Zhang Jianbin, Chen Jie, Xu Xiaojie, Sun Mingsheng, Chen Shu, Liu Peng, Ye Zhidong
Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.
Department of Endocrinology, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, Beijing, China.
Front Neurol. 2022 Apr 14;13:765795. doi: 10.3389/fneur.2022.765795. eCollection 2022.
Report our preliminary experience of carotid endarterectomy (CEA) for the treatment of carotid near-occlusion (CNO) with recurrent symptoms.
Retrospectively analyze the demographics, treatment detail, and outcomes data of 122 patients with CNO from 2014 to 2020. According to whether distal full collapse exists, patients were classified into the full collapse group and the non-full collapse group. The incidence of death, myocardial infarction, stroke, and other variables were compared between the two groups.
A total of 122 patients with CNO and recurrent symptoms were enrolled. The demographics were comparable between the two groups. Thirty-day incidence of primary endpoints was 1.85% in the full collapse group and 4.41% in the non-full collapse group. Twelve-month incidence of primary endpoints was 7.41% in the full collapse group and 4.41% in the non-full collapse group. One re-stenosis occurred in the non-full collapse group 8 months after CEA.
For patients with CNO with recurrent symptoms, CEA is not worse than the results described in historical control groups, despite whether distal full collapse exists. The shunt is important to avoid intraoperative hypoperfusion and postoperative hyperperfusion. The long-term results should be further evaluated.
报告我们采用颈动脉内膜切除术（CEA）治疗有复发症状的颈动脉近闭塞（CNO）的初步经验。
回顾性分析2014年至2020年122例CNO患者的人口统计学资料、治疗细节和结局数据。根据是否存在远端完全塌陷，将患者分为完全塌陷组和非完全塌陷组。比较两组的死亡、心肌梗死、中风发生率及其他变量。
共纳入122例有复发症状的CNO患者。两组的人口统计学资料具有可比性。完全塌陷组的30天主要终点发生率为1.85%，非完全塌陷组为4.41%。完全塌陷组的12个月主要终点发生率为7.41%，非完全塌陷组为4.41%。非完全塌陷组在CEA术后8个月发生1例再狭窄。
对于有复发症状的CNO患者，无论是否存在远端完全塌陷，CEA的结果均不劣于历史对照组所描述的结果。分流对于避免术中低灌注和术后高灌注很重要。长期结果应进一步评估。
