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Offenheitsrate der A. carotis externa (ACE) nach simultaner Desobliteration im Rahmen der Karotisthrombendarteriektomie (Karotis-TEA)

Patency of the external carotid artery after disobliteration simultaneous to internal carotid artery endarterectomy

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Zusammenfassung

Hintergrund

Die Frage der Desobliteration der A. carotis externa (ACE) simultan zur operativen Behandlung von Karotisstenosen wird aufgrund der geringen klinischen Relevanz und der teilweise inakzeptablen Restenose- bzw. Verschlussraten umstritten diskutiert.

Patienten und Methode

In 105 Fällen erfolgte die Eversionsendarteriektomie am Abgang der ACE in Kombination mit einer blinden distalen Desobliteration während der Karotis-TEA. Mit einer duplexsonographischen Untersuchung wurde die Restenose- bzw. Offenheitsrate bestimmt.

Ergebnisse

Es konnte in 87 Fällen (83%) eine Nachuntersuchung durchgeführt werden. Die Offenheitsrate betrug nach einem durchschnittlichen Zeitraum von 21 Monaten (0,5–43 Monate) 97%. Restenosen fanden sich in 5%. Diese traten in 71% der Fälle innerhalb der ersten sechs postoperativen Monate auf.

Schlussfolgerung

Im Falle von höhergradigen Restenosen der ACI kann die ACE einen potenziellen Kollateralweg darstellen. Die hohe Offenheitsrate über einen langen Zeitraum rechtfertigt daher die Mitbehandlung der ACE im Rahmen der Karotis-TEA.

Abstract

Background

Disobliteration of the external carotid artery (ECA) during internal carotid endarterectomy (CEA) is controversial because of its poor clinical relevance and the unacceptable rate of restenosis.

Patients and methods

In a total of 105 cases, a combination of blind distal disobliteration and eversion endarterectomy at the orifice of the ECA was done during CEA. Using duplex sonography, the patency of the ECA was investigated.

Results

The patency rate in a total of 87 investigated cases after a follow-up of 21 months (0.5–43 months) was 97%, with a restenosis rate of 5%. In most of the cases, restenosis/occlusion appeared within the first 6 postoperative months (71%).

Conclusion

In cases of high-grade restenosis of the internal carotid artery, the ECA may be a potential collateral pathway. Therefore, the high patency rate over a long follow-up period justifies this procedure.

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Authors and Affiliations

  1. Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Südring 81, 18059, Rostock, Deutschland

    M. Korzen

  2. Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universität Rostock, Schillingallee 35, 18055, Rostock, Deutschland

    C.M. Bünger, E. Klar & W. Schareck

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  1. M. Korzen
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  2. C.M. Bünger
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  3. E. Klar
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Correspondence to M. Korzen or C.M. Bünger.

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Teile dieses Beitrags entsprechen der Dissertationschrift von M. Korzen.

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Korzen, M., Bünger, C., Klar, E. et al. Offenheitsrate der A. carotis externa (ACE) nach simultaner Desobliteration im Rahmen der Karotisthrombendarteriektomie (Karotis-TEA). Gefässchirurgie 16, 342–345 (2011). https://doi.org/10.1007/s00772-010-0829-3

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