경동맥 협착증에 대한 외번 내막절제술의 결과 (The Results of Eversion Endarterectomy for Carotid Artery Stenosis)

서지정보

· 발행기관 : 대한혈관외과학회
· 수록지 정보 : Vascular Specialist International / 28권 / 1호 / 32 ~ 36페이지
· 저자명 : 박정영, 권우형, 서보양

초록

Purpose: Potential benefits of eversion carotid endarterectomy (eCEA) compared with conventional carotid enderterectomy (cCEA) are more simple and faster reanastomosis with a low risk of restenosis. However, in Korea, eCEA is not popular having only one report of eCEA. This study aimed to investigate the results of eCEA.
Methods: From July 2008 to September 2010, authors performed 36 eCEAs for patients with carotid artery stenosis in our hospital. Patients' demographics and clinical data were retrospectively reviewed. Regarding early (＜30 days) results including the frequency of postoperative stroke, myocardial infarction, cerebral hyperperfusion syndrome, bleeding, cranial nerve palsy, new brain lesions (NBLs) on diffuse-weighted MRI (DW-MRI) and mortality were examined. Mid-term results such as stroke, death and restenosis after over thirty days were also examined.
Results: Mean age was 66.6 years old and 88.9% of the patients were male. Twenty-four patients (66.7%) had a previous neurological event in the preceding 6 months. A carotid shunt was used in 3 cases (8.3%) and mean carotid clamping time was 25.4 minutes. One case (2.8%) of non-disabling ipsilateral stroke, 1 case (2.8%) of wound hematoma and 1 case (2.8%) of cranial nerve palsy developed after operation. DW-MRI was conducted in 27 patients (75.0%) and NBLs were detected in 4 patients (11.1%). One case (2.8%) of restenosis was discovered during the follow-up period (mean, 9.0 months), and there were no strokes or death.
Conclusion: Early and mid-term postoperative stroke and complication rates of eCEA were acceptable in our series. However, to assess efficacy of eCEA, further large-volumed and long-term follow-up studies are needed.

영어초록

Purpose: Potential benefits of eversion carotid endarterectomy (eCEA) compared with conventional carotid enderterectomy (cCEA) are more simple and faster reanastomosis with a low risk of restenosis. However, in Korea, eCEA is not popular having only one report of eCEA. This study aimed to investigate the results of eCEA.
Methods: From July 2008 to September 2010, authors performed 36 eCEAs for patients with carotid artery stenosis in our hospital. Patients' demographics and clinical data were retrospectively reviewed. Regarding early (＜30 days) results including the frequency of postoperative stroke, myocardial infarction, cerebral hyperperfusion syndrome, bleeding, cranial nerve palsy, new brain lesions (NBLs) on diffuse-weighted MRI (DW-MRI) and mortality were examined. Mid-term results such as stroke, death and restenosis after over thirty days were also examined.
Results: Mean age was 66.6 years old and 88.9% of the patients were male. Twenty-four patients (66.7%) had a previous neurological event in the preceding 6 months. A carotid shunt was used in 3 cases (8.3%) and mean carotid clamping time was 25.4 minutes. One case (2.8%) of non-disabling ipsilateral stroke, 1 case (2.8%) of wound hematoma and 1 case (2.8%) of cranial nerve palsy developed after operation. DW-MRI was conducted in 27 patients (75.0%) and NBLs were detected in 4 patients (11.1%). One case (2.8%) of restenosis was discovered during the follow-up period (mean, 9.0 months), and there were no strokes or death.
Conclusion: Early and mid-term postoperative stroke and complication rates of eCEA were acceptable in our series. However, to assess efficacy of eCEA, further large-volumed and long-term follow-up studies are needed.

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