ĐIỀU TRỊ NGOẠI KHOA HẸP ĐỘNG MẠCH CẢNH NGOÀI SỌ TẠI BỆNH VIỆN CHỢ RẪY: KINH NGHIỆM 10 NĂM

Abstract

Introduction: Carotid endarterectomy has been proven for many years worldwide to be a safe and effective treatment method. Although there have been many studies evaluating the results of carotid endarterectomy, there are currently few studies evaluating the long-term results of surgery. Objective: To assess the short-term, mid-term and long-term outcomes of carotid artery stenosis treated with carotid endarterectomy. Patients and methods: A retrospective descriptive case series was conducted from March 2012 to December 2022 at the Vascular Surgery Department of Chợ Rẫy Hospital. Results: During the period from 2012 to 2022, we performed 294 cases of carotid endarterectomy. The average age was 67.3 (52-91). The male/female ratio was 5.6/1. 82.7% of patients had symptoms of carotid artery stenosis at admission, 85.7% of patients had severe stenosis of the carotid artery on the surgical side on computed tomography. 68% of patients were given general anesthesia; carotid shunting was performed in 23,9 % of patients. Carotid endarterectomy was performed using the inversion technique in 218 cases (74.1%), 46 cases (15.6%) underwent with conventional plus patch angioplasty, the remaining cases (10.3%) were incised longitudinally and sutured directly. Early results: there were 8 (2.7%) cases of cerebrovascular accident, of which 3 (1%) cases died, myocardial infarction had 2 cases (0.83%). After 1-5 years of follow-up, all patients had good clinical symptoms, and there were 7 (2.4%) cases of restenosis. Conclusion: Carotid endarterectomy is a safe and effective treatment method with low rates of adverse events and complications. The rates of restenosis and cerebrovascular accidents during medium and long-term follow-up are very low.