Clinical Study On Carotid Angioplasty And Stending With Cerebral Protection Device In Treatment Of Severe Carotid Stenosis

Background:Stroke is the third leading cause of death in the world today,second only to cardiovascular disease and cancer.Ischemic stroke is a series of pathological changes that occur after cerebral ischemia and hypoxia caused by intracranial or extracranial vascular stenosis or thrombosis.Extracranial carotid artery stenosis is a common cause of ischemic stroke.Objective:Carotid artery stenting(CAS)has emerged as a potentially less invasive alternative to carotid endarterectomy in the 1980s.The purpose of this study is to evaluate the efficacy,safety,surgical method and prevention of complications of CAS with cerebral protection device in treatment of patients with severe carotid stenosis,to understand the factors related to ischemic stroke in patients with severe carotid artery stenosis and restenosis after implantation.Methods:Clinical data of 48 patients received CAS during October 2013 to December 2014 were analyzed retrospectively,recording the data of sex,age,basic disease,smoking history,blood lipid,blood glucose,homocysteine,clinical symptoms,the site and degree of stenosis,the incidence of restenosis,transient ischemic attack(TIA),stroke and death were also observed through follow-up.Results:Of the 48 patients with carotid artery stenosis,36(75%)were symptomatic stenosis and 12(25%)were asymptomatic stenosis.Analysis of symptomatic stenosis homocysteine and degree of carotid artery stenosis was significantly higher than asymptomatic stenosis.All the 48 patients received CAS successfully,the average stenosis rate was(85.27±11.52)%and the postoperative residual stenosis rate was(18.12±3.36)%,the difference was statistically significant(P<0.01).No new TIA,cerebral ischemia and patient death occurred in the following up,but the severe stent restenosis were observed in 3 patients and stent fracture in 1 patient.Conclusion:Homocysteine,arterial stenosis may be independent of symptomatic internal carotid artery stenosis.CAS with cerebral protection device in treatment of severe carotid stenosis safe and effective,but the long-term effecacy needs to be p roved in future.