ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT BÓC LỘN NGƯỢC NỘI MẠC ĐIỀU TRỊ TẮC ĐỘNG MẠCH CẢNH TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Surgery for carotid artery disease has been applied for a long time. Carotid artery surgery should be the first choice in patients with low surgical risk, with the group having symptoms with stenosis of 50 - 99% and the group without symptoms with stenosis from 70 - 99% of the research sample [7]. There are two surgical methods, including eversion endarterectomy and artificial vascular patch. According to the study of Cao P et al. (2000), with a sample size of 1353 cases, comparing the two surgical methods of inverted endarterectomy and artificial vascular patch surgery, there was no difference in long-term follow-up. However, the mortality rate in the follow-up period of inverted endarterectomy was lower than that of artificial vascular patch surgery, accounting for 8.1% and 9.3% of the research sample, respectively [6]. At Cho Ray Hospital, many studies have not evaluated the long-term results of carotid blood circulation after endovascular carotid artery dissection. That is the reason why we conducted this study. Methods: Retrospective description of case series. Results: The study had an average age of 75.4 ± 18.2, with the majority being male. Lipid metabolism disorders and diabetes accounted for 88.9% and 70.8%, respectively. Most of the cases in the study were symptomatic, accounting for 76.2%. Carotid Arterial lesions with 70-90% stenosis of the lumen diameter were the main ones, accounting for 79.8% of the study sample. Local anesthesia accounted for 57.2%. Most did not use shunts during surgery. Common carotid and internal carotid artery combined everion endarterectomy accounted for a high proportion, accounting for 89.5%. The carotid artery clamping time was about 18.5 minutes, and the average surgical time was about 54 minutes. The technical success rate was 97.9%, the 30-day mortality rate was 2.7%. The primary patency rate accounted for 85.1% of the study sample during the follow-up period. Conclusion: Surgical treatment of infrarenal abdominal aortic aneurysm has a high technical success rate, few complications, and a high survival rate in the follow-up period. Therefore, this method is effective, safe, and has few complications