The Clinical Efficacy Analysis Of Carotid Artery Stenosis Treated With Carotid Endarterectomy

Objective:To summarize the clinical data of Carotid endarterectomy in treating the patients with carotid artery stenosis,analyze the effect and prognosis of Carotid endarterectomy in treating carotid artery stenosis and explore its efficacy and safety thus providing certain reference for the clinical treatment of carotid artery stenosis.Methods:Retrospective analysis of 89 cases of patients with carotid artery stenosis undergoing Carotid endarterectomy from the department of Vascular Surgery of the Second affiliated hospital of Nanchang University from Jan,2013 to June,2017.To gather the hospitalization data of patients including the general information(name,gender,age),the past medical history(Hypertension,diabetes,coronary heart disease,smoking,drinking),preoperative conditions(whether there was cerebral infarction symptoms,degree of carotid artery stenosis,mRS score the day before surgery),the situation during surgery(operation time,crossclamp time,whether the shunt tube was used,surgical ways,),postoperative situations(postoperative complications,including cerebral infarction,cerebral hemorrhage,cerebral perfusion,Cranial Nerve Injuries,acute myocardial infarction,wound hematomas and other complications,mRS scores when discharging from hospital),the postoperative follow-up(symptom improvement situations,whether have the occurrence of myocardial infarction,stroke and restenosis as well as mRS scores).All the patients were followed up from 10 months to 63 months,and to make survival analysis on the follow-up status.Results:1?There are total of 89 cases that meet inclusion and exclusion criteria,among which 68 male cases and 21 female cases,aging from 52 to 85 years old with an average age of 66.8±6.4;22cases of mild stenosis,67 cases of severe stenosis and62 cases of symptomatic carotid stenosis.2?Previous medical history: 76 cases with hypertension history,26 cases of diabetes,13 cases of coronary heart disease,29 of smoking history and 19 cases of alcoholic intake history3?Complications within 30 days postoperation: 5 cases had postoperation wound hemorrhage or hematoma(2 cases undergoing evacuation of hematoma and 3 cases were relieved after conservative medical therapy),2cases of cranial nerve injury(1case of hypoglossal nerve injury,1 cases of facial nerve mandible injury),2cases of cerebral stroke(both were relieved after conservative medical therapy,without leaving any sequelae).4?mRS score results before and after operation: the mRS one day before operation,mRS scores 0 :17 cases,mRS scores 1: 35cses;mRS scores 2 :22cases,mRS scores 3 :13 cases,mRS scores 4 :2 cases.The mRS scores at the discharge of hospitalization : m RS scores 0 :39 cases;mRS scores 1 :20 cases;mRS scores 2 :19 cases;mRS scores 3 :8 cases;mRS scores 4:3cases.Among the 62 cases of symptomatic carotid artery stenosis,48 cases have been improved in term of their clinical symptoms with improvement rate of 77.4%.The Nonparametric test of mRS scores before and after surgery showed that there was significant difference in the preoperative and postoperative scores(P<0.05).Conclusion:1?Carotid endarterectomy have low occurrence rate of complications,safe and effective;2?Carotid endarterectomy can improve the clinical symptoms for the patients with carotid artery stenosis;3?The previous history of coronary heart disease and peripheral vascular diseases are the influence factors for the mid-and long-term adverse outcomes after carotid endarterectomy.