Determining Changes in Diameter of Internal Carotid Artery Before and After Primary Repair in Carotid Endarterctomy.

[摘要] IntroductionandPurposes:Cerebrovascularaccident(CVA)isthethirdleadingcauseofdeathworldwide.ThemostcommoncauseofCVAisobstructivelesionsoftheproximalinternalcarotidartery,forwhichavarietyofsurgicalandnonsurgicaltherapeuticmodalitieshavebeenproposed.Inthesurgicalapproach(carotidendarterectomy)severaldifferentmethodshavebeenemployedforarterialrepairwhichincludeprimaryrepair,syntheticorautologousvenouspatchesandeversionendarterectomy.Thesedifferentmethodshaveledtodifferentoutcomesintermsofpostoperativearterialdiameterandthedevelopmentofrestenosis.Thepresentarticleaimsatstudyingthechangesininternalcarotidarterydiameterafterprimaryrepairinpatientsundergoingcarotidendarterectomyinshohada-eTajrishmedicalcenter,vascularsurgerydepartment.MaterialsandMethods:Adescriptivecross-sectionalclinicalstudywascarriedouton42operationsofcarotidendarterectomyperformedon36patients(Sixpatientswereoperatedonbilaterally).Arterialrepairwasuniformlyperformedbyprimaryrepair.Thediameterofthearterywasexactlymeasuredbyaspecialcaliperbeforeandaftertheoperation.Follow-upassessmentwasperformedbycolorDopplerultrasound6monthsaftersurgery.Anyvariationinthearterialdiameterordevelopmentofrestenosiswasrecordedinindividualquestionnairesandresultswerestatisticallyanalyzed.Results:In42primaryrepairsofinternalcarotidarterywehadanincreaseinpostoperativearterialdiameterin40.5%ofcaseswithameanincrementof3.17percent.In14.2percenttherewasnochangeandin45.3percentthearterialdiameterdecreasedwithameanof2.8percent.StatisticallythelatterfigurewasnotconsideredsignificantbasedonaT-teststudy.Follow-upcolorDopplerultrasoundperformed6monthsaftertheoperationrevealedastenosisupto25%in22.7%ofpatientswhichwasnotstatisticallysignificant.Conclusion:Thisstudyshowsthatprimaryrepairofinternalcarotidarteryaftercarotidendarterectomydoesnotresultinnarrowingorrecurrentstenosisandthereforecouldbeconsideredasasafeandsatisfactorymethodofarterialrepair.However,theauthorsrecommendfurthercontrolledtrialstocomparethispracticewiththeothermethodsofarterialrepair.

[学科分类] 基础医学

[关键词] Stroke;Endarterectomy;Carotid Diameter.