[Efficacy and safety analysis of carotid endarterectomy in the treatment of completely collapsed carotid artery near-occlusion].

Objective: To evaluate the clinical efficacy and safety of carotid endarterectomy (CEA) in the treatment of completely collapsed carotid artery near-occlusion (CANO). Methods: A retrospective analysis was performed on the clinical data of patients with completely collapsed CANO who underwent CEA in the Department of Neurosurgery, Affiliated Hospital of Qingdao University, from January 2020 to December 2024. The changes in the diameter of the collapsed distal internal carotid artery and cerebral blood perfusion on the near-occlusion side before and after surgery were compared, so as to comprehensively assess the clinical efficacy of CEA for completely collapsed CANO. The postoperative follow-up was conducted via outpatient visits or hospitalization at 1, 3, and 6 months after discharge, followed by regular visits every 12 months thereafter. The follow-up content included the occurrence of perioperative complications and long-term clinical outcomes. Results: A total of 30 patients were enrolled with the age of (68±7) years old, including 26 males and 4 females. All patients presented neurological symptoms prior to admission, consisting of 7 cases (23.3%) of transient ischemic attack and 23 cases (76.7%) of cerebral infarction. All patients underwent eversion CEA. The diameter of the collapsed distal internal carotid artery on the near-occlusion side was (3.99±0.80) mm postoperatively, which was larger than the preoperative value of (2.34±0.55) mm. The cerebral blood flow on the near-occlusion side was (63±22) ml·100 g-1·min-1 postoperatively, higher than the preoperative level of (34±15) ml·100 g-1·min-1 (both P<0.05). Perioperative complications occurred in 5 patients (16.67%), while no severe complications such as intracranial hemorrhage, surgical site hematoma, incision infection, or death were observed in any patient during the entire perioperative period. A postoperative death occurred in 1 patient (3.3%) at 4 months. Conclusion: For patients with completely collapsed CANO, CEA could not only partially restore the diameter of the collapsed distal internal carotid artery but also effectively improve cerebral perfusion, making it a safe and effective therapeutic method.