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

Objective To retrospective analysis the patients’ clinical data of CEA conducted in neurology department of Ningxia Medical University General Hospital(hereinafter referred to as the General Hospital)and CAS conducted in neurosurgery department of Cardiovascular and Cerebrovascular Hospital Affiliated to Ningxia Medical University(hereinafter referred to as the Cardiovascular Hospital)from February 2012 to October 2016 to evaluate the safety and effectiveness of the two surgery,and further analyze the factors that affect its safety and effectiveness,hoping to provide reference for the selection of surgical methods and intraoperative precautions and reducing the complications on perioperative and long-term to improve the safety and effectiveness of surgery and serve patients better.Method According to strict inclusion and exclusion criteria to collecte eligible patients’ clinical data in two groups to analyze the preoperative(risk factors,clinical manifestations,location and extent of carotid stenosis,mRS score in preoperative time)and postoperative data(Perioperative complications,follow-up information)to observe the perioperative and long-term efficacy.Considering the economic and other reasons,counting the hospitalization cost and time of the two groups to provide different choices on surgical methods for patients and their families is meaningful.Results(1)There was no difference in preoperative data between the two groups(P>0.05).(2)There has difference on the incidence of perioperative major adverse events about CEA and CAS group(P<0.05).(3)There was no significant difference in other adverse events(except carotid sinus reaction)(P>0.05),but There was significant difference in carotid sinus reaction(P<0.01).(4)After one year ’follow-up,there was no significant differencebetween the two groups in terms of the main end point,ipsilateral stroke and restenosis of the surgical site(P>0.05).(5)There has significant difference on the hospitalization cost、time and surgery duration time(P<0.01).Conclusion(1)Perioperative safety of CAS is superior to that of CEA,but there is no difference between the direct cause of major adverse events in the two surgery.(2)CEA and CAS are both effective in the treatment of carotid artery stenosis.(3)The carotid sinus reaction rate of CAS are higher than CEA.(4)The time of surgery and hospitalization of CEA are longer than CAS,the cost of hospitalization of CAS are higher than CEA.