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Carotid atherosclerotic stenosis is closely related to recurrent ischemic stroke. Currently, therapies for carotid artery stenosis are mainly intensive medication or surgery, including carotid artery stenting (CAS) and carotid endarterectomy (CEA). The prevention of stroke lies in identifying risk factors for carotid artery stenosis, screening patients with high risk of recurrent stroke, so as to benefit from medication or surgery. However, therapeutic schedule is formulated only according to the degrees of carotid artery stenosis, and there lacks of individualized treatment. Recently, new imaging modalities, such as noninvasive high.resolution MRI (HRMRI) could detect the vulnerability of carotid atherosclerotic plaque. Compared with the degree of carotid artery stenosis measured by conventional DSA, noninvasive HRMRI can precisely predict the risk of ipsilateral stroke according to plaque morphology, so as to guide individualized treatment. DOI: 10.3969/j.issn.1672-6731.2017.05.012

Objective To analyze the application of hybrid treatment for complicated carotid artery stenosis and occlusion and explore its clinical significance. Methods The clinical data of 12 patients, including 8 carotid artery occlusion patients and 4 multilevel carotid artery stenosis patients, who received hybrid treatment during the surgery were analyzed, and the efficacy and safety of combined surgical techniques were explored. Results For 8 carotid artery occlusion patients, 7 procedures were successful. For 4 multilevel carotid artery stenosis patients, all procedures were successful. They underwent both carotid endartertectomy (CEA) and common carotid artery angioplasty during the surgery. There was no neurological morbidity or mortality after operation. Conclusions Intraoperative angioplasty combined with CEA (hybrid treatment) is an effective and safe method for carotid artery occlusion or multilevel carotid artery stenosis. doi：10.3969/j.issn.1672-6731.2014.02.005

Objective To review the clinical data of elderly patients treated by carotid endarterectomy (CEA) and carotid artery stenting (CAS), and analyze the safety of two kinds of surgery. Methods A total of 691 patients with carotid artery stenosis underwent CEA (121 cases) and CAS (570 cases) respectively. The risk factors, clinical symptoms and postoperative complications in 2 groups of patients were analyzed, and the safety of two kinds of surgery were assessed. Results After 30 d of operation, no significant difference was found between 2 groups in death rate (0.83% vs 1.05%, P = 1.000), stroke rate (4.13% vs 1.93% , P = 0.258) or myocardial infarction rate (0.83% vs 0, P = 0.175). Heart complications and cranial nerve injury rate in CEA group was significantly higher than that in CAS group (8.26% vs 1.05%, P = 0.000; 4.96% vs 0, P = 0.000), while sinus bradycardia or hypotension rate in CEA group was significantly lower than that in CAS group (0 vs 7.54%, P = 0.002). Conclusions Both CEA and CAS are safe for the elderly patients. However, the conditions of elderly patients should be evaluated before operation in order to reduce occurence of complications after operation. doi：10.3969/j.issn.1672-6731.2014.01.006Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v14n1a6

doi：10.3969/j.issn.1672-6731.2014.02.001