Prognostic Analysis Of Carotid Endarterectomy Combined With Carotid Artery Stenting For Internal Carotid Artery Occlusion

[Objective]To collect the clinical manifestations and risk factors of patients with internal carotid artery occlusion,and to explore the prognostic factors of carotid endarterectomy combined with carotid artery stenting.[Method]Analysis the clinical data of patients with internal carotid artery occlusion who underwent hybird surgery in the First Affiliated Hospital of Soochow University.Patients underwent carotid ultrasound screening,and digital subtraction angiography confirmed internal carotid artery occlusion or subtotal occlusion.Recorded the collateral circulation compensation.All patients were followed up by telephone or clinic.According to the follow-up Modified Rankin Scale,all patients were divided into a good prognosis group(mRS score 0-2)and a poor prognosis group(mRS score 3-6),baseline data and prognostic factors between the two groups are compared.[Results]A total of 25 patients were included in the study,including 13 cases of limbs weakness,2 cases of limbs numbness,4 cases of speech disadvantage,9 cases of dizziness,3 cases of syncope,2 cases of blurred vision or black sputum.1 case of symptomless.(Note:A patient may have multiple symptoms when admitted to the hospital).There were 19 males(76%),8(32%)who had smoking,19(76%)with a history of hypertension,and 9(36%)with a history of diabetes.There were no significant differences in age,gender,history of hypertension,history of diabetes,NIHSS score at admission,low-density lipoprotein,opening of ophthalmic artery collaterals,anterior and posterior communicating artery collaterals between the good prognosis group and the poor prognosis group(P>0.05).There was a statistically significant difference in the opening of the pial collateral artery(P<0.05).[Conclusion]The history of hypertension and diabetes,the NIHSS score at admission,and the opening of the anterior and posterior communicating arteries were not associated with the prognosis of the combined surgery.The opening of the pial collateral artery was a factor influencing the prognosis of the composite surgery.