Clinical Analysis Of Forming Complex Of Carotid Artery Stenosis

Background:Carotid artery system caused by atherosclerotic stenosis and occlusionand ischemic stroke (ischemic stroke) is closely related to the occurrence, clinicalinterventions including carotid artery intima Department of internal medicinetreatment,stripping treatment of surgery and vascular intervention. In recent years,with the rapid development of interventional techniques, interventional equipment ofcontinuous improvement and the continuous improvement of technology, and the use ofcerebral protection device, carotid stenting angioplasty has been increasingly used in thetreatment of ischemic stroke, as the carotid artery intima gold standard decortication(carotid endarterectomy, CEA) is a challenge, both merits become a hot controversy, inthis paper, the center line in patients with carotid artery stenting were retrospectivelyanalyzed, the evaluation of carotid artery stenting (carotid angioplasty and stenting,CAS) in treatment of ischemic stroke of the safety, feasibility, validity.Objective: To investigate the risk factors of CAS in the treatment of carotid arterystenosis, the analysis of its effectiveness, safety and technical feasibility, indications andcomplications of the prevention and treatment of CAS in different populationdifferences summary.Methods:A retrospective analysis from2003to2013in our hospital of carotid arterystenting in184cases,218stents. Analysis of the forming of gender, age, hypertension,high blood fat, high blood sugar, smoking, complex vascular risk factors and carotidartery stent complications, mortality, stroke, and then the relationship between thestenosis rate, to investigate the factors and how to prevent. And many factors in oldgroup, vascular risk factors analysis and comparison of group complexity, technicalfeasibility discussion on, on the barrier between carotid artery stenting is safe andeffective.Results:The immediate postoperative results:218stents were implanted in this study of183patients with carotid artery stenosis, application of umbrella204, the far endsaccule14. The success rate of operation was100%. Postoperative angiography showed stenosis patients improved obviously, visible brain parenchymal perfusion improved.The complex vascular stent (including single vascular stenosis, vascular parallel serialnumber, serial and parallel stenosis lesions of stenosis, stenosis and aneurysm,combined with other lesions of vascular disease, complex)138people (75.4%). Seriouscomplications after7people (3.8%). Peri operation period (after30days)2deaths(mortality1.1%), preoperative stenosis (stenosis50%-100%average79.58±12.56%),postoperative residual stenosis0%-30%(mean12.02±8.96%stenosis). PreoperativeNIHSS score0-16(mean0.87±1.89) NIHSS score at discharge (mean0.63±1.71)0-16.2, the follow-up results, follow-up of151people (82.5%),32(17.5%) lost to follow-up.Postoperative CTA, DSA explicitly vascular87people,7people (7.7%), of which3months after surgery,4(4.6%). During the follow-up period,4recurrent stroke (2.6%),stroke0people within1years after operation. Various causes of death of12people(7.9%), of which1years after surgery in the death of7people (4.6%). The proportion isconsistent with the reported literature. Statistical data of elderly group, complexvascular group showed the incidence rate of complications, the incidence of stroke/death, rate was higher than that of normal group, but no statistical difference.Conclusion: Carotid artery stenting in treatment of ischemic cerebrovascular disease isa safe, effective. The efficacy and safety of no less than the gold standard for carotidendarterectomy, and its use in wider scope, for the high-risk group, complex group andother groups of vascular operation is safe, effective. Cerebral protection device iseffective to reduce the complications and mortality.