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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Influence of Contralateral Carotid Occlusion on Outcomes After Carotid Endarterectomy: A Meta-Analysis
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Influence of Contralateral Carotid Occlusion on Outcomes After Carotid Endarterectomy: A Meta-Analysis

机译：对侧颈动脉闭塞对颈动脉内膜切除术后结果的影响：META分析

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BackgroundThere is a controversy about whether the contralateral carotid occlusion (CO) in patients undergoing carotid endarterectomy (CEA) is associated with worse early and long-term outcomes. The aim of this systematic review and meta-analysis was to investigate the impact of CO on outcomes after CEA. MethodsPubMed, Embase, and MEDLINE databases were searched until January 2018 for studies comparing early and long-term outcomes of CEA in patients with CO and with patent contralateral carotid (CP). Two independent reviewers identified studies meeting our inclusion/exclusion criteria, extracted relevant data and assessed quality. Fixed- or random-effects models were used to calculate the overall effect estimates. ResultsOur literature search identified 35 articles eligible for inclusion in the review and analysis. Patients with CO had higher rate of preoperative symptoms (Stroke?+?transient ischemic attack [TIA]) (odds ratio [OR]?=?1.20, 95% confidence interval [CI]: 1.11-1.31) and had increased risk of perioperative neurological complications (Stroke?+?TIA) (OR?=?1.63, 95% CI: 1.36-1.94) compared with those with CP. No significant difference in the perioperative mortality rate (OR?=?1.40, 95% CI: .99-1.98) and the stroke-free survival rate at 5 years (OR?=?1.06, 95% CI: .79-1.40) between 2 groups was identified. ConclusionsThe presence of CO results in higher rate of preoperative symptoms and increases perioperative risk of neurological complications in CEA, but do not have a significant impact on the perioperative mortality rate and the stroke-free survival rate at 5 years. Careful consideration should be given in perioperative care in these patients.
机译：Backgroundshere是关于颈动脉胚胎切除术（CEA）患者对侧颈动脉闭塞（CO）的争议与早期和长期结果更严重。该系统审查和荟萃分析的目的是调查CEA后CO对结果的影响。在2018年1月期间搜查了方法，EMBASE和MEDLINE数据库，用于比较CEA与CO和专利对侧颈动脉（CP）的早期和长期成果的研究。两个独立审查员确定了满足我们的包含/排除标准，提取相关数据和评估质量的研究。固定或随机效应模型用于计算整体效果估计。结果我们的文献搜索确定了35篇文章，有资格纳入审查和分析。 CO患者具有较高的术前症状（中风？+？瞬态缺血性攻击[TIA]）（差距[或]？=？1.20,95％置信区间[CI]：1.11-1.31）并且具有围手术期的风险增加与CP的CP相比，神经系统并发症（中风？+？TIA）（或？= 1.63,95％CI：1.36-1.94）。围手术期死亡率（或？=？1.40,95％CI：.99-1.98）和5年（或？=？1.06,95％CI：.79-1.40）的无统一性差异组2之间被确定。结论CO的存在导致术前症状的速度较高，增加了CEA中神经复杂性的围手术危险，但对5年来没有对围手术期死亡率和无卒中的存活率产生重大影响。在这些患者的围手术期护理中应仔细考虑。

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