双侧 Carotid 狭窄症患者的 Ipsilateral Carotid 重血管化对对侧 Carotid 双重参数的影响

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Updated: Jul 11, 2025

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

Molly Ratner¹, Caron Rockman¹, Pratik Chandra¹

¹Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, New York.

Annals of vascular surgery

|November 2, 2023

概括

侧动脉复血管化可以改变对侧动脉的速度,可能改变感知到的狭窄症的严重程度. 大多数患者经历了峰值缩速度的下降,但糖尿病和冠状动脉疾病等并发症降低了这种可能性.

科学领域:

血管外科血管外科
诊断成像诊断成像诊断成像
心血管医学心血管医学

背景情况:

双重超声波速度测量指导动脉再血管化决策.
严重的ipsilateral大脑管狭窄可能会人为地提高 contralateral 速度.
在ipsilateral干预后的逆侧速度变化尚未完全理解.

研究的目的:

为了评估逆侧大脑动脉双重速度下降后ipsilateral大脑动脉内切除术或支架.
评估ipsilateral revascularization对感知到的逆侧侧 carotid 狭窄症严重性的影响.

主要方法:

对前性收集数据 (2013-2021) 的回顾性分析.
包括在4个月内进行手术前和手术后双重扫描的患者.
排除了患有逆侧动脉封闭的患者.
根据峰值缩速度 (PSV) 值,定义了中度 (50-69%) 和严重 (>70%) 的狭窄.

主要成果:

129名患有双侧动脉狭窄症的患者接受了干预 (98人进行了关节切除术,31人进行了支架).
在67.2%的患者中,干预后的逆侧PSV减少.
54名患者经历了逆侧狭窄症严重程度分类的变化.
冠状动脉疾病和糖尿病与相反的PSV下降的可能性较低有关.

结论:

侧动脉复血管化可以改变对侧动脉的速度和感知狭窄.
很大一部分患者经历了相反的PSV降低,但近三分之一的患者保持稳定或增加.
冠状动脉疾病和糖尿病等并发症预测对侧面PSV的减少较小.
在高危患者中,可能需要重新评估对侧面动脉的评估,可能需要轴向成像.

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