[颈动脉血管重建术静脉移植:长期结果]。

L Voirin, J L Magne, I Farah, C Sessa, B Chichignoud, H Guidicelli
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引用次数: 0

摘要

颈动脉重建(CAR)可以通过多种技术实现。选择的方法是基于患者的症状、颈内动脉粥样硬化病变的扩散以及通常处理这些患者的外科团队的经验。在1987年1月至1995年5月间,我们使用隐静脉移植物进行了185例CAR。所有患者的手术指征为动脉粥样硬化性闭塞性疾病,其中62%无症状。术后早期1例患者因误吸死亡,2例患者发生脑卒中(1大1小),5例患者因颈动脉夹持不耐受发生短暂性缺血发作。晚期再狭窄2例,移植物闭塞2例。累计手术发病率和死亡率为1.6%。该系列研究表明,静脉移植颈动脉重建可获得满意的短期和长期效果,是动脉内膜切除术的重要替代方法。双工扫描随访未发现静脉移植物形态退化的证据。
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[Carotid revascularizations by venous grafting: long-term results].

Carotid artery reconstruction (CAR) may be achieved through a variety of techniques. The method of choice is based upon the patient's symptoms, the diffusion of the atheromatous lesion in the internal carotid artery and the experience of the surgical team that usually deals with these patients. Between January 1987 and May 1995, we performed 185 CAR using saphenous vein graft. The indication for surgery was atherosclerotic occlusive desease in all patients, sixty-two per cent of whom were asymptomatic. In the early postoperative period one patient died of aspiration, two patients suffered a stroke (one major and one minor) and five patients had a transcient ischemic attack due to carotid clamping intolerance. Two late restenosis and two graft occlusions occurred. The cumulative operative morbidity and mortality rate was 1.6%. This series demonstrates than venous grafting for carotid reconstruction yields satisfactory short- and long-term results and is a valuable alternative to endarteriectomy. Follow-up by Duplex-scan revealed no evidence of morphological degradation of the vein grafts.

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