The application of carotid endarterectomy in symptomatic carotid artery stenosis:a report of 40 cases

Objective To summarize the short-term efficacy and applied experience of carotid endarterectomy(CEA) in symptomatic carotid artery stenosis.Methods A total of 40 patients with symptomatic carotid artery stenosis to receive CEA were recruited in this study.All the patients had clinical symptoms of cerebral ischemia.The carotid atheromatous plaque and carotid stenosis were first screened by carotid Doppler ultrasonography and transcranial Doppler (TCD), then conformed respectively through enhanced magnetic resonance angiography (CE-MRA),CT angiography (CTA),digital subtraction angiography (DSA).The degrees of carotid artery stenosis of extracranial segment were all equal to or more than 70%.In them,5 cases combined ulcer lesion,and 1 case combined one-lateral internal carotid stenosis and another lateral internal carotid complete occlusion.CEA operation was carried out under general anesthesia using endotracheal intubation combined cervical plexus block.Carotid temporal shunting tube was used in all cases.Patch angioplasty was performed in 32 cases.Results No perioperative deaths happened.Thirty-one cases had significant improvement of ischemic cerebral symptom,and 9 cases had certain improved.Postoperative hyper-perfusion syndrome and hemodynamic instability happened separately in 1 case.The complications of perioperative period of symptomatic carotid artery stenosis were 5.0% consistent with the standard of American Heart Association (AHA) equal to or less than 6%.All cases were followed up.No vascular restenosis happened during re-examination of double lateral cervical vascular ultrasonography at 6 weeks and 3 months after operation.Conclusions CEA is a safe and effective treatment method for symptomatic carotid artery stenosis.