The Clinical Study Of Carotid Artery Stenosis Treated With Carotid Endarterectomy And Carotid Artery Stenting

Objective:In recent years,the incidence of carotid artery stenosis which caused by atherosclerosis or occlusive disease is higher and higher,and carotid artery stenosis disease is one of the important causes of ischemic stroke.Stroke,even TIA,seriously affects the patient's quality of life,and is the main cause of disability.The world health organization published in 2012 that stroke is the most important cause of death in the mid-income and high-income countries.There are about 700000 people died in stroke in United States each year.Therefore,for the treatment of carotid stenosis disease is particularly important.In 1953,Michael De Bakey had finished the first case of CEA.And in 2012,CEA was ecommended on ESVS as grade A,because the existing class I evidence for carotid artery stenosis patients with symptomatic proved that CEA is the preferred treatment plan.Up to now,CEA has gradually become the gold standard in treatment of carotid artery stenosis disease.However,in recent years,with the mature of cavity technology,improvement of intervention quipment,development of interventional technology and the enhancement of operator technology,the CAS is increasingly applied in the treatment of ischemic cerebral apoplexy.The relative merits of the two,catches attention of modern scholars and clinical workers,and becomes a research hotspot.we retrospectively analyzed 182 patients in this paper who had underwent CEA or CAS in our hospital since 2010 to 2013,and compared the incidence of the postoperative incision complications and restenosis,and perioperative major adverse cardiovascular and cerebrovascular event.Method:There are 182 patients treated with CEA or CAS since 2010 to 2013 in our department,182 of carotid stenosis patients.They are divided into 2 groups by the treatment methods:108 patients into CEA group,and 74 patients into CAS group,to compare with postoperative incision complications and restenosis,and perioperative major adverse cardiovascular and cerebrovascular event,etc.SPSS19.0 software is adopted to make chi-square test and t test,and when P < 0.05,there are significant differences.Result: The frequency of postoperative incision complications of two groups are no significant difference.The patency rate of two groups are both high,and postoperative restenosis rate in 3 months and 2 years are no obvious difference.The incidence of TLR in 30 days and 2 years are no significant difference,and there are no restenosis after the second operation.CAS group has a higher incidence of stroke(9.46%)than CEA group(1.85%),and especially for 70 years or older patients the frequency is higher,which is 50%.The incidence of stroke includes major stroke and TIA,and the difference mainly comes from TIA,and the major stroke rates of the two groups have no significant difference.There is a relatively satisfactory result in mortality of the two kinds of operation.The overall mortality rate is low,which is 1.65%.The CEA group is just 0.93%,and the CAS group is 2.7%,and there is no significant difference between two groups.Conclusion:Tere are no significant difference on the incidence of postoperative incision complications,restenosis,TLR and MACCE between CEA and CAS.CAS is only about 16 years,but its development prospect is excited! CEA,especially for older patients,has a lower stroke rate,so,for patients,with cerebrovascular accident risk,especially the older,CEA is better.So,the curative effect of CEA and CAS are equivalent and complement each other.