New Technique for Stroke Prevention and Treatment – Carotid Endarterectomy
Overview of stroke and its causes
Cerebrovascular disease ranks as the third leading cause of human death, with more than 2 million people dying from stroke each year. Cerebrovascular accidents are the leading cause of death and disability in all regions of the world, regardless of race. Data show that 1.2 to 1.5 million new complete strokes occur in China each year. Among the cerebrovascular accidents, ischemic stroke accounts for 75% to 90%. The main cause of ischemic stroke is due to carotid artery stenosis or occlusion, resulting in ischemia or even necrosis of brain tissue.
Carotid artery stenosis is the main cause of ischemic stroke. The most common cause of carotid artery stenosis is the formation of atherosclerotic plaques, abnormal proliferation of intima and smooth muscle cells in the arterial vessel wall due to abnormal lipid metabolism in the muscle, which finally leads to narrowing of the lumen diameter or even occlusion. Carotid artery stenosis occurs mostly in middle-aged and elderly people over 50 years old, but in recent years, due to westernized lifestyles, young people in their 30s are also found to have carotid artery stenosis.
The “past life” of carotid endarterectomy
In the 1950s, medical experts successfully performed the first carotid endarterectomy to prevent cerebral infarction. Since then, carotid endarterectomy has become a standard procedure for preventing cerebral infarction. Currently, carotid endarterectomy has become a routine treatment for atherosclerotic carotid stenosis in Europe and the United States, with about 150,000 people receiving this procedure each year. In China, this surgery has not yet been widely carried out, and only a few larger hospitals have reported cases, but the number is still small. The reasons for this are related to the low level of popularity of medical care in China, the small number of screened patients, and the lack of patient awareness of the dangers of carotid stenosis; in addition, the lack of publicity on the dangers of carotid stenosis by the doctors themselves is also one of the important reasons for the failure to carry out this surgery widely in China.
In recent years, Dr. Jin Yongjian, Director of Traumatic Cerebrovascular Neurosurgery of Aviation General Hospital, has introduced this advanced treatment concept and technology into China, bringing better treatment options for patients with ischemic cerebrovascular diseases, especially those with severe carotid stenosis.
Typical case introduction
The patient, Han Zhenlong, male, aged 64, was seen in the Department of Neurology of Aviation General Hospital on January 17, 2015 for left-sided limb weakness with unfavorable speech. The neurology department gave conservative treatment to unblock the blood vessels. Because of the patient’s severe stenosis, hard atherosclerotic plaque and poor vascular condition, the treatment plan – carotid endarterectomy – was determined for him after discussion in the cerebrovascular disease treatment team. On March 20, the patient underwent carotid endarterectomy under general anesthesia with intracranial vascular ultrasound monitoring after a thorough preoperative evaluation by the team of Director Jin of the Department of Traumatic Cerebrovascular Neurosurgery.
Specialist Profile
Dr. Jin Yongjian is a chief physician and medical doctor, the director of traumatology and cerebrovascular department of Aviation General Hospital, and a young neurosurgeon in China.
He studied at the largest cerebrovascular disease treatment center in Japan and studied under top neurosurgeons such as Nagata, the chief expert of cerebrovascular neurosurgery in Japan and the founder of Mori typing, and then received his MD degree from the National University of Kochi, Japan. Dr. Kim has been engaged in the treatment of cerebrovascular diseases for more than 20 years and has accumulated rich clinical experience in minimally invasive surgery and interventional treatment of cerebrovascular diseases.
His specialties include diagnosis and treatment of ischemic cerebrovascular diseases (including smog, cerebral infarction, cerebral venous thrombosis, transient ischemic attack, etc.); diagnosis and treatment of cerebral atherosclerotic vascular diseases (including carotid stenosis, vertebral artery stenosis, subclavian artery stenosis, intracranial vascular stenosis, etc.); diagnosis and treatment of hemorrhagic cerebrovascular diseases (including cerebral aneurysm, cerebral arteriovenous malformation, cerebral arteriovenous fistula, hypertensive cerebral hemorrhage, etc.). Diagnosis and treatment of hemorrhagic cerebrovascular diseases (including cerebral aneurysm, cerebral arteriovenous malformation, cerebral arteriovenous fistula, hypertensive cerebral hemorrhage, etc.); neurovascular decompression for intractable migraine; interventional treatment of intracranial and carotid vascular diseases (including whole brain angiography, interventional embolization of intracranial aneurysm, carotid artery stenting treatment).
Consultation time: Tuesday (morning)
Consultation telephone: 010-59520282
Jin Yongjian, Department of Neurosurgery, Aviation General Hospital of China Medical University