CEA 治疗伴对侧颈内动脉闭塞的颈动脉重度狭窄的疗效

摘要

目的 评价颈动脉内膜剥脱术治疗一侧颈内动脉重度狭窄伴对侧颈内动脉闭塞的疗效.方法 回顾性分析11例患者的临床资料,包括围手术期并发症及近远期疗效;并比较术前及术后3个月颈部及大脑中动脉血管血流峰值. 结果 即刻成功率为100%,术后患者脑缺血症状均得到改善,围手术期无病例死亡或缺血性脑卒中等严重并发症发生,仅有1例出现皮下血肿、1例出现短暂声音嘶哑,经积极治疗后均好转. 随访率100%,随访时间6~61 ( 32 .5 ±17 .2 )个月. 患者均无术侧颈动脉再狭窄,其中1例再发对侧缺血性脑卒中. 术后患者颈动脉血流峰值及大脑中动脉收缩期血流峰值与术前比较差异有统计学意义(均P<0 .05 ). 结论 对于一侧颈内动脉重度狭窄伴对侧颈动脉闭塞的高危患者,颈动脉内膜剥脱术具有满意的围手术期结果和较好的远期脑卒中预防疗效.%Objective To analyze the peri-operative mortality ,stroke rates and late benefits of carotid endarterectomy ( CEA) with contralateral occlusion in a single medical center .Methods The clinical data of 11 cases were analyzed retrospectively , including postoperative period and follow-up and compare the peak velocity of carotid artery and middle celebral artery 3 months before and after operation.Results The technical success rate was 100% with no peri-operative mortality or ischemic stroke .The overall peri-operative complication occurred in 2 patients , including 1 subcutaneous haematomas and 1 transient hoarseness .The average follow-up time was 32 .5 ±17 .2 months with follow-up rate 100%.The difference of the peak velocity of carotid artery and middle celebral artery 3 months before and after operation was significant (all P<0.05).Conclusion CEA for patients with contralateral to an occluded carotid artery can be performed with acceptable perioperative mortality and stroke risk rates , as well as a satisfactory long-term beneficial effect in stroke prevention .