Analysis Of The Effecacy Of Carotid Endarterectomy Performed In 41 Elder Patients

Objective:The prevalence of cerebrovascular disease is 719/10 million in China.there are about 2 million new stroke patients in the country every year.about 85% of cerebrovascular diseases in stroke are ischemic,and about 15-20% of ischemic stroke is due to the stenosis of the extracranial carotid artery.the elderly patients are the high incidence of cerebrovascular disease,and the WHO stipulates that the people who rae over 65 years old are called elderly.elderly patients with brain vascular condition is poor,the majority of the elderly patients with long-term hypertension,diabetes,heart and kidney and peripheral vascular disease.it was once believed that elder patients with multiple risk factors had high risk,so the clinical choice of treatment has become a thorny issue.this study investigated the efficacy of carotid endarterectomy performed in elderly patients with carotid artery stenosis.Methods : Clinical data of 41 carotid artery stenosis cases were analyzed retrospectively in which patients over 65 years old have received carotid endarterectomy operations after preoperation evaluations in Shengjing Hospital affiliated to China Medical University from Jun 2009 to Feb 2017,whose age range from 65 to 77 years old,the average age(70 + 3.5),male 32 cases,female 9 cases;38 cases of symptomatic carotid artery stenosis,3 patients with asymptomatic carotid artery stenosis;16 cases with the history of cerebral infarction,31 cases with the history of hypertension,8 cases with the history of diabete,29 cases with the history of smoking.these operations were performed in identical procedure by the same surgeon.use the changes of NIHSS score,the carotid artery stenosis diameter and the peak systolic velocity of carotid artery before and after operation to evaluate the efficacy of carotid endarterectomy in elderly patients with carotid artery stenosis.Results:41 cases of carotid endarterectomy were successfully completed,30 cases of transvaginal bypass were successfully placed.second days after operation,1 cases of incision bleeding.fourth days after operation,1 patients with high perfusion syndrome.transient ischemic attack seizures in patients with symptomatic carotid stenosis disappeared after operation,the symptoms of cerebral ischemia were improved.no cerebral apoplexy in all surgical patients during the perioperative period which accord with the carotid endarterectomy quality standards established by the American Heart Association.the follow-up time was 1 year,and the follow-up rate was 100%.1 restenosis occurred after 8 months of follow-up.6 months after operation and 1 year after operation,the improvement of nerve function was obvious(P<0.05).6 months after operation and 1 year after operation,the peak systolic flow rate was reduced(P<0.05).6 months after operation,1 year after operation,the diameter of carotid artery stenosis was less than that of 1 weeks after the operation(P<0.05).Conclusions:Active and rational use of bypass technology not only reduces operation risk,but also reduces the incidence of complications.carotid endarterectomy has fewer complications and lower restenosis rate in elderly patients with carotid artery intima stenosis.the effect of carotid endarterectomy for the elderly patients with carotid artery stenosis is positive.