Objective To explore the surgical treatment strategies and surgical techniques for carotid artery stenosis patients with severe calcification.Methods A total of 33 patients with carotid artery stenosis with severe calci-fication undergoing surgical treatment were selected from the Second Affiliated Hospital of Naval Medical University from January 2020 to June 2023.Individual selection of valgus CEA,patch CEA,carotid endarterectomy+artificial vascular interplacement,CAS under proximal brain protection,CAS under distal brain protection and TCAR were performed to an-alyze the characteristics and effects of different surgical methods.Results Among the 33 patients with carotid artery stenosis and severe calcification,14 patients(42.4％)underwent inversion CEA,6 patients(18.2％)underwent pa-tenting CEA,and 2 patients(6.1％)underwent CEA+artificial vascular replacement,3 patients(9.1％)with CAS protected by the proximal brain,7 patients(21.2％)with CAS protected by the distal brain,and 1 patient(3.0％)with TCAR.No serious neurological complications occurred after surgery.Symptoms improved or disappeared after 6 months of follow-up.Conclusions For patients with carotid artery stenosis accompanied by severe calcification,CEA is generally the first choice,and attention should be paid to the use of brain protection devices when selecting CAS to re-duce the risk of perioperative cerebral infarction.
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