Analysis of the Curative Effect and Prognostic Risk Factors of Carotid Artery Stenosis Treated by Carotid Endarterectomy

WAN Xingzhong; TANG Bo; ZHANG Yong; JIA Wenjie; YAO Qilong

doi:10.3639/j.issn.2095-3097.2025.03.013

Abstract：Objective To explore the efficacy and risk factors ofcarotid endarterectomy(CEA)in the treatment of ca-rotid artery stenosis.Methods A retrospective study was conducted on 126 patients with CEA admitted to the Department of Neurology in Jiayuguan First People's Hospital from February 2018 to July 2022.The mean flow velocity of the middle cerebral artery(MVmcA),pulsatile index(PI),and incidence of poor prognosis were evaluated.Logistic regression model was used to analyze the risk factors for poor prognosis.Results At 5 days and 12 months after surgery,MVmcA and PI levels were signifi-cantly higher in all subjects than before surgery,and the difference was statistically significant(P<0.05);there was no statisti-cally significant difference in MVmcA and PI levels between 12 months after surgery and 5 days after surgery(P>0.05).Among the 126 patients who underwent CEA surgery,24(19.05%)had poor prognosis,including 4(16.67%)with stroke,5(20.83%)with cardiovascular adverse events,3(12.50%)with cranial nerve injury,7(29.17%)with local hematoma,and 5(20.83%)with restenosis after CEA.The univariate results showed that the presence of hyperlipidemia,use of a bypass catheter,history of smoking,degree of carotid artery stenosis,and duration of carotid artery occlusion were associated with poor prognosis in pa-tients after CEA surgery,and the differences were statistically significant(P<0.05).The results of multivariate logistic regression showed that the presence of hyperlipidemia,smoking history,and non-use of diversion catheter were risk factors for poor prog-nosis in patients after CEA surgery(P<0.05).Conclusion CEA treatment can effectively improve cerebral blood flow perfusion in patients with carotid artery stenosis,with good therapeutic effects;patients who have high blood lipids,a history of smoking,and have not used a catheter after CEA surgery are more likely to have poor prognosis.Clinically,the incidence of poor progno-sis in CEA patients can be reduced based on their risk factors.