Efficacy Of Eversion And Conventional Carotid Endarterectomy For Carotid Stenosis And Analysis Of Risk Factors For Postoperative Complications

Purpose:Carotid endarterectomy is a standard procedure for treating carotid stenosis.The purpose of this study was to investigate the operation of eversion carotid endarterectomy(ECEA)and conventional carotid endarterectomy(CCEA).Are there any differences in the postoperative complications and short-term patency.At the same time,the factors affecting the occurrence of postoperative complications and treatment measures are discussed.Methods:Retrospectively collected data on patients with carotid stenosis who underwent ECEA and CCEA surgery for carotid artery stenosis who were treated at the First Affiliated Hospital of Bengbu Medical College from January 2016 to July 2019.Age,gender,previous hypertension,diabetes,coronary heart disease,stroke history,etc;intraoperative data:whether to use a bypass tube,carotid artery block time,etc;Postoperative data:perioperative stroke,cervical hematoma,cardiac insufficiency,hyperperfusion syndrome,cranial nerve injury,and short-term patency.All patient data were entered into an Excel spreadsheet and statistically analyzed using SPSS 25.0 software.Measurement data are expressed as mean±standard deviation,and T test is used.Count data is expressed as a percentage,using the X~2 test(if necessary,Fisher exact probability is used).The correlation between various related factors and postoperative complications was analyzed using Logistic regression model.Consider P<0.05 as statistically significant.Results:A total of 48 patients were collected in this study,including 26 in the ECEA group and 22 in the CCEA group.Age(P=0.067),gender(P=0.938),history of previous hypertension(P=0.922),history of previous diabetes(P=0.100),history of stroke(P=0.766),history of coronary heart disease(P=0.827),history of atrial fibrillation(P=0.502)and other general information were not statistically different.There were statistically significant differences in intraoperative blocking time between the two groups(23.28±2.23 min in the CCEA group,18.38±1.79 in the ECEA group,P=0.00),and the use of bypass tubes(8 in the CCEA group,0 in the ECEA group,P=0.001)also difference.Postoperative cardiac insufficiency(1 in CCEA group,0 in ECEA group,P=0.468),hyperperfusion syndrome(2 in CCEA group,2 in ECEA group,P=0.629),ischemic stroke(2 cases in CCEA group,3 cases in ECEA group,P=0.581),cervical hematoma(1 case in CCEA group,1 case in ECEA group,P=0.712),nerve injury(5 cases in CCEA group,2 cases in ECEA group,P=0.145)),Carotid restenosis at 6 months after operation(4 in CCEA group,1 in ECEA group,P=0.326),and carotid PSV at 6 months after operation(61.68±11.69 in CCEA group,59.76±7.73 in ECEA group,P=0.495)No significant difference,but carotid restenosis at 12 months after operation(6 in CCEA group,1 in ECEA group,P=0.039),and carotid PSV at 12 months after operation(CCEA group 67.09±14.33,ECEA group59.92±7.95,P=0.034)was statistically different.Logistic regression analysis showed that carotid artery occlusion time was related to postoperative stroke P=0.041.Conclusions:1.Compared with CCEA,ECEA can shorten the time of carotid artery occlusion and reduce the incidence of postoperative ischemic stroke;It has a good medium to short term patency rate.2.It is of great importance to master the anatomy before surgery,strictly evaluate the condition,conduct fine operation during surgery and observe closely after surgery to prevent the occurrence of complications.3.Strict control of patients'blood pressure and blood lipid,persuasion of patients to quit smoking,and rational use of anti-platelet drugs are of great significance to the prevention of postoperative adverse events related to CEA and the prevention of postoperative restenosis.