高纤维蛋白原血症颈动脉内膜剥脱术中紧急取栓1例报告并文献复习.

Objective To investigate the risk and prevention strategy of carotid endarterectomy（ CEA） in patients with transient ischemic attack（ TIA） complicated with hyperfibrinogenemia. Methods The clinical data of a patient with internal carotid artery stenosis complicated concomitant hyperfibrinogenemia who developed thrombosis after CEA was analyzed retrospectively. The clinical manifestations, laboratory examination, treatment process were analyzed combined with relevant literature. Results The preoperative examination showed that one side of internal carotid artery was severely stenosed with hyperfibrinoemia. The patients were treated with defibrillation, lipid-lowering and antiplatelet therapy. CEA was performed 2 weeks later. The operation was successful, but stroke occurred immediately after the operation. The incision was reopened instantly, and the thrombus was removed successfully by catheter and stent technology. Batroxobin was used to reduce the fiber in the process. The neurological function recovered to normal after resuscitation and the imaging examination also showed that the carotid artery on the stenosis side has restored blood circulation. According to the coagulation function index after operation, the patient was continued to receive the treatment of reducing fiber, lipid and antiplatelet. Conclusions Hyperfibrinogenemia is an independent risk factor for atherosclerosis and stroke. During the operation of CEA, defibrillation therapy should be carried out throughout the whole process of the perioperative period, so as to prevent the occurrence of stroke immediately after operation. [ABSTRACT FROM AUTHOR]