平均的な規模の地域病院で頸動脈内膜剥離術を受けた無症候性・無症候性患者の長期成績

Long-Term Outcomes of Symptomatic and Asymptomatic Patients Undergoing Carotid Endarterectomy in an Average-Volume Community Hospital.

• José M Alvarez Gallesio
• Patricio Gimenez Ruiz
• Michel David
• Martin Devoto
• Alejandro Caride
• Raúl A Borracci

抄録

:頸動脈内膜剥離術の長期的な有用性は、平均的な規模の病院ではまだ十分に検討されていない。そこで我々の目的は、中規模病院における頸動脈内膜摘出術の長期成績を評価することである。人口統計学的および術後の転帰をKaplan-Meier生存率解析により短期および長期的に評価した。平均年齢は72歳で、65％が男性であった。平均年齢は72歳、65％が男性であった。入院期間の中央値は3日（IQR 3-4）、平均追跡期間は56ヶ月であった。入院死亡は記録されなかった。120ヵ月追跡時の脳卒中の自由度は97.4％、死亡97.3％、再狭窄98.7％、複合イベント92.9％（log rank p=0.042）であり、無イベント生存率は症候性患者で84.4％、無症候性患者で96.1％（log rank p=0.025）であった。

: Long-term benefit of carotid endarectomy has not yet been fully investigated in average volume centers. Thus our purpose is to evaluate long-term results of carotid endarterectomies at a medium-volume hospital. : A retrospective analysis of carotid artery stenosis operated between 2008 and 2017 in a community hospital was done. Demographic and postoperative outcomes were evaluated in short and long-term by Kaplan-Meier survival analysis. : 167 procedures in 159 patients were included. Average age was 72 years, and 65% were men. Twenty-nine percent of patients were symptomatic and the rest asymptomatic. Median hospitalization was 3 (IQR 3-4) days and the mean follow-up was 56 months. No hospital mortality was recorded. At 120-month follow-up, freedom of stroke was 97.4%, death 97.3%, restenosis, 98.7% and all combined events 92.9% (log rank p= 0.042) Combined event-free survival was 84.4% in symptomatic patients, and 96.1% in asymptomatic patients (log rank p = 0.025). : In a medium-volume hospital combined event-free survival was 84.4% in symptomatic patients and 96.1% in asymptomatic at a 10- year follow-up.