The Analysis Of TCD Detection Of The Middle Cerebral Artery Blood Flow Perfusion Before And After CEA

Objective: carotid endarterectomy(carotid endarterectomy, CEA) is the treatment of carotid atherosclerotic stenosis of the "gold standard" operation method.Opened to internal carotid artery(internal carotidartery, ICA), stripped of thickening of the intima and attached to the plaque, make already narrow vascular diameter increases, blood flowing, thus improving intracranial blood perfusion. Application of transcranial Doppler ultrasound(Transcrinial Doppler, TCD) to test before and after operation records of middle cerebral artery(MCA) blood flow and perfusion to confirm carotid intima stripped of the surgery effect;Through observation of postoperative patients with clinical manifestations, learn excessive cerebral perfusion syndrome(cerebral hyperperfusion syndrome, CHS) whether and there is a direct correlation between rising CEA postoperative cerebral perfusion.Methods: randomly selected 100 patients, preoperative by color doppler ultrasound(color doppler flow imaging, of a CDFI) and multislice CT angiography(multi ‐ slice spiral CT angiography, CTA) diagnosis of carotid artery stenosis degree was 70%- 70%,preoperative day via transcranial doppler ultrasound(Transcrinial doppler, TCD)inspection, on the third day after the operation line of TCD examination again, two groups of data recorded in middle cerebral artery(MCA) systolic peak flow velocity(peak systolic velocity, PSV), compare the two groups before and after operation data contrast analysis, and by the tube bed doctor patient symptoms, whether there is a severe headache, eye and facial pain, confusion, visual impairment, seizures or any non symptom such as cerebral ischemic focal defect, chance for people developing symptoms before and after the surgery middle cerebral artery(MCA) blood flow velocity(PSV), and not the symptoms of patients with middle cerebral artery(MCA)blood flow velocity(PSV) for contrast analysis.Results: 100 cases of carotid intima stripping operation smoothly, transcranialdoppler ultrasound record total of 100 of 200 middle cerebral artery blood flow velocity information, transcranial doppler ultrasonography(TCD) detection of middle cerebral artery(MCA) velocity are surgery on the same side, including preoperative ipsilateral MCA minimum velocity for 41 cm/s, maximum flow rate of 102 cm/s, preoperative mean blood flow velocity was(69.70± 13.10) cm/s.Postoperative ipsilateral MAC minimum velocity is 88 cm/s, maximum flow rate of 166 cm/s, postoperative mean blood flow velocity was(116.30 ± 17.70) cm/s, compared with preoperative and postoperative side middle cerebral artery blood flow velocity increased value of 46.60±19.50, t = 31.04, p < 0.05, with statistical significance.Number of patients with symptoms of high perfusion was recorded for 12 cases, 12%, there are 6 patients postoperative TCD detection did not suggest excessive perfusion, 6 cases of headache sufferers, headache nausea and vomiting(3 cases), high spirits, sleep disorders, in 3, op in 1 case, fidgety in 1 case, acute cerebral hemorrhage in 1 case, cerebral hemorrhage rate was 1%, no deaths occurred.List of 12 patients with CEA ipsilateral middle cerebral artery blood flow velocity before and after operation, calculated by SPSS17.0 statistical analysis software, 12 cases of postoperative patients with abnormal symptoms of preoperative MCA mean blood flow velocity was(61.83± 14.83) cm/s, postoperative MCA mean blood flow velocity was(124.17 ± 15.92) cm/s, P > 0.05, no statistical significance.Conclusion: carotid intima peeling technique through surgery to remove internal carotid artery atherosclerotic plaque, the vascular patency, eliminate the unstable plaque due to cracking or thrombosis fall off the consequences of, can obviously reduce the recurrence of transient ischemic attack(TIA) and cerebral infarction of probability,carotid intima stripped carotid stenosis with obvious therapeutic effect, safety and reliable.Carotid intima stripping technique can significantly increase in the ipsilateral brain arteries blood flow velocity, increase artery perfusion.Carotid intima stripped surgery postoperative ipsilateral middle cerebral artery blood flow velocity of the rise in value and whether excess cerebral perfusion syndrome has no direct causal relation, the occurrence of excessive perfusion syndrome may be associated with a variety of factors,its mechanism needs further research.