The Clinical Efficacy Study Of Carotid Endarterectomy In The Treatment Of Carotid Artry Stenosis

Objective:To investigate the efficacy of carotid endarterectomy(CEA)in the treatment of carotid stenosis.Methods: A retrospective analysis of 82 patients with carotid stenosis who admitted and were treatmentde by CEA from January 2016 to January 2018 in the neurosurgical five department of Tianjin Huanhu Hospital was performed.The clinical factors related to postoperative complications were analyzed by statistical methods.Univariate and multivariate regression analysis of postoperative complications such as stroke/death,perfusion,and local complications were performed to obtain independent risk or protection factors.Result: The mean age was 61.20±6.88 years,68 males and 14 females.All the 82 patients underwent unilateral carotid exfoliation.There were 1 cases of postoperative complications,3 cases(3.7%)with stroke/death,;3 cases(3.7%)with cardiovascular accident,and comprehensive perfusion 1 case(1.2%);3 cases(3.7%)of cranial nerve injury,the symptoms of hoarseness improved before discharge.Two patients(2.4%)with restenosis.After the comparison of different clinical factors,the postoperative complications of asymptomatic patients and symptomatic patients were not statistically significant(P=1.000>0.05).there was no significant difference in postoperative complications of vertebral artery stenosis(P=0.756>0.05).No postoperative complications of contralateral internal carotid artery stenosis(P=0.821>0.05).There were no significant differences in complications in 4 weeks or not before surgery(P=0.267>0.05).Univariate analysis of postoperative complications,coronary heart disease was a related factor of postoperative stroke/death(P=0.015<0.05).Through logistic analysis,there were no clinically independent factors associated with postoperative complications.Conclusion: Carotid endarterectomy is a classic surgical procedure for the treatment of asymptomatic and symptomatic stenosis.Treatment of carotid stenosis can completely relieve carotid stenosis,improve cerebral arterial blood perfusion,and have lower postoperative complications.In this study,the classic CEA procedure under the microscope,intraoperative direct suture,and no drainage tube were used to treat carotid stenosis.Asymptomatic patients with stroke/mortality is 0%,symptomatic stroke / mortality is 4.3%.Coronary heart disease is a postoperative stroke/death related factor.Preoperative cardiac ultrasound,electrocardiogram and other routine examinations,and even coronary CTA is necessary,especially for patients with cornary bypass or stent surgery.