The Clinical Data Analysis Of Carotid Artery Stenosis Treated With Carotid Endarterectomy And Carotid Artery Stenting

Objective: To study the safety and efficacy of carotid endarterectomy and carotid artery stenting in the treatment of carotid artery stenosis,and analyze the related clinical data.Methods:This study retrospectively analyzed the First Affiliated Hospital of Shihezi University Medical College from October 2013 to October 2017 in Department of neurosurgery for carotid endarterectomy and carotid artery stenting in two groups of 112 cases,from the patient's own factors(admission symptoms,NIHSS score,age,vital organ function,basic diseases,smoking),carotid stenosis(position of stenosis,degree of stenosis,length of stenosis),Success rate of operation,perioperative adverse events(death,myocardial infarction,stroke,hematoma,infection,cranial nerve injury,high perfusion syndrome,carotid sinus syndrome)and long-term follow-up(ischemic events,restenosis,death,m RS score)safety analysis and the validity of the two.By comparing the operation time of the two,the time of hospitalization and the cost of hospitalization,the choice of operation was provided.The relationship between different age(70 years old and less than 70 years)with perioperative complications,major adverse events and restenosis during the perioperative period was analyzed.All data were analyzed by SPSS19.0 statistics and normal data.Normal distribution data were expressed by mean standard deviation.The non normal distribution data were described by median four percentile interval.According to the normal distribution,the use of t test does not conform to the normal distribution of the rank sum test,and the p<0.05 is statistically significant.Results:Carotid endarterectomy was performed in 34 cases and carotid artery stenting in 78 cases.(1)There was no significant difference in admission symptoms,NIHSS score,age,smoking history,vital organ function(including hypertension,diabetes,hyperlipidemia,coronary heart disease)between the two groups(p>0.05).(2)There was no significant difference between the two groups in the narrow position,the degree of stenosis and the length of stenosis(p>0.05).(3)The major adverse events in the perioperative period,1 cases of CEA patients with stroke(2.9%),0 cases died,0 cases of myocardial infarction,1 cases of CAS patients with stroke(1.3%),0 cases died,1 cases of myocardial infarction(1.3%),no significant difference(p>0.05);perioperative adverse events in more than 4.Cases of high perfusion syndrome in CEA group(11.8%),CAS group of 1 cases(1.3%)had significant difference(p<0.05);cranial nerve injury occurred in 2 cases in group CEA(5.9%);carotid sinus syndrome group CAS 31 cases(39.7%)had significant difference(p<0.01).(4)Long-term follow-up showed that there was no significant difference in ischemic events,restenosis,death and m RS scores between the two groups(p>0.05).(5)The operation time of CEA group was 127.35±29.63 min and CAS group was 132.58±47.27 min,no significant difference between the two(p>0.05);hospitalization time in group CEA was 22.32±7.73 d and CAS group was 19.56±5.65 d,no significant difference between the two(p>0.05);CEA group hospitalization costs 32232.47±5676.93 yuan,96534.48±4836.35 yuan in CAS group,two with significant difference(p<0.01).(6)In group CEA,3 cases were treated with valgus,and31 were traditional.(7)In group CAS,11 patients with local anesthesia had no major adverse events in the perioperative period.(6)There were 22 cases of perioperative adverse events which were greater than or equal to 70 years old,and 22 cases were less than 70 years old.There were statistical significance(6.5%,95% CI,0.13-5.47)(p<0.05).There was no significant difference in the incidence of major adverse events and restenosis in the perioperative period(p>0.05).Conclusions:(1)Carotid endarterectomy and carotid artery stenting are safe and effective for the treatment of carotid stenosis,and there is no significant difference between the two.(2)Over 70 years old patients than <70 years old patients in the perioperative period of high incidence of complications,two perioperative major adverse events had no significant difference.(3)The cost of hospitalization in group CEA was significantly lower than that in group CAS,but the time of hospitalization was slightly longer,and the operation mode could be selected according to the patient's specific conditions.