Comparative Analysis Of Complications Of Carotid Endarterectomy And Carotid Artery Stenting In The Treatment Of Carotid Artery Stenosis Within 30 Days After Operation

Objective: To compare the occurrence of complications within 30 days after the treatment of carotid stenosis(CS)with carotid endarterectomy(CEA)and carotid stenting(CAS).Evaluate the safety of two surgical methods for treating carotid stenosis.Methods:This study retrospectively analyzed that patients with carotid artery stenosis treated with CEA or CAS at the Department of Vascular Surgery of the First Affiliated Hospital of Fujian Medical University from 2013.03 to 2017.09 were classified into the CEA group and the CAS group according to the surgical method.The final CEA group was included.Of the 34 patients,14 were symptomatic carotid stenosis(SCS),20 were asymptomatic carotid stenosis(ACS),23 were included in the CAS group,including 13 SCS and 10 ACS.Comparison of preoperative general conditions(age,gender,history of hypertension,history of coronary artery disease,history of peripheral arterial disease,history of diabetes,history of hyperlipidemia,history of stroke,history of smoking,and history of alcohol consumption)between two treatment groups Brain complications,cardiovascular complications,and local complications within 30 days were analyzed statistically.Result:1.Comparison of preoperative general data between the two treatment groups: There was a statistically significant difference in age between the two groups(P<0.002),the average age of patients in the CAS group was greater than that of the CEA group.2.In the two treatment groups,there were 2 cases of transient ischemic attack(TIA)within 30 days after surgery(1 in CEA group,1 in CAS group),1 case in stroke(CI in 1 case,0 in CAS group),and brain.There were 5 cases of transient perfusion syndrome(CHS)(1 case in CEA group and 4 cases in CAS group).There was a statistically significant difference in the total incidence of brain complications between the two treatment groups 30 days after surgery(X2 = 6.294,p = 0.012).The total incidence of brain complications in the CAS group within 30 days after surgery was higher than that in the CEA group.3.Comparison of cardiovascular complications within 30 days after operation in CEA and CAS groups: arrhythmia(1 in CEA group,1 in CAS group),myocardial infarction(1 in CEA group,0 in CAS group),bradycardia(CEA group 2 cases,CAS group 4 cases),hypotension(CEA group 2 cases,CAS group 4 cases);the incidence of cardiovascular complications within 30 days after surgery was statistically significant(X2 = 12.004,p = 0.001).4.Local complications within 30 days after operation in CEA and CAS groups: In the postoperative CEA group,there were 4 cases of cranial nerve injury,2 cases of local hematoma,2 cases of postoperative pseudoaneurysm in the CAS group and 30 cases of the two treatment groups.There was no statistically significant difference in the incidence of local complications within days(p>0.05).Conclusion:1.CEA and CAS clinical treatment of carotid stenosis are safe and feasible;2.In clinical treatment,elderly CS patients with revascularization tend to choose CAS;3.The incidence of brain complications and cardiovascular complications in the CAS group was higher than in the CEA group within 30 days after surgery.CEA is still the first choice for clinical treatment of carotid stenosis.