Comparison of routine shunting and selective shunting in patients with moderate and severe carotid artery stenosis undergoing carotid endarterectomy
10.3760/cma.j.issn.1673-4904.2017.09.016
- VernacularTitle:中重度颈动脉狭窄行颈动脉内膜切除术中常规转流和选择性转流的临床应用对比
- Author:
Daping WEN
;
Jian CUI
;
Jun HANG
- Keywords:
Carotid stenosis;
Endarterectomy;
carotid;
Stroke
- From:
Chinese Journal of Postgraduates of Medicine
2017;40(9):824-827
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the therapeutic effect between routine shunting and selective shunting in patients with moderate and severe carotid artery stenosis undergoing carotid endarterectomy (CEA). Methods One hundred and ninety-two patients with moderate and severe carotid artery stenosis undergoing CEA were selected, and the patients were divided into control group (routine shunting) and observation group (selective shunting) according to the random digits table method with 96 cases each. The intraoperative carotid artery occlusion time and incidences of stroke event 30 d after operation were recorded. Results In the observation group, the rate of carotid artery shunting was 35.4％ (34/96), among which the rate of carotid artery shunting in patients with contralateral severe carotid artery stenosis or occlusion was 8/13, the rate of carotid artery shunting in patients with unilateral carotid stenosis was 31.3％ (26/83), and there was statistical difference (χ2 = 13.006, P<0.01). There was no statistical difference in intraoperative carotid artery occlusion time between control group and observation group ( t=2.091, P>0.05). In the observation group, the intraoperative carotid artery occlusion time in patients with carotid artery shunting was significantly shorter than that in patients without carotid artery shunting:(4.36 ± 0.48) min vs. (10.15 ± 0.91) min, and there was statistical difference (t=7.884, P<0.05). There was no statistical difference in the incidence of stroke event 30 d after operation between control group and observation group (χ2 = 1.189, P>0.05). Conclusions The selective shunting during CEA can reduce the incidence of postoperative stroke event in patients with carotid artery stenosis, and especially it can give a good clinical effect in the patients with contralateral severe carotid artery stenosis or occlusion.
