Carotid Endarterectomy And Carotid Stenting For Carotid Artery Stenosis A Single-center Clinical Study Of Narrow Therapeutic Effects

Objective To comparatively analyze the safety and effectiveness of carotid endarterectomy(CEA)and carotid artery stenting(CAS)in the treatment of carotid artery stenosis and to investigate the differences in clinical efficacy between the two surgical approaches.Methods A prospective study was conducted to divide 161 patients with carotid artery stenosis requiring surgery into two groups: the CEA group with 72 patients and the CAS group with 89 patients.The relevant clinical data of these patients were collected,including general clinical data,preoperative data and postoperative data.Clinical data included gender,age,symptoms,preoperative symptoms of infarction and severity of stenosis,TIA(transient ischemic attack),severe cognitive impairment,and past medical history.Preoperative data in this study were NIHSS(National Institutes of Health Stroke Scale),m RS(Modified Rankin Scale),and MMSE(Mini-Mental State Examination)scores.Postoperative data comprised perioperative adverse events,postoperative cervical vascular ultrasound results at 3 months,6months,and 1 year during follow-up,and hospitalization costs,and other indicators.The differences in general clinical data,preoperative and postoperative data between the CEA and CAS groups were analyzed.The data were analyzed by SPSS 25.0software.The count data were expressed as percentages(%),and the chi-square test was performed for comparison between groups.The normally distributed measurement data were expressed as mean ± standard deviation(x ± s)and t-test was carried out to make a comparison between groups.The data that were not normally distributed were expressed as medians and quartiles.And non-parameter test was performed for comparison between groups.Data by repeated measurement(NIHSS score,m RS score,and MMSE score before surgery,24 hours,30 days,90 days and 1year after surgery)were analyzed by repeated ANOVA.If the p-value is less than 0.05,the difference is statistically significant.Results In this study,there were no statistical differences between the two groups in general clinical information such as gender,age,preoperative symptoms of infarction,severity of stenosis,and past medical history(P>0.05).There were no statistically significant differences in preoperative NIHSS score,m RS score,and MMSE score between the two groups(P>0.05).There were no serious complications or deaths in the two groups.There were no statistically significant differences in complications caused by surgeries between the two groups.Lower hospitalization cost in the CEA group was found than in the CAS group,with a statistically significant difference(P<0.05).According to the follow-up ultrasound results,the plaque detection rate and restenosis rate in the CEA group were significantly lower than those in the CAS group at 6 months and 1 year postoperatively(P<0.05).The differences in the improved NIHSS and MMSE scores were statistically significant at30 days,90 days 1 year postoperatively between the CEA group and the CAS group(p<0.001).And the improvement of m RS after surgery was statistically significant between the CEA and CAS groups for those with minor infarction before surgery(p<0.001).Conclusion For the treatment of patients with carotid artery stenosis,the hospitalization cost was lower in the CEA group than in the CAS group.In terms of long-term efficacy,the plaque detection rate at 6 months and 1 year by postoperative follow-up ultrasound was significantly lower in the CEA group than in the CAS group,and the restenosis rate was lower in the CEA group than in the CAS group.The neurological status and cognitive function of patients improved in both groups after treatment.Besides,the more improved NIHSS and MMSE scores were found postoperatively in the CEA group,and CEA was proven to be more effective in improving m RS scores in patients with preoperative infarction symptoms.