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首页> 外文期刊>Vascular and endovascular surgery >Temporary hypotension following endarterectomy for severe carotid stenosis: should we treat it?
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Temporary hypotension following endarterectomy for severe carotid stenosis: should we treat it?

机译：严重颈动脉狭窄的内膜切除术后暂时性低血压：我们应该治疗吗？

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In patients with severe carotid stenosis, the author has observed that temporary low blood pressure often occurs in the postoperative period. The hypotension typically develops 2 to 4 hours following operation, is asymptomatic, and resolves within 12-24 hours. In recent years treatment has consisted of simple observation, avoiding the use of vasopressors. Other reports of hemodynamic instability following carotid endarterectomy emphasize high blood pressure. The author rarely observes postoperative hypertension in his practice and has wondered if technical factors explain the difference. A consecutive series of primary carotid endarterectomies recently performed by the author was prospectively studied to determine the incidence of postoperative hypotension. Forty-nine of 180 consecutive patients (27%) developed hypotension below 90 mm Hg systolic (range 65-90). All had severe stenosis as an indication for operation. Only 1 patient required treatment for symptoms related to the low blood pressure. Simple observation of the remaining 48 patients with postoperative hypotension did not result in complications nor delay discharge. Data management, selection of patients, surgical technique, and results are discussed. Temporary postoperative hypotension in patients with severe carotid stenosis is common and appears to be benign. The author speculates that this phenomenon may protect ischemic brain tissue from sudden hyperperfusion, and as such should not be treated with vasopressor medication unless symptoms are present.
机译：在严重的颈动脉狭窄患者中，作者观察到术后经常发生暂时性低血压。低血压通常在手术后2至4小时内发展，无症状，并在12-24小时内消退。近年来，治疗包括简单观察，避免使用升压药。颈动脉内膜切除术后血流动力学不稳定的其他报道强调高血压。作者在实践中很少观察到术后高血压，并且想知道技术因素是否可以解释这种差异。前瞻性地研究了作者最近进行的一系列连续的原发性颈动脉内膜切除术，以确定术后低血压的发生率。 180例连续患者中有49例（27％）收缩压低于90 mm Hg（范围65-90）。所有患者均有严重的狭窄作为手术指征。只有1位患者需要治疗与低血压相关的症状。简单观察其余48例术后低血压患者，不会导致并发症或延迟出院。讨论了数据管理，患者选择，手术技术和结果。严重颈动脉狭窄患者术后暂时性低血压很常见，并且似乎是良性的。作者推测，这种现象可以保护缺血性脑组织免于突然的过度灌注，因此，除非出现症状，否则不应使用升压药治疗。

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