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| Clinical application of vascular ultrasound in carotid endarterectomy |
| FU Wenyan LI Shuling |
| Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Autonomous Region, Huhhot 010059, China |
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Abstract Objective To invastigate the clinical application value of vascular ultrasound in carotid endarterectomy (CEA). Methods Fifty-one patients with carotid atherosclerotic stenosis (stenosis rate was more than 50%) scheduled for CEA in Department of Neurosurgery of Affiliated Hospital of Inner Mongolia Medical University from March 2013 to January 2015 were selected. Carotid ultrasound was performed before operation, during operation and after operation for 6-8 hours and 7-10 days. Two dimensional images showed the diameter of the tube, the thickness of the inner membrane, the size of the plaque and the echo. The color Doppler showed the blood flow and the blood flow characteristics of the stenosis, and the changes of hemodynamics were detected by the frequency spectrum of Doppler. Computed tomographic angiography (CTA) was performed before surgery and 7-10 days after surgery. Results The coincidence rate of ultrasound diagnosis and surgical results of carotid artery stenosis was 88.23%. There was high consistency between ultrasound assessment of plaque echo characters and surgical results. The flow rates of carotid arteries stenosis in 51 cases were decreased significantly during operation and after operation, which showed statistically significant differences compared with that pre-operation (P ＜ 0.05); the RI value was increased, with significant difference (P ＜ 0.05); after operation, among 51 vessels, the lumen of 49 vessels was broadened, the blood flew was smooth, and 2 vessels had thrombosis. Ultrasound showed greater consistency to CTA in carotid artery stenosis, the coincidence rate was 76.48%; the plaque echo property evaluated by ultrasound was better than that of CTA. Conclusion Before operation, vascular ultrasound can helps to diagnose carotid stenosis degree accurately, and knows about the echo characteristics and stability of the plaque, intraoperative monitoring for carotid artery can reduce complications during operation; postoperative re-examination can evaluate the surgery effects, decrease the incidence of perioperative stroke and restenosis as well as disability rate and mortality, which has important significance to increase the success rate of CEA. Therefore, intravascular ultrasound can be as a priority for preoperative screening, intraoperative monitoring and postoperative follow-up of CEA.
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