The Study Of Preventing Restenosis After Carotid Endarterectomy With Vascular Patch

Objective: Study of preventing restenosis after carotid endarterectomy with or without the vascular patch.Methods: A total of 72 patients with carotid stenosis who admitted to the Affiliate d Hospital of Chinese Medicine of Xinjiang Medical University were detected, all of them underwent carotid endarterectomy, 6 of whom underwent bilateral carotid e ndarterectomy, were recorded 78 operations of surgery. To preoperative internal car otid ultrasound measurements inside diameter(<4.0mm placed the patch) and intra operative observation of specific situations as a packet basis, were retrospectively a nalyzed. Which after carotid endarterectomy forming vascular patch 40 cases(exper imental group), after stripping carotid artery intima direct suture 38 cases(control group). Basic information to preoperative, intraoperative mean carotid clamping tim e, mean operative time, postoperative complications within 30 days, after the short and long term carotid restenosis extent as the main outcome measures were analyz ed.Results: There was no significant difference between the two groups preoperative b asic information(P>0.05). Postoperative complications within 30 days on the cerebr al hyperperfusion syndrome(CHS) incidence, the patch group is higher than the no n-patch group, the difference was statistically significant(P<0.05). Experimental gro up in average carotid blocking time and average operative time was significantly lo nger than the control group, comparing the two groups have no significant differen ce(P<0.05). 78 cases were followed up for more than two years, none were lost.Within six months in which the two groups showed no significant difference in pat ency(P>0.05). 6 to 12 month patency rate between the two groups was statisticall y significant(P<0.05). The patch group patency rate is better than non-patch group. More than 12 to 24 months, the number of cases and the degree of stenosis recu rrence, the non-patch group were also significantly higher than the patch group, pat ency rate between the two groups was statistically significant(P<0.05).Conclusion: Vascular patch forming in the prevention of carotid endarterectomy res tenosis have a significant effect, can significantly improve the degree of carotid ar tery patency in the long-term. At the same time patch forming have some drawbac ks, it is recommended to use as possible depending on the circumstances.