title: [Efficacies of carotid endarterectomy in the treatment of atherosclerotic carotid artery stenosis].
abstract: OBJECTIVE
  To explore the feasibility and efficacy of carotid endarterectomy (CEA) in the treatment of atherosclerotic carotid artery stenosis (ACAS).
  
  
  METHODS
  From January 2002 to December 2010, 126 ACAS patients undergoing carotid endarterectomy at our hospital were retrospectively analyzed. There were 92 males and 34 females with an average age of 65.5 years old (range: 48 - 75). Among them, 25 had sequelae of cerebral infarction, 69 symptomatic cerebral ischemia and 32 asymptomatic. Sixty-two patients were monitored intra-operatively with transcranial Doppler (TCD). Among them, 5 patients underwent arterial shunt due to a reduced of blood flow in middle cerebral artery for over 50%. The other 64 patients without TCD monitoring underwent intra-operative arterial shunt. And 22 patients underwent patch angioplasty with autologous or prosthetic vascular patch. Intracranial hyperperfusion was prevented by a compression of common carotid artery or control was successful without perioperative mortality. All patients with cerebral ischemic symptoms and some patients with cerebral infarction sequelae had much post-operative improvement. Deviated tongue protrusion occurred in 10 patients and 8 of them recovered at Week 2 post-operation. And 118 patients were followed up for a mean period of 46.5 months (range: 6 - 96). Two patients with deviated tongue protrusion had slight improvements; 2 patients with severe carotid artery stenosis underwent stent angioplasty; 4 patients with moderate carotid artery stenosis received conservative treatment; among 7 deceased patients, two died of cerebral infarction.
  
  
  CONCLUSIONS
  CEA is effective in the treatment of carotid artery stenosis with a high success rate. TCD monitoring during CEA is valuable for preventing cerebral ischemia and intracranial hyperperfusion. Arterial shunt and arterial patch angioplasty should be considered according to certain conditions during CEA.
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing, China. gu-yq@263.net
authors.forename: Yong-quan
authors.initials: YQ
authors.lastname: Gu
authors.forename: Lian-rui
authors.initials: LR
authors.lastname: Guo
authors.forename: Li-xing
authors.initials: LX
authors.lastname: Qi
authors.forename: Yang
authors.initials: Y
authors.lastname: Hua
authors.forename: Xue-feng
authors.initials: XF
authors.lastname: Li
authors.forename: Jian-ming
authors.initials: JM
authors.lastname: Guo
authors.forename: Heng-xi
authors.initials: HX
authors.lastname: Yu
authors.forename: Shi-jun
authors.initials: SJ
authors.lastname: Cui
authors.forename: Ying-feng
authors.initials: YF
authors.lastname: Wu
authors.forename: Zhu
authors.initials: Z
authors.lastname: Tong
authors.forename: Xin
authors.initials: X
authors.lastname: Wu
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhong-Hao
authors.initials: ZH
authors.lastname: Wang
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial