When it comes to carotid artery stenosis, in the past we thought that people over the age of 60 were at high risk. Nowadays, its age of onset has moved forward significantly, and there are not a few patients in their 40s.
What should I do if carotid artery stenosis occurs? Mild levels can be controlled by medication, and if the stenosis exceeds 70%, surgical intervention is required regardless of whether there are symptoms or not. There are also patients who are not severely narrow, but the symptoms are very obvious, frequent transient cerebral ischemia, and even cerebral infarction, such patients should also undergo surgical intervention.
So, the question arises again, if the doctor judges that surgical treatment is needed, is it to do endometrial detachment or stent implantation? This is a problem that makes many patients entangled and confused. Dr. Qian Hai, deputy chief physician of the Department of Cerebrovascular Surgery of Sanbo Brain Hospital of Capital Medical University, introduced that there are huge differences in the proportion of patients with endometrial decortication and stent implantation at home and abroad. According to statistics, the number of patients who do peeling surgery in the United States is ten times that of patients who do stent implantation, while the situation in China is just the opposite. The reason is directly related to the resistance of the Chinese people to the opening of the surgery and the late start of the domestic endometrial decortication surgery, and the lack of publicity.
In fact, for many years endometrial detachment surgery has been considered the "gold standard" procedure for treating carotid plaque with stenosis and preventing stroke (stroke), which allows the plaque to be completely stripped clean under microscopy and restore the patency of the blood vessels. Its advantage is that it can solve the problem of carotid artery stenosis cleanly and thoroughly, but it is after all an open surgery, and there will inevitably be risks, such as the need to block blood vessels during surgery, so the brain will face the risk of temporary ischemia, and there may also be a risk of overperfusion (increased cerebral blood flow).
The biggest feature of stent implantation is that there is no need to open the operation, and the principle is to put the stent to open the blood vessel and let the blood flow through. However, it does not remove plaque, and there is also a risk of plaque shedding and causing cerebral infarction or overperfusion during surgery.
In general, the two treatment methods have their own advantages and disadvantages, and there is no need to worry too much about which is better or worse. The actual situation of the patient should be comprehensively considered and the individualized treatment mode suitable for the patient should be selected.
Of course, it is undeniable that with the strengthening of the training and promotion of carotid artery stenosis intimal stripping technology in China, its clinical application will certainly be more popular.
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