Risk Factor Analysis For Carotid Intimal Hyperplasia After Carotid Endarterectomy

Objective: To assess the carotid artery intimal hyperplasia after carotid endarterectomy(CEA)and analyze the related risk factors to strengthen secondary prevention and control early restenosis after CEA.Method: We randomly selected 60 patients who underwent CEA from October 2017 to December 2019 in neurosurgery department of our hospital.The median follow-up time was 6.4(range,3–32)months.Intimal thickness,intimal growth rate,vascular diameter,and blood flow velocity parameters were recorded at different time points after the operation.Analysis of variance and dual logistic regression analyzed changes and risk factors of carotid intimal hyperplasia after CEA.Results: The intimal thickness was 1.44 ± 0.59 mm.Its thickness gradually increased over time,but the growth rate(0.246 ± 0.165 mm/month)gradually decreased.The four intimal growth rate quartiles were 0.025–0.129,0.129–0.204,0.204–0.323,and0.323–0.741 mm/month.The first and fourth quartile groups differed in smoking history(6 vs.12,P = 0.028),plaque nature(vulnerable plaque,6 vs.12,P = 0.028),surgical procedure(carotid endarterectomy with pacth(pCEA),13 vs.8,P = 0.033),and severe vertebral or subclavian arterial stenosis(2 vs.7,P = 0.048).The intimal growth rate on the patch was slower than that of the original wall.The plaque nature was an independent risk factor for a high intimal growth rate(odds ratio,6.052;95% confidence interval,1.159–31.609;P = 0.033).Conclusion:The intimal carotid thickness increased gradually after CEA,with a gradually decreasing growth rate.The intimal growth rate was faster in smokers,vulnerable plaque carriers,and patients with severe vertebral or subclavian arterial stenosis.The plaque nature was an independent risk factor for intimal growth rate.The intimal growth rate after pCEA was slower than after other types of CEA and was faster on the patch than on the original wall.