Comparison Of The Efficacy Of Stent Implantation And Drug Treatment In The Initial Internal Carotid Artery And Risk Factors For Carotid Stenting Restenosis

Objective: In order to evaluate the efficacy and safety of internal carotid artery stenosis stent implantation,the effect of carotid stenting was compared with that of drug alone.Furthermore,the independent risk factors of restenosis after internal carotid artery stenting were predicted to prevent thrombosis and restenosis.Method: From January 2015 to December 2017,the clinical patients of Department of Neurology,affiliated Hospital of Guilin Medical College,were collected and followed up.Exclusion of intracranial aneurysms,dissection of arteries,intracranial arteriovenous malformations and serious organ damage,such as heart,liver and kidney,All patients were divided into stenting group(n =45)and drug group(n = 40).Data such as NIHSS score were collected from all patients after admission and one year later.The re-occurrence of cerebral vascular events and blood biochemical examination,1 year later carotid and vertebral artery color ultrasound examination results,using SPSS23 statistical analysis,the stent group and the drug group were compared between the baseline of the two groups;The NIHSS scores and the incidence of cerebrovascular events after one year were compared between the drug group and the stent group.The patients were divided into non-stenosis group(32 cases)and restenosis group(13 cases).SPSS 23 was used to analyze the potential risk factors of restenosis 1 year after internal carotid artery stenting.The variables(P< 0.05)were included in the logistic regression model for multivariate analysis.Results: 1.The 45 cases of carotid artery stenting operation success rate was100%,postoperative residual stenosis rate of less than 30%,vascular stenosis by preoperative average 83.5 + 14.6% to 6.5 + 1.5% on average after operation,postoperative complications occurred in 2 cases of inguinal hematoma,1 cases of vasovagal reaction without perioperative hypotension,serious complications;2.There was no significant difference in NIHSS score before and after treatment in the drug group.The NIHSS score of the drug group was not significantly improved before and after treatment,the NIHSS score of the stent group was significantly different before and after treatment,and the score after treatment was lower than that before treatment.The NIHSS score of stent group improved significantly after treatment;3.The proportion of recurrent cerebral infarction after 1 year was 15.0 in the drug group and 2.2in the stent group.The difference was statistically significant(2.575%,0.048 < 0.05),and the proportion of TIA after one year was significantly higher than that of the control group(P < 0.05).There was a significant difference between the drug group(20.0%)and the stent group(4.4%)(2 / 936).The incidence of new cerebral infarction and new TIA in the patients with internal carotid artery stenting combined with drug group was significantly lower than that in the drug group(P< 0.05),and the incidence of new cerebral infarction and new TIA was significantly lower in the drug group than in the drug group(P < 0.05);4.Univariate analysis showed that hypertension,diabetes mellitus BMI and internal carotid artery intima media thickness ? 0.9 mm were significantly different between stent non-stenosis group and stent restenosis group(P < 0.05).Diabetes mellitus BMI and internal carotid artery thickness ? 0.9 mm were the potential risk factors for carotid artery stent implantation in patients withrestenosis;5.Multivariate analysis: the results of logistic regression analysis showed that the three variables of hypertension and diabetes mellitus had statistical significance(P < 0.05),and the internal carotid artery thickness ? 0.9mm had no significant difference in regression analysis(P > 0.05).Conclusions:1.severe onset of carotid artery stenting for stenosis of internal carotid artery is relatively safe,less complications,can effectively improve the carotid artery stenosis;carotid artery stenosis was 2.stenting treatment can better improve the prognosis and reduce the recurrence of ischemic cerebrovascular events compared to 3.;hypertension,diabetes,body mass index is the independent risk factors of restenosis after carotid artery stenting.