Effect analysis of carotid endarterectomy for high bifurcation carotid artery stenosis
10.3760/cma.j.cn115354-20211125-00769
- VernacularTitle:颈动脉内膜切除术治疗高分叉颈动脉狭窄的疗效分析
- Author:
Junchen SI
1
;
Kai YU
;
Kai LIN
;
Qunlong JIANG
;
Guoyang YIN
;
Jiheng HAO
;
Jiyue WANG
;
Liyong ZHANG
Author Information
1. 聊城市人民医院神经外科，聊城 252000
- Keywords:
Carotid artery stenosis;
High bifurcation;
Carotid endarterectomy;
Posterior abdomen of digastric muscle
- From:
Chinese Journal of Neuromedicine
2022;21(2):139-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explores the clinical efficacy and safety of carotid endarterectomy in patients with high bifurcation carotid artery stenosis.Methods:A total of 169 patients with carotid artery stenosis (147 patients with non-high bifurcation carotid artery stenosis and 22 patients with high bifurcation carotid artery stenosis), underwent carotid endarterectomy under surgical microscope in our hospital from January 2017 to January 2020, were included in the study. Patients with high bifurcation carotid artery stenosis were operated by cutting off the posterior abdomen of the digastric muscle to assist in exposing the distal end of the internal carotid artery plaque. Cervical CTA/DSA examination was performed within one week of surgery to confirm whether carotid artery stenosis was relieved; ultrasound examination of cervical vessels was performed 6 months and 1 year after surgery to determine whether restenosis was appeared in the carotid artery. The surgical efficacy, perioperative complications and re-examination results were compared between the two groups.Results:Postoperative carotid artery stenosis was relieved in both groups. The proportions of new cerebral infarction and temporary neurological impairment between the two groups (4.5% vs. 2.0%; 9.1% vs. 3.4%) showed no significant differences ( P>0.05). Carotid artery restenosis was not found in both groups. There was no obvious functional abnormality in the digastric muscles of patients with high bifurcation carotid stenosis. Conclusion:Cutting off the posterior abdomen of the digastric muscle during carotid endarterectomy can better expose the distal end of the internal carotid plaque in patients with high bifurcation carotid stenosis, and provide convenience for effective relief of carotid artery stenosis with high safety.
