Explore The Improvements That Carotid Endarterectomy Works To The Ischemic Optic Neuropathy Of Carotid Artery Stenosis

Objective:To explore the improvements that Carotid Endarterectomy(CEA)works to the ischemic optic neuropathy of carotid artery stenosis,and to explore relationships between them,and do contributes to the clinic treatments.Methods:Our retrospective study based on the 50 severe carotid artery stenosis patients.The patients had been treated in the neurosurgery at the central hospital of Dalian from october.2015 to February.2017.After being admited to collect medical history,who observed in all patients with amaurosis fugax.Given routine treatment of secondary prophylaxis of cerebrovascular disease,and then improved the head and neck angiography(CTA,MRA and DSA)check.Addition we need perfecting the fluroescence fundus angiography(FFA)inspections,in order to make clear diagnosis of carotid artery with severe stenosis,the patients who associated with ischemic optic neuropathy.What needs to point out is that the stenosis degree of all the patients reached 70-99%.The position of plaques in carotid artery bifurcation or the interal carotid artery.We divided the patients into 2 parts: 30 patients receive the CEA surgery and work as the experimental group,and the other 20 patients get the expectant treatment and work as the contrast group.After that we prepared some monitoring for the patients separately before the surgery and after one week,one month,three months,and a year.The monitoring includes vision,the ophthalmic artery velocity of transcranial doppler and the arm-retina circulation time.Postoperaive pathology were confimed as carotid atherosclerotic plaques.After the surgery there is professional ultrasound physician who did the carotid ultrasound examinations for the patients.If the treated carotid artery side didn’t narrow again,we will keep on the monitoring,but if not,we will give it up.Rearch results:After admission,all patients were admitted to the hospital,who were given regular oral administration of aspirin 100 mg daily and atorvastain calcium 20 mgevery night.The sugar and pressure in the blood were controlled well.All the 30 patients in the experimental group not only had a smooth and sucessful operation,but also the plaques were completely removed.The pathological reports of postoperative were all carotid atherosclerotic plaques.During the follow-up period of 1 week,1month,3months,and a year,the ultrasonic examination of carotid artery was perfomed by the professional doctor.In the experimental group,30 patients with detailed physical examination,we find that the visual acuity was more and more clear than befor surgery and with no amaurosis fugax happened.After the surgery,the patients’ eyesight get obviously better especially after one month,not only the peak of the ophthalmic artery velocity was much higher,but also the arm-retina circulation time was shortened than before especially after one week.The distinction has significance in the statistics.(p<0.05).In the contrast group,20 patients with conservative treatment who were cured by secondary prevention of conventional cerebrovascular disease.The same doctor detected the visual acuiy index,the velocity of opthalmic artery of TCD and the arm-retinal circulation time with the identical time.They didn’t have much difference on the upper aspects.(p>0.05).Checked test of vision,the peak of the ophthalmic artery velocity and the arm-retinal circulation time of the EG Which change siginificantly compared with CG.(p<0.05).Conclusions:The carotid endarterectomy can apparently improve the condition of ischemic optic neuropathy of carotid atherosclerotic stenosis.Carotid atherosclerotic stenosis can lead to ischemic optic neuropathy,an important reason of ischemic optic neuropathy which is carotid atherossclerotic.They may be casually related to each other.