Treatment Strategy of Extracranial Carotid Artery Stenosis / 中国微创外科杂志

ABSTRACT

Objective To discuss the therapeutic method of extracranial athemsclerotic carotid artery stenosis . Methods A retrospective analysis was conducted in 51 patients with angiography confirmed carotid artery stenosis from January 2012 to June 2012 in our hospital.The carotid endarterectomy (CEA) was performed in 16 cases, while the carotid artery stenting (CAS) was performed in 35 cases. Results All the 51 operations were successfully completed .There were 1 case of transient ischemic attack ( TIA) 3 days after CEA operation , 1 case of postoperative stroke after CAS operation , and 1 case of carotid sinus pressure after CAS operation . The follow-up period of all the cases was 9-15 months, with an average of 13.6 months.Ultrasound review of the carotid artery found no restenosis. Conclusion According to medical information of the patients with extracranial carotid atherosclerotic stenosis , we tend to adopt the CAS treatment in patients with following situations ①transient ischemic attack at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%;②mild than disabling stroke onset at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%; ③carotid artery stenosis ≥2 cm under neck vascular CTA and cerebral angiography .We tend to adopt CEA treatment in patients with following situations①asymptomatic carotid stenosis with degree ≥70%;②symptomatic carotid stenosis with degree range from 50%to 69%;③asymptomatic carotid artery stenosis with degree <70%, but with instable situation of lesions under angiography or other examinations .