;R. Pulli
研究目的：评估在单中心颈动脉内膜切除术中早期夹持颈动脉远端（ICA）的改良手术技术的可行性和有效性。研究设计：回顾性研究，教学医院。材料与方法1996 ~ 2002年共进行2235例cea检查。直到1999年4月，术中策略包括标准隔离和分离颈动脉分叉，预备夹持颈动脉（1组；1090例干预）。从1999年5月开始，我们对颈动脉远端进行早期隔离和夹持，随后剥离颈动脉分叉，夹持颈外动脉和颈总动脉（2组；1145例干预）。结果2组患者均可采用改良手法。2组清醒时神经功能缺损发生率明显低于1组（分别为0.4%和1.8%;p=0.02）。结论术中早期远端控制颈内动脉是可行的，有助于减少术中神经事件的发生。
AIM OF THE STUDYTo assess the feasibility and effectiveness of a modified surgical technique with early clamping of the distal internal carotid artery (ICA) during carotid endarterectomy in a single centre experience.STUDY DESIGNRetrospective study, teaching hospital.MATERIAL AND METHODSBetween 1996 and 2002, 2235 CEAs were performed. Until April 1999, the intra-operative strategy consisted of standard isolation and dissection of the carotid bifurcation preliminary to ICA clamping (group 1; 1090 interventions). Starting from May 1999, we performed early isolation and clamping of the distal ICA, followed by dissection of the carotid bifurcation and clamping of the external and common carotid artery (group 2; 1145 interventions).RESULTSThe modified technique was feasible in all the patients of group 2. In group 2 there was a significantly lower incidence of neurological deficit on waking than in group 1 (0.4% and 1.8%, respectively; p=0.02).CONCLUSIONSEarly distal control of the internal carotid artery during CEA is feasible and could contribute to reducing intra-operative neurological events.