Study On Selective Shunt Carotid Endarterectomy

Objective:To determine the complications and risk factors of stroke or death within 30 days after carotid endarterectomy under the selective shunt of symptomatic carotid stenosis,as well as the factors influencing the shunt.Methods:From August 2011 to August 2019,patients with symptomatic carotid stenosis diagnosed by our single center and underwent selective shunt carotid resection were included in the study.Results:A total of 649 cases were diagnosed as symptomatic stenosis of the carotid artery and underwent selective carotid endarterectomy.There were 16 cases(2.47%)with stroke or death within 30 days after operation.Multivariate analysis showed that preoperative mRS?3(P = 0.011,OR = 5.168,95% CI: 1.456-18.343)and contralateral severe carotid stenosis(P = 0.039,OR = 3.080,95% CI: 1.056-8.982)were independent risk factors for stroke or death within 30 days after operation.75 cases(11.56%)underwent shunt during operation.There were significant differences between shunt group and non-shunt group in gender(P = 0.041),age(P = 0.000),history of heart(P = 0.000),history of diabetes(P = 0.002)and drinking history(P = 0.049),but there was no difference in contralateral severe carotid stenosis(P = 0.380).Conclusion:Our study shows that selective shunt can control stroke and death events at a low level within 30 days after CEA in patients with symptomatic carotid stenosis.Preoperative mRS? 3 and severe contralateral stenosis were related to the occurrence of stroke and death events 30 days after operation.Women,old age,diabetes mellitus,hypertension,heart disease and drinking were more likely to receive shunt,while severe stenosis of contralateral carotid artery did not affect the shunt.