Objective To summarize the experience in carotid endarterectomy(CEA)for the treatment of carotid artery stenosis,in order to decrease postoperative complications and enhance clinical efficacy.Methods The clinical data of 64 cases receiving surgical treatment for carotid artery stenosis from January 2022 to December 2024 were analyzed retrospectively.Clinical data including age,gender,condition of underlying diseases,degree of carotid artery stenosis,degree of coronary artery stenosis,cerebral blood flow before operation,characteristics of carotid plaques before operation,usage of antiplatelet drugs during perioperative period,usage of carotid shunt during operation,intraoperative carotid artery occlusion time,operation time,postoperative complications and follow-up results were collected.Results All 64 patients underwent CEA successfully.Among them,14 cases underwent shunt during operation,48 cases received single antiplatelet therapy during perioperative period and 16 cases received dual antiplatelet therapy.The median operation time was 161.50(138.00,186.50)min,the clamping time was(28.42±10.72)min.The incidence of postoperative complications included 1 case of incisional infection(1.56%),1 case of incisional hematoma(1.56%),1 case of internal carotid artery occlusion(1.56%),1 case of cerebral hypoperfusion(1.56%).There were no cerebral infarction,no cerebral hyperperfusion,no cardiac events and no brain nerve injury.There was no one case of postoperative complications in the patients who underwent shunt during operation.All patients were followed up for 3～38 months.Among them,there were 2 cases of stroke and there was no death during the fellow-up period.The clamping time was significantly shorter in shunting group than in non-shunting group[(18.43±6.64)min vs.(31.22±9.98)min,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).The degree of carotid artery stenosis was more severe in the dual antiplatelet group than in the single antiplatelet group[on operation side(χ2=-2.377,P<0.05),on contralaternal side(χ2=-2.261,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).Conclusions CEA is an effective treatment for carotid artery stenosis,shunting during CEA is safe.Meticulous perioperative management and operative procedures could help to reduce the rate of postoperative complications.

Objective To summarize the experience in carotid endarterectomy(CEA)for the treatment of carotid artery stenosis,in order to decrease postoperative complications and enhance clinical efficacy.Methods The clinical data of 64 cases receiving surgical treatment for carotid artery stenosis from January 2022 to December 2024 were analyzed retrospectively.Clinical data including age,gender,condition of underlying diseases,degree of carotid artery stenosis,degree of coronary artery stenosis,cerebral blood flow before operation,characteristics of carotid plaques before operation,usage of antiplatelet drugs during perioperative period,usage of carotid shunt during operation,intraoperative carotid artery occlusion time,operation time,postoperative complications and follow-up results were collected.Results All 64 patients underwent CEA successfully.Among them,14 cases underwent shunt during operation,48 cases received single antiplatelet therapy during perioperative period and 16 cases received dual antiplatelet therapy.The median operation time was 161.50(138.00,186.50)min,the clamping time was(28.42±10.72)min.The incidence of postoperative complications included 1 case of incisional infection(1.56%),1 case of incisional hematoma(1.56%),1 case of internal carotid artery occlusion(1.56%),1 case of cerebral hypoperfusion(1.56%).There were no cerebral infarction,no cerebral hyperperfusion,no cardiac events and no brain nerve injury.There was no one case of postoperative complications in the patients who underwent shunt during operation.All patients were followed up for 3～38 months.Among them,there were 2 cases of stroke and there was no death during the fellow-up period.The clamping time was significantly shorter in shunting group than in non-shunting group[(18.43±6.64)min vs.(31.22±9.98)min,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).The degree of carotid artery stenosis was more severe in the dual antiplatelet group than in the single antiplatelet group[on operation side(χ2=-2.377,P<0.05),on contralaternal side(χ2=-2.261,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).Conclusions CEA is an effective treatment for carotid artery stenosis,shunting during CEA is safe.Meticulous perioperative management and operative procedures could help to reduce the rate of postoperative complications.

Objective To investigate the factors affecting the incidence of epilepsy after cranioplasty.Methods A retrospective case control study was conducted on the clinical data of 171 patients with skull defect who underwent cranioplasty between January 2012 and December 2015.There were 126 males and 45 females,with an average age of 50.9 years (range,16-78 years).The patients were divided into epileptic seizure group (61 cases) and non epileptic seizure group (110 cases).The gender,age,defect cause,defect location,defect duration,perioperative antiepileptic drug use,skull defect regional depression volume (Vd),skull defect regional integrity volume (Vf),skull defect regional depression rate (Pd) of two groups were recorded.Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factor of epilepsy after cranioplasty.Results All patients were followed up for 54 months averagely (range,18-90 months).Sixty-one patients (35.7％) had epilepsy after cranioplasty.Univariate analysis suggested that age,defect cause,defect location,defect duration,perioperative antiepileptic drug use,and Vf were not associated with epilepsy after cranioplasty (all P ＞ 0.05);while gender,Vd,and Pd was associated with epilepsy after cranioplasty (P ＜ 0.05).Multivariate logistic regression analysis demonstrated that Pd (OR =0.024,95％ CI 0.001-0.502,P ＜0.05) was independent predictor of epilepsy after cranioplasty.Conclusion Pd is an independent risk factor for epilepsy after cranioplasty and depression degree could significantly affect its incidence.