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首页> 外文期刊>Sao Paulo Medical Journal >Early and late results of carotid endarterectomy: retrospective study of 70 operations
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Early and late results of carotid endarterectomy: retrospective study of 70 operations

机译：颈动脉内膜切除术的早期和晚期结果：70例手术的回顾性研究

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CONTEXT: Indications and results of carotid endarterectomy have been defined from clinical multicentric trials like the European Carotid Surgery Trialists, North-American Symptomatic Carotid Endarterectomy Trial and Asymptomatic Carotid Atherosclerosis Study. The patients included in these trials were highly selected, as were the surgeons performing the operations. Clinical practice is different but the same results should be achieved. OBJECTIVE: To study indications, technique, early and late results, and whether carotid endarterectomy has been performed in accordance with standards defined by multicentric trials. DESIGN: Retrospective case report study. SETTING: A tertiary care private hospital. PARTICIPANTS: 57 patients, on whom 70 carotid endarterectomies were performed over a 10-year period. The median age was 66.4 ± 7.8 years; 43 (75.4%) were male, 41 (71.9%) hypertensive, 36 (63.1%) current smokers and 24 (21.0%) had diabetes. Bilateral carotid stenosis was present in 31 (54.3%) patients, peripheral arterial occlusions in 32 (56.1%) and ischemic cardiopathy in 25 (43.1%). All patients had had angiography and 41 (71.9%) had also had a duplex-scan of neck arteries. Cerebral imaging via computerized tomography scan or magnetic resonance imaging was obtained for 36 patients. Patients were followed up over a period of one to 122 months. MAIN MEASUREMENTS: early and late post-operative death, early and late post-operative stroke, and recurrence of atheroma plaque and symptoms relative to carotid stenosis. RESULTS: There was one post-operative death (1.4%) caused by myocardial infarction and two early strokes (2.8%): a total complication rate of 4.2%. After 3 and 5 years, 95.4% and 81.3% of patients respectively were stroke-free and 72.8% and 67.3% were alive. There were four recurrences and two of them related to stroke. Forty-nine (70%) stenoses operated on were symptomatic. Brain infarction was detected in 59.2% of patients who underwent computerized tomography scan or magnetic resonance imaging. CONCLUSIONS: Carotid endarterectomy was done in accordance with international standards. The most frequent cause of late death was myocardial infarction, and recurrences were related to stroke. Patients should be followed up closely.
机译：背景：颈动脉内膜切除术的适应症和结果已通过临床多中心试验进行了定义，例如欧洲颈动脉外科手术研究者，北美有症状颈动脉内膜切除术试验和无症状颈动脉粥样硬化研究。这些试验中包括的患者以及进行手术的外科医生都是经过高度筛选的。临床实践不同，但应获得相同的结果。目的：研究适应症，技术，早期和晚期结果，以及是否按照多中心试验确定的标准进行了颈动脉内膜切除术。设计：回顾性病例报告研究。地点：三级私立医院。参加者：57名患者，在10年期间进行了70次颈动脉内膜切除术。中位年龄为66.4±7.8岁;男性为43（75.4％），高血压为41（71.9％），目前吸烟者为36（63.1％），糖尿病为24（21.0％）。双侧颈动脉狭窄发生在31名患者中（54.3％），外周动脉阻塞发生在32名患者中（56.1％），缺血性心脏病发生在25名患者中（43.1％）。所有患者均进行了血管造影检查，其中41例（占71.9％）还进行了颈部动脉双重扫描。通过计算机断层扫描或磁共振成像对36例患者进行了脑成像。对患者进行了1到122个月的随访。主要测量指标：术后早期和晚期死亡，术后中风早期和晚期，以及动脉粥样斑块的复发和与颈动脉狭窄有关的症状。结果：心肌梗死造成1例术后死亡（1.4％）和2例早期中风（2.8％）：总并发症发生率为4.2％。 3年和5年后，无卒中患者分别占95.4％和81.3％，存活率分别为72.8％和67.3％。有四次复发，其中两个与中风有关。进行手术的四十九例（70％）狭窄是有症状的。在接受计算机断层扫描或磁共振成像检查的患者中，有59.2％的患者发现了脑梗塞。结论：颈动脉内膜切除术是根据国际标准进行的。晚期死亡的最常见原因是心肌梗塞，复发与中风有关。患者应密切随访。

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