Analysis Of The Effect Of Stent Implantation In Patients With Internal Carotid Artery Stenosis And Cognitive Impairment

Part one Effect of carotid Stent implantation on patients with carotid Stenosis complicated with Cognitive impairmentObjective: The purpose of this study is to treat the patients with carotid artery stenosis with cognitive impairment by carotid artery stent implantation,and to follow up the patients after operation to understand the changes of cognitive function in different periods after carotid artery stent implantation in patients with carotid artery stenosis.It is of far-reaching significance to improve the cognition and quality of life of patients with carotid artery stenosis complicated with cognitive impairment,and can provide reference for clinical treatment of this disease.Methods: From March 2018 to March 2019,58 patients with internal carotid artery stenosis and cognitive impairment,aged65-80 years,were selected.All patients were examined by DSA and were in accordance with the diagnosis of cognitive impairment.The degree of stenosis was determined according to the standard of the north American symptomatic carotid endarterectomy experimental cooperation group.The degree of stenosis of the internal carotid artery was 50-99%.All patients were the first time to have a disease,excluding severe aphasia,blindness,disturbance of consciousness,serious dysarthria or mental disorder,or hemiplegia cannot complete the checker.The cognitive function of the patients was evaluated by MMSE and Mo CA.The data of the evaluation results were input into Excel to establish a database.SPSS20.0 was used for statistical processing.The paired t-test wasused before and after the treatment for each measurement index.The repeated measurement data were used for each test index at multiple time points The difference was statistically significant(P< 0.05).The changes of cognitive function scores were compared before operation,3 months after operation,6 months after operation and 12 months after operation to determine whether carotid stent implantation can improve the cognitive function of patients.Results: Among the 58 patients,carotid stents were implanted safely and successfully in all patients.The scores of MMSE and Mo CA before stent implantation were 23.03±2.01 and 21.38±1.44.after 3 months of follow-up,the scores of MMSE and Mo CA were higher than those before stent implantation,but there was no statistical significance.The total scores of MMSE and Mo CA of the patients at 6 and 12 months after operation were significantly higher than those before operation.In the Mo CA domain score,the scores of language fluency,attention,visual space and execution,and delayed recall at 6 and 12 months after operation were significantly higher than those before treatment,and there was statistical significance.Part two Analysis of perioperative complications of carotid artery stentingObjective: To investigate the perioperative complications and related management of carotid stenting,and to analyze the prognosis of carotid stenting through follow-up.Methods: In the first part,58 patients with moderate and severe carotid stenosis were treated with carotid stenting.The perioperative complications and related management of carotidstenting were analyzed,followed up,and the prognosis was analyzed.Results: Carotid artery stents were implanted successfully in all 58 patients.The perioperative complications of all patients were statistically analyzed.It was found that subcutaneous hematoma occurred in 2 cases after CAS,pseudoaneurysm occurred in 1 case,ischemic stroke occurred in 2 cases,microembolism was considered in 2 cases,carotid dissection occurred in 1 case,heart rate was lower than 50 beats / min in 2cases,and persistent hypotension occurred in 2 cases.One patient developed intracranial hypertension after operation.Through telephone follow-up,2 of 58 patients developed transient ischemic attacks in the blood supply area of the related blood vessels within6 months after operation.12 months after operation,2 patients had cerebral ischemic events,including 1 case of transient ischemic attack and 1 case of symptomatic cerebral infarction with persistent numbness and weakness of one limb.