Intraoperative duplex ultrasonography in carotid endarterectomy: The impact on indication for immediate revision and intermediate-term outcome

被引:6
作者
Ott, C. [1 ]
Heller, G. [1 ]
Odermatt, A. [1 ]
Furrer, M. [1 ]
机构
[1] Kantonsspital Graubunden, Dept Surg, CH-7000 Chur, Switzerland
来源
VASA-JOURNAL OF VASCULAR DISEASES | 2008年 / 37卷 / 02期
关键词
intraoperative duplex ultrasonography; carotid endarterectomy; quality control; carotid stenosis;
D O I
10.1024/0301-1526.37.2.151
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Background: Thromboembolic complications in relation to carotid endarterectomies (CEA) are frequently associated with technical errors. We analyzed prospectively the impact of intraoperative duplex ultrasonography (IODS) in CEA on immediate revision and postoperative results. Patients and methods: We have observed 70 patients with 74 CEA. Indications for surgery were asymptomatic high grade stenosis (70-99%) or symptomatic stenosis of > 50%. IODS findings were rated as "relevant", "minor" or "normal". Relevant findings were immediately repaired. Peri- and postoperative neurological events were analyzed in Duplex Scans controls in a median length of follow-up of 17.3 months. Outcome of patients with "minor" findings (group A) were compared with patients having "normal" or corrected "relevant" findings (group B). Results: In 8/74 cases (11%) we found relevant findings leading to immediate revision. In 25/74 (34%) cases minor findings were detected which were not revised. In group A (n = 25, 34%) two asymptomatic occlusions and one recurrent high grade stenosis were found during follow-up. In group B (n = 49,66%) we detected two high and two low grade stenosis. The 30 day death and stroke rate was 1.4% (n = 1). Conclusions: IODS is a sensitive method to detect immediately pathological findings. Its correction seems to reduce the incidence of early occlusions and therefore early neurological events.
引用
收藏
页码:151 / 156
页数:6
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