頸動脈病変を有する患者での治療上の問題点:-虚血性心疾患の合併について-

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Recently carotid endarterectomy is increasing but postoperative myocardial infarction is frequently observed. It has been reported in foreign countries that the atherosclerotic coronary artery diseases were frequent in patients with carotid artery lesion(s). In Japanese, however, the relationship between the atherosclerotic changes of the carotid artery and the coronary artery were not well known. We studied this point here. The subjects were 136 consecutive patients of hemispheric cerebral infarction and they were divided into five groups according with their carotid angiographic findings as I) severe and II) mild lesion(s) at the carotid bifurcation, III) severe and IV) mild lesion(s) at the other portion(s) than carotid bifurcation and V) no carotid lesion. The ischemic changes of ECGs in their neurologically stable stage were analysed by Minnesota code. And the angiographic findings and the ECG manifestations were compared. In each group, half of the ECG abnormalities were the changes of ST-T. Myocardial infarction was recognized about 5% in all groups, but no statistical differences were observed. Though the percentage of abnormal ECGs was not so different in each group, almost all ECG-changes were severe in group I (12/13 cases). On the other hand, 50-70% were severe in other groups. So it was suggested that there is some relationship between the severe atherosclerotic changes at the carotid bifurcation and the coronary artery disease in the Japanese as well, but it is not sodistinctive as in white and negro. Careful management for cardiovascular system is important in pre-and post-operative medical care on the carotid endarterectomy.
The Japanese Society on Surgery for Cerebral Strokeの論文

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