A Study Of Internal Carotid Artery Near Occlusion And Distal Hypoperfusion Stenosis

Background:The mortality rate of cerebrovascular events in China has been ranked second and the disability rate of cerebrovascular events was the highest.According to statistics,there are about 3 million new stroke patients in China every year,and about 2 million patients die each year from stroke.Strokes impose a heavy burden on society and families.Ischemic cerebrovascular disease have an serious effects on people’s health and is the leading cause of disability and death.Chronic stenosis of the internal carotid artery caused by atherosclerosis is an important risk factor for ischemic stroke.Internal carotid artery near occlusion is a special stage in the progression of carotid atherosclerotic stenosis,and it is difficult to diagnose.Internal carotid artery near occlusion continues to develop and eventually leads to internal carotid artery occlusion,but its prognosis is better than internal carotid artery occlusion.The treatment of internal carotid artery stenosis is of great significance in the prevention of ischemic cerebrovascular disease.Although carotid endarterectomy and carotid stenting are used to treat carotid stenosis,there is no consensus on the treatment of internal carotid artery near occlusion and distal hypoperfusion stenosis,and the treatment methods and prognosis reported at home and abroad are also differentObjective:This study summarizes and analyzes the clinical data of all patients with internal carotid artery near occlusion undergoing carotid endarterectomy between January 1,2015 and December 31,2018.And to investigate the efficacy of carotid endarterectomy in the treatment of internal carotid artery near occlusion and distal hypoperfusion stenosis and the risk factors associated with complicationsMethods:11 patients with chronic internal carotid artery neat occlusion were selected from 285 patients with carotid atherosclerotic stenosis treated by carotid endarterectomy in the Department of Neurosurgery,Qilu Hospital of Shandong University from January 1,2015 to December 31,2018.All 11 patients were male.We collect the preoperative diameter of the distal lumen of the internal carotid artery near occlusion,the diameter of the ipsilateral external carotid artery,the diameter of the contralateral internal carotid artery,and the diameter of the ill side internal carotid artery during follow-up to perform statistics analysis.And we analyzed the possible factors of complications after operation,including preoperative symptoms,hypertension,diabetes,hyperlipemia,coronary heart disease,smoking history and drinking history.Results:The diameter of the ill side internal carotid artery during follow-up was significantly larger than that before surgery(P=0.000<0.05),and there was no significant difference from the contralateral side(P=0.831>0.05).During the follow-up period of 11 patients,one patient developed intracranial hemorrhage at 20 days postoperatively,and one patient had a cardiac infarction on the first day after surgery.Risk factors such as preoperative symptoms,hypertension,diabetes,hyperlipidemia,coronary heart disease,smoking history and drinking history were not significantly associated with intracranial hemorrhage and myocardial infarction.However,coronary heart disease is a suspected risk factor for postoperative myocardial infarctionConclusion:Carotid endarterectomy is safe for the treatment of internal carotid artery near occlusion;and the internal carotid artery near occlusion distal hypoperfusion stenosis can restore normal size after blood flow impact.This study did not find the risk factors associated with intracranial hemorrhage;coronary heart disease is a suspected risk factor for postoperative myocardial infarction.