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a:2:{s:4:"TEXT";s:122:"Choice of the method of surgical or endovascular correction of the atherosclerotic stenosis of the internal carotid artery";s:4:"TYPE";s:4:"HTML";}

Authors: Bockeria L.A.1, Bakhmet’ev A.S.2, Petrosyan K.V.1, Kovalenko V.I.1, Temrezov M.B.3, Makhaldiani B.Z.1

Company:

1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Rublevskoe shosse, 135, Mposcow, 121552, Russian Federation;
2 Razumovskiy Saratov State Medical University, ulitsa Bol'shaya Kazachya, 112, Saratov, 410012, Russian Federation;
3 Aliev Karachay-Cherkess State University, ulitsa Lenina, 29, Cherkessk, 369202, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Heading: Original Research

UDC: 616.133.3-004.6-007.271-089.844

Link: Clinical Physiology of Blood Circulaiton. 2019; 1 (3): 5-11

Quote as: Bockeria L.A., Bakhmet’ev A.S., Petrosyan K.V., Kovalenko V.I., Temrezov M.B., Makhaldiani B.Z. Choice of the method of surgical or endovascular correction of the atherosclerotic stenosis of the internal carotid artery. Cardiovascular Surgery News. 2019; 3 (1): 5–11 (in Russ.). DOI: 10.24022/2588-0284-2019-3-1-5-11

Keywords:  сarotid endarterectomy carotid stenting internal carotid artery atherosclerosis restenosis

Received / Accepted:  March 13, 2019 / March 26, 2019

Full text:  


Abstract

Objective. Improving the results of surgical and endovascular correction of an isolated atherosclerotic stenosis of the internal carotid artery by choosing the optimal surgical intervention based on a study of the results of various options for carotid endarterectomy and carotid angioplasty with stenting.

Patients and methods. The results of the surgical treatment of 256 patients with isolated atherosclerotic stenosis of the internal carotid artery at the hospital, near and distant follow-up were analyzed. Depending on the method of stenosis correction, patients were divided into 4 groups (Ia – carotid endarterectomy without a patch; Ib – carotid endarterectomy with a patch; II – eversional carotid endarterectomy and III – carotid angioplasty and stenting).
Also, in order to identify risk factors for restenosis, dispensary observation of patients after open surgical interventions was carried out (1st group consisted of patients under the supervision of an angiosurgeon and following all recommendations, patients of 2nd control group «fell out of sight» of the surgeon and did not follow the recommendations).

Results. In all considered periods, more preferable results were achieved in eversion carotid endarterectomy and stenting groups (in terms of such factors as survival rate, ischemic stroke, and restenosis of the operated segment). More than 70% of the internal carotid artery restenosis in the group of patients with deaf blanket suture of the arteriotomy hole was observed in 6.6% of patients, using a polytetrafluoroethylene patch in 4.3%, after eversional endarterectomy in 2.1% and after stenting in 1.6% of patients. In the group of patients with active follow-up, up to 3 years after surgery, restenosis of more than 70% was noted in 1.9%, whereas in the control group, in 6.3% of patients.

Conclusions. The immediate and long-term results of surgical treatment of patients with stenosis of the internal carotid artery showed the advantage of eversion carotid endarterectomy and stenting over classical endarterectomy, which, in turn, is justified in patients with low operational risk in the presence of a reduced tolerance of the brain to ischemia and in a situation that makes it difficult eversion endarterectomy and stenting.

References

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About Authors

Leo A. Bockeria, Academician of RAS and RAMS, orcid.org/0000-0002-6180-2619;
Artem S. Bakhmet'ev, Cand. Med. Sc., Assistant of Department of Radiological Diagnostics and Therapy, Cardiovascular Surgeon,
orcid.org/0000-0003-3814-5515;
Karen V. Petrosyan, Cand. Med. Sc., Chief of Department of Endovascular Surgery and Heart and Vascular Examinations, Cardiovascular Surgeon,
orcid.org/0000-0003-3480-1570;
Vladimir I. Kovalenko, Dr. Med. Sc., Professor of Cardiovascular Department, Cardiovascular Surgeon, orcid.org/0000-0002-5347-3376; Marat B. Temrezov, Dr. Med. Sc., Director of Vascular Regional Center, Chief of Cardiovascular Department, Cardiovascular Surgeon,
orcid.org/0000-0002-5521-2823;
Badri Z. Makhaldiani, Postgraduate, Cardiovascular Surgeon, orcid.org/0000-0001-6084-2064

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