视频:高龄颈动脉狭窄患者颈动脉内膜切除术和颈动脉支架成形术的安全性比较
Topic: Comparison between outcomes of carotid endarterectomy and carotid artery stenting in treating elderly patients
作者:谌燕飞,宋刚,凌锋,郭锋,张文彬,华扬,蔡兵,焦力群
Authors: CHEN Yan-fei, SONG Gang, LING Feng, GUO Feng, Zhang Wen-bin, HUA Yang, Cai Bing, JIAO Li-qun
原文链接:中国现代神经疾病杂志, 2014, 14(1): 21-24
Associated with: Chinese Journal of Contemporary Neurology and Neurosurgery, 2014, 14(1): 21-24
摘要:手术采用全身麻醉,术中持续TCD监测同侧大脑中动脉血流速度,并由监测软件自动记录微栓子数量。取胸锁乳突肌前缘切口,暴露颈动脉鞘后游离暴露出颈总动脉、颈内动脉和颈外动脉,先颈总动脉夹闭试验,若TCD监测显示病变侧大脑中动脉血流下降幅度超过基础值的50%,则放置转流管。采用无创血管钳阻断甲状腺上动脉、颈外动脉、颈内动脉和颈总动脉,纵行切开颈总动脉及颈内动脉血管壁,用神经剥离子剥除颈动脉内膜及斑块,清除附壁的斑块组织直至血管壁光滑,修剪整齐远端内膜,显微镜下连续缝合血管壁。依次开放颈外动脉、颈总动脉及颈内动脉的阻断夹。若开放后TCD监测显示大脑中动脉血流增加>150%,则部分阻断颈总动脉然后逐渐开放,以防止过度灌注。复查超声,证实血管通畅后,依次缝合切口。
Topic: Comparison between outcomes of carotid endarterectomy and carotid artery stenting in treating elderly patients
作者:谌燕飞,宋刚,凌锋,郭锋,张文彬,华扬,蔡兵,焦力群
Authors: CHEN Yan-fei, SONG Gang, LING Feng, GUO Feng, Zhang Wen-bin, HUA Yang, Cai Bing, JIAO Li-qun
原文链接:中国现代神经疾病杂志, 2014, 14(1): 21-24
Associated with: Chinese Journal of Contemporary Neurology and Neurosurgery, 2014, 14(1): 21-24
摘要:手术采用全身麻醉,术中持续TCD监测同侧大脑中动脉血流速度,并由监测软件自动记录微栓子数量。取胸锁乳突肌前缘切口,暴露颈动脉鞘后游离暴露出颈总动脉、颈内动脉和颈外动脉,先颈总动脉夹闭试验,若TCD监测显示病变侧大脑中动脉血流下降幅度超过基础值的50%,则放置转流管。采用无创血管钳阻断甲状腺上动脉、颈外动脉、颈内动脉和颈总动脉,纵行切开颈总动脉及颈内动脉血管壁,用神经剥离子剥除颈动脉内膜及斑块,清除附壁的斑块组织直至血管壁光滑,修剪整齐远端内膜,显微镜下连续缝合血管壁。依次开放颈外动脉、颈总动脉及颈内动脉的阻断夹。若开放后TCD监测显示大脑中动脉血流增加>150%,则部分阻断颈总动脉然后逐渐开放,以防止过度灌注。复查超声,证实血管通畅后,依次缝合切口。
Introduction:
ISSN: 1672-6731