Analysis on the therapeutic effect of carotid endaterectomy: a report of 65 cases

Abstract

Objective To discuss the therapeutic effect of carotid endarterectomy (CEA) for patients with carotid atherosclerotic stenosis.  Methods A total of 65 patients with carotid atherosclerotic stenosis were enrolled. There were 35 cases of left stenosis (53.85%) and 30 cases of right stenosis (46.15%). According to North American Symptomatic Carotid Endarterectomy Trial (NASCET), there were 17 cases of moderate stenosis (26.15%) and 48 cases of severe stenosis (73.85%). All of them underwent CEA, and the postoperative complications and prognosis were observed and assessed.  Results CEA was successfully performed in 65 patients with a mean operation time of 90 min and a mean carotid blocking time of 30 min. There was no use of carotid patch and no intraoperative shunting. After CEA, the clinical symptoms of all patients were improved. Postoperative complications were as follows: one patient presented muscle weakness and numbness of contralateral extremities, and recovered after one-week symptomatic treatment; cranial nerve injury occurred in 2 cases: one recurrent laryngeal nerve injury and the other glossopharyngeal nerve injury, however, all injuries were transient and were cured 6 months after the operation; one case presented restenosis of ipsilateral carotid without clinical symptom and thus received conservative treatment; one case suffered from acute myocardial infarction 4 months after the operation, and recovered after symptomatic treatment; one case died without clear cause of death 9 months after the operation. None of these patients occurred with ischemic stroke. Conclusions Full preoperative preparation, close monitoring and meticulous manipulation during operation, frequent postoperative observation and treatment can ensure the treatment effect of CEA.

DOI: 10.3969/j.issn.1672-6731.2015.03.009