A Study Of Factors And Preventions For Complications Of Carotid Endarterectomy

BackgroundStroke is one of the most common angiopathy for the old people.And the rate of stroke is increasing as the aging society is coming.Stroke has becoming the second most popular disease impairing the people's health.And Carotid artery stenosis is the most common pathogeny of ischemic stroke.Carotid endarterectomy(CEA)is the mainly treatment of carotid artery stenosis.Since the first operation of CEA was operated by DeBakey in 1953,it has been accepted by the doctors and patients.As the development of endovascular technique,CEA tended to be displaced by endovascular technique because of its less traumatism and complications.There are a lot of studies debating about the best treatment for carotid artery stenosis.However CEA has advantages over CAS and it has become the golden standard method for curing carotid artery stenosis.The debate about the efficacy and safety of CEA is continuous.As CEA has been performed in China in recent years and only a little agency can make it,it's curious to make standardization for improving its safety.ObjectiveTo summarize the cases of CEA from January 2006 to January 2016 in department of Neurosurgery,Qilu Hospital of Shandong University in order to provide preventions for the complications of CEA.MethodsTo summarize the cases of CEA from January 2006 to January 2016 in department of Neurosurgery,Qilu Hospital of Shandong University including the gender,age,smoking,drinking,concomitant diseases,symptom,unilateral(bilateral)carotid stenosis,extent of stenosis,shunt,blood pressure,complications and so on.We analyzed the possible factors of complications after CEA with the Univariate and multifactor analysis.Results1 The trial included 102 patients with 49 bilateral stenosis ones and 53 unilateral stenosis ones.There were 81 male patients and 21 female patients,aging from 42 to 82.The mean age of patients was 63.28±6.754.2 Symptom:There are 47 transient ischemic attack(TIA)patients 50 ischemic stroke patients and 5 asymptomatic patients.3 Pre-operation:There were 43 smoking patients 31 drinking patients 68 hypertention patients 32 diabetes mellitus 16 coronary heart disease patients and 26 cerebral infarction patients.4 Operation:selective shunting:31 patients.All patients were performed operation during general anesthesia and one drainage tube was put in the wound after operation.5 the Complications post-operation in 30 days:ischemic stroke 6(5.9%)patients,cerebral hyperperfusion syndrome 6(5.9%)patients,cranial nerve injury 9(8.8%)patients,Hypoglossal(XII)3(2.9%)patients,Vagus(X)5(4.9%)patients,Marginal mandibular branch of facial nerve 1(1.0%)patient,the acute myocardial infarction 9(8.8%)patients,wound hematoma 4(3.9%)patients,death 2(2.0%)patients.Conclusions1 The degree of carotid stenosis is the independent risk factors of ischemic stroke or death.2 The degree of carotid stenosis is the risk factor of cerebral hyperperfusion syndrome.3 The age and history of coronary disease are the dependent risk factors of acute myocardial infarction while sex is its independent risk factors.