Current Status Of Carotid Endarterectomy Treatment For Carotid Artery Stenosis In China

Objective:To study the status about the carotid endarterectomy in the treatment of carotid stenosis in China and evaluate the safety and efficacy of the surgery. Methods:We searched all articles about the carotid endarterectomy in the treatment of carotid stenosis in WANFANG database(http://www.wanfangdata.com.cn), CNKI database(http://www.cnki.net), Chinese Biomedical database(http://sinomed.imicams.ac.c n),CQVIP database (http://cqvip.imicams.ac.cn) from Jan2001to Aug2011. The keywords of all articles are carotid artery stenosis and endarterectomy, carotid artery stenosis and surgery, carotid artery stenosis and the surgical treatment. System-Analysis was performed by collecting information in accordance with inclusion and exclusion criteria from all papers available. Results:83trials from59research centers entered the research and were published from April2002to July2011.61articles were removed for their data came from the same center and were repeated. To evaluate the quality of the articles,articles including less than10cases were removed, and54articles were selected at last. The trials included2500patients. There were1700male patients and614female patients, sex of186cases is unknown. Male and female prevalence ratio was approximately3:1. Patients had a mean age of61.3±10.2years (range=39-86). The majority of patients with symptom before surgery accounts for86%. Unilateral carotid stenosis are more common, accounting for78%. Concomitant diseases included hypertension (61%), diabetes (37%), cerebral infarction (37%), coronary heart disease (34%), myocardial infarction (3%). The ratio of using shunt in surgery was42%, and the ratio of using patch was23%. The most of the common complications was cranial nerve injury (3.2%) after surgery. The complications ratios including wound hematoma, excessive infusion, restenosis, the acute coronary syndrome, cerebral infarction, cerebral hemorrhage, minor stroke, myocardial infarction and death were3.1%,2.4%,1.7%,1.1%,0.9%,0.6%,0.5%,0.3%and1.4%respectively. Follow-up rate was87%. Conclusion:The carotid endarterectomy in the treatment of carotid stenosis was safe and effective.