| Background:Cerebrovascular disease is a common disease associating with intracranial vascular lesions or neck vascular lesions.According to some statistics,in the sequence of human disease causing death,cerebrovascular disease has been ranked the top three,which seriously affect the human's health and living quality.As a result of human living habits and diet changes and the elderly population increasing,the morbidity of the cerebrovascular disease has been continually increasing.Cerebrovascular disease can be divided into two categories,one is ischemic cerebrovascular disease,the other is bloody cerebrovascular disease.Ischemic cerebrovascular disease is more common in clinic,accounting for about 84%of all patients with cerebrovascular disease.Cerebrovascular disease is a serial of disease,which is characteristic with low blood supply,lacking of oxygen,brain damage.Cerebral arteriosclerosis can make the intracranial vessel narrow and lower the vascular blood flow,which can cause the cerebrovascular disease.Now the treatment of the cerebrovascular disease in China can be divided in medical treatment and surgical treatment.Medical treatment includes expansion,thrombolysis,anti-platelet treatment and brain function recovery.As the nerve cells are non-renewable cells,and it's hard to control the time widow of thrombolysis,and the tolerance of hypoxia of brain cells is very limited.Therefore,the efficacy of medical treatment of ischemic or infarcted brain tissue is not very good.Carotid endarterectomy(CEA)is the main treatment of surgical treatment.The operation can directly cut the diseased blood vessels,remove the blockage of blood vessel,restore vascular lumen blood flow,and improve brain circulation.To some extent,CEA can remove the reason of stroke.As a result,CEA can play an important role in the precaution of stroke.The early implementation of CEA can recover the brain blood supply and the damaged brain tissue function of the patients who have already gotten the stroke.Therefore,CEA is known as gold standard of the treatment of carotid artery stenosis.Objective:The changes of contralateral blood flow velocity were analyzed and compared on carotid and vertebral arteries in patients with carotid endarterectomy(CEA)on unilateral stenosed-side.So as to seek the hemodynamic changes on the evaluation of the disease and the clinical significance on diagnosis and prognosis.Methods:50 patients with severe stenosis on one side carotid artery(70-99%),and contralateral with mild or no stenosis were retrospectively analyzed from April 2009 to April 2014 in the Department of Neurosurgery of Dalian Central Hospital.These 50 patients underwent CEA on stenosed-side.All patients were followed up postoperative in 1 week,1 month,6 months and 12 months to review neck vascular ultrasonography.The contralateral blood flow velocity in common carotid,internal carotid and vertebral artery was recorded,and the all data was analyzed statistically and compared.Results:all operations were successful.After surgery the blood flow on the surgical carotid artery was unobstructed,and its hemodynamics returned to normal.The symptoms of all patients were significantly improved.The blood flow velocity of contralateral common carotid,internal carotid and vertebral artery decreased evidently compared with that of preoperative,and the difference was statistically significant(P<0.05).Conclusion:After CEA on the severe stenosed-side of carotid artery,the blood flow velocity of contralateral common carotid,internal carotid and vertebral artery showed a overall downward trend.And the change of the blood flow velocity often start in the early stage after the operation.But when the blood flow velocity of contralateral artery decrease,the blood flow shear stress of the related artery can also decrease.This can enlarge the risk of the atheromatous plaque.As a result,after the CEA operation people should continue controlling the risk factors of atherosis and pay more attentions to the variety of the contralateral endangium. |
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