This study is a prospective, single center cohort study. By combining pathological examination of carotid atherosclerotic plaque with preoperative imaging examination, we explore the imaging characteristics of high-risk carotid plaque, and explore the effectiveness and safety of different surgical methods (CAS and CEA) for high-risk plaque patients with carotid stenosis.
According to the inclusion and exclusion criteria, 100 patients with carotid artery stenosis who underwent surgical reconstruction surgery at our research center were prospectively collected from December 2023 to December 2024. Preoperative laboratory examinations such as blood routine, biochemistry, coagulation, and imaging examinations such as carotid artery ultrasound and TCCD, carotid artery ultrasound contrast, high-resolution MRI, head MRI plain scan, carotid artery CTA or DSA were completed, Based on the comprehensive evaluation of the patient's condition by the supervising physician, the appropriate surgical method (CEA or CAS) is selected. Follow up will be conducted 1/3/6/12 months after surgery to evaluate the incidence of endpoint events (cerebral infarction+all-cause death+postoperative restenosis), MoCA and MMSE cognitive scores, quality of life scores, and severe perioperative complications. At the same time, for patients undergoing CEA surgery, pathological examination of the postoperative carotid artery plaque will be conducted to clarify the nature of the plaque, and combined with imaging examination, the characteristics of high-risk carotid artery plaques will be studied
Study Type
OBSERVATIONAL
Enrollment
100
After the patient is admitted to the hospital, the supervising doctor comprehensively evaluates the patient's general condition and adopts CEA or CAS treatment. The researcher does not provide advice to the supervising doctor and only observes safety and effectiveness
Xuanwu Hospital, Capital Medical University
Beijing, China
RECRUITINGAny Periprocedural Stroke, Myocardial Infarction, or Death During1 month Peri-procedural Period, and Postprocedural Ipsilateral Stroke 1 to 12-months.
Composite of any periprocedural stroke (ipsilateral or contralateral; major or minor), myocardial infarction, or death during1 month peri-procedural period, and postprocedural ipsilateral stroke 1 to 12-months.
Time frame: 0 to 12 months
Rate of complications
Rate of complications within 30 days, complications include cranial nerve and peripheral nerve injury, vascular injury, wound complications as neck incision or related to puncture site, and other (such as anesthesia) complications.
Time frame: 30days
Incidence of ipsilateral stroke
Incidence of ipsilateral stroke at 30 days follow up
Time frame: 30days
Incidence of death
Incidence of death at 30 days follow up.
Time frame: 30 days
Carotid restenosis rate
Carotid restenosis was defined as restenosis ≥50% after carotid revascularization, that is, peak systolic velocity ratio (PSVR) ≥2.0 on ultrasound examination.
Time frame: 3,6,12 months
Improvement in cognitive function
Cognitive function was assessed by Mini-mental State Examination (MMSE) during follow up.
Time frame: 0,3,6,12months
Improvement in cognitive function
Cognitive function was assessed by Montreal Cognitive Assessment Scale (MoCA) during follow up.
Time frame: 0,3,6,12months
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Quality of life rating
Use VascuQol to evaluate quality of life scores
Time frame: 30 days
Ultrasound and pathological indicators related to high-risk plaques
Ultrasound are used to visualize plaques, combined with pathological examination, to identify the imaging characteristics of high-risk plaques
Time frame: 0-7days
CT and pathological indicators related to high-risk plaques
CT are used to visualize plaques, combined with pathological examination, to identify the imaging characteristics of high-risk plaques
Time frame: 0-7days
MRI and pathological indicators related to high-risk plaques
MRI are used to visualize plaques, combined with pathological examination, to identify the imaging characteristics of high-risk plaques
Time frame: 0-7days