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颈动脉内膜切除术的结果:来自单中心回顾性队列研究的见解。

Outcomes of carotid endarterectomy: Insights from a single-center retrospective cohort study.

作者信息

AlSheikh Sultan, Aljabri Badr, Alanezi Tariq, Al-Salman Mussaad, Aldossary Mohammed Y, Almashat Abdulatif H, Elmutawi Hend S, Aldoghmani Rakan A, Altuwaijri Talal, Iqbal Kaisor, Altoijry Abdulmajeed

机构信息

From the Department of Surgery (AlSheikh, Aljabri, Al-Salman, Aldossary, Altuwaijri, Iqbal, Altoijry), Division of Vascular Surgery; from the College of Medicine (Alanezi, Almashat, Elmutawi, Aldoghmani), King Saud University, Riyadh, and from the Department of Surgery (Aldossary), Division of Vascular Surgery, Dammam Medical Complex, Dammam, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2024 Apr;45(4):405-413. doi: 10.15537/smj.2024.45.4.20230899.

Abstract

OBJECTIVES

To analyze the outcomes of carotid endarterectomy in individuals with carotid artery stenosis in the context of a tertiary care center.

METHODS

We carried out a retrospective cohort investigation between 2015-2022. Patient data includes demographics, risk factors, preoperative medications, and operative details. The primary outcomes were 30-day postoperative stroke and mortality rates, while the secondary outcome of the study was to assess the morbidity of the procedure.

RESULTS

The mean age of the 54 patients was 66.9±9.88 years, and 57.4% were men. The 30-day stroke rate was 3.7%, and the mortality rate was 1.9%. Most patients did not develop postoperative complications; however, surgical site hematoma was the most common complication encountered (12.9%). Long-term follow-up showed disease regression in 68.5% of patients, with a minority of patients developing ipsilateral restenosis. Admission to an intensive care monitoring unit was the only independent predictor of postoperative complications.

CONCLUSION

This study provided insights into the outcomes of carotid endarterectomy in patients with carotid artery stenosis, emphasizing the importance of careful patient selection and postoperative monitoring. Perioperative risks, including stroke and mortality, were within acceptable limits. Further research incorporating structured and non-structured data for predictive analyses, should explore refining patient profiling and optimizing treatment approaches for different carotid artery stenosis clinical and morphological presentations.

摘要

目的

在三级医疗中心的背景下分析颈动脉内膜切除术治疗颈动脉狭窄患者的疗效。

方法

我们在2015年至2022年期间进行了一项回顾性队列研究。患者数据包括人口统计学信息、风险因素、术前用药及手术细节。主要结局为术后30天的卒中发生率和死亡率,次要结局为评估该手术的发病率。

结果

54例患者的平均年龄为66.9±9.88岁,男性占57.4%。术后30天的卒中发生率为3.7%,死亡率为1.9%。大多数患者未出现术后并发症;然而,手术部位血肿是最常见的并发症(12.9%)。长期随访显示68.5%的患者病情缓解,少数患者出现同侧再狭窄。入住重症监护病房是术后并发症的唯一独立预测因素。

结论

本研究为颈动脉狭窄患者颈动脉内膜切除术的疗效提供了见解,强调了谨慎选择患者及术后监测的重要性。围手术期风险,包括卒中和死亡率,均在可接受范围内。纳入结构化和非结构化数据进行预测分析的进一步研究,应探索完善患者特征分析并优化针对不同颈动脉狭窄临床和形态学表现的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4178/11147582/b471c949feee/SaudiMedJ-45-4-405_1.jpg

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