Comparative Results of Surgical Treatment of Bilateral Atherosclerotic Occlusive Stenotic Carotid Artery Disease

Authors

  • Алексей Анатольевич Фокин South Ural State Medical University, 64, Vorovskogo street, Chelyabinsk, 454092, Russian Federation
  • Мария Владимировна Мудрякова South Ural State Medical University, 64, Vorovskogo street, Chelyabinsk, 454092, Russian Federation

DOI:

https://doi.org/10.21638/11701/spbu11.2016.305

Abstract

ICA occlusion leads to stroke at a frequency of up to 40% during the first year after the occlusion, and then at a rate of about 7% per year. The occlusion of the internal carotid artery in the neck is observed in 90% of cases, in other cases, occlusion takes place in the cavernous terminal part of the internal carotid artery. Improved treatment results, taking into account the information obtained in the prevention of ischemic stroke in patients with occlusion of the internal carotid artery in the remote period of observation. During the period from 2007 to 2015 in the department of vascular surgery OKB №3 530 patients were treated with lesions of brachiocephalic arteries. The number of patients with occlusion of the internal carotid artery on one side and stenosis on the other was 93 (17.5%). The group of patients treated only conservatively maintained a high incidence of TIA, 20.5% over the first year of observation. Within 8 years, 26.6% had ipsilateral stroke in the pool, this marked the occurrence of the two deaths due to myocardial infarction, and 8 due to ischemic stroke; Two patients had concomitant death due to cancer. The results of 8 years observation on operated and non-operated patients show that in patients who were operated on in most cases the marked signs of impairment of cerebral circulation in ipsilateral hemisphere were not developed. The results of observation over a group of patients who were not operated coincide with the average data according to which the patients who suffered an ischemic stroke have the risk development of the subsequent stroke at a level of 5–9% in a year, and approximately 40% of them have a repeated stroke over a 5 year period after the first stroke. The best clinical effect belonged to carotid endarterectomy, performed on patients with transitional ischemic attacks. The analysis of the results of the research testifies to the stable and long-term effect of the procedure. Refs 8. Fig 1. Tables 2.

Keywords:

occlusion of internal carotid artery, stenosis of internal carotid artery, carotid endarterectomy, ischemic stroke

Downloads

Download data is not yet available.
 

References

Литература

Кобза И. И., Мелень А. П., Трутяк Р. И. и др. Профилактика ишемического инсульта у пациентов с окклюзией внутренней сонной артерии: магистрализация наружной сонной артерии // Сердце и сосуды. 2013. № 3. С. 37–41.

Национальные рекомендации по ведению пациентов с заболеваниями брахиоцефальных артерий: Российский согласительный документ. М.: Российское общество ангиологов и сосудистых хирургов; Ассоциация сердечнососудистых хирургов, 2013. URL: http://angiolsurgery.org/recommendations/2013/recommendations_brachiocephalic.pdf (дата обращения: 27.03.2013).

Покровский А. В., Белоярцев Д. Ф. Хроническая сосудисто-мозговая недостаточность (окклюзионное поражение ветвей дуги аорты) // Клиническая ангиология. 2004. Т. 1. С. 734–804.

Шатравка А. В., Сокуренко Г. Ю., Акифьева О. Д. и др. Oценка эффективности операций на наружной сонной артерии // Ангиология и сосудистая хирургия. 2015. Т. 21, № 2. С. 115–123.

Lee J. I., Jander S., Oberhuber A., Schelzig H. et al. Stroke in patients with occlusion of the internal carotid artery: options for treatment // Expert Rev. Neurother. 2014. Vol. 14, No 10. P. 1153–1167.

Dalainas I., Avgerinos E. D., Daskalopoulos M. E. et al. The critical role of the external carotid artery in cerebral perfusion of patients with total occlusion of the internal carotid artery // J. Int. Angiol. 2012. Vol. 31,No 1. P. 16–21.

Белова А. Н. Шкалы, тесты и опросники в неврологии и нейрохирургии: руководство для практикующих врачей и научных работников. М., 2004. 432 с.

Robert L. Grubb Jr., William J. Powers. Surgical results of the Carotid Occlusion Surgery Studys // J. Neurosurgery. 2013. No 2. P. 25–33.


References

Kobza I. I., Melen’ A. P., Trutiak R. I. et al. Profilaktika ishemicheskogo insul‘ta u patsientov s okkliuziei vnutrennei sonnoi arterii: magistralizatsiia naruzhnoi sonnoi arterii [Prevention of coronary stroke of the occlusion of the internal carotid artery: magistralisation of the outer carotid artery]. Serdtse i sosudy, 2013,no. 3, pp. 37–41. (In Russian)

Natsional’nye rekomendatsii po vedeniiu patsientov s zabolevaniiami brakhiotsefal’nykh arterii: Rossiiskii soglasitel’nyi dokument [National recommendations for the patients with brachiocephalic arteries:Russian conciliation Document]. Мoscow, Rossiiskoe obshchestvo angiologov i sosudistykh khirurgov; Assotsiatsiia serdechnososudistykh khirurgov, 2013. Available at: http://angiolsurgery.org/recommendations/2013/recommendations_brachiocephalic.pdf (accessed: 27.03.2013) (In Russian)

Pokrovskii A. V., Beloiartsev D. F . Khronicheskaia sosudisto-mozgovaia nedostatochnost’ (okkliuzionnoe porazhenie vetvei dugi aorty) [Chronic neurovascular brain deficiency (occlusion defeat of the braches of the aorta arc]. Klinicheskaia angiologiia, 2004, vol. 1, pp. 734–804. (In Russian)

Shatravka A. V., Sokurenko G. Iu., Akif ’eva O. D. et al. Otsenka effektivnosti operatsii na naruzhnoi sonnoi arterii [Evaluation of the effectiveness of the operations on the external carotid artery]. Angiologiia I sosudistaia khirurgiia, 2015, vol. 21, no. 2, pp. 115–123. (In Russian)

Lee J. I. Jander S., Oberhuber A., Schelzig H. et al. Stroke in patients with occlusion of the internal carotid artery: options for treatment. Expert Rev. Neurother, 2014, vol. 14, no. 10, pp. 1153–1167.

Dalainas I., Avgerinos E. D., Daskalopoulos M. E. et al. The critical role of the external carotid artery in cerebral perfusion of patients with total occlusion of the internal carotid artery. J. Int. Angiol., 2012,vol. 31, no. 1, pp. 16–21.

Belova A. N. Shkaly, testy i oprosniki v nevrologii i neirokhirurgii: rukovodstvo dlia praktikuiushchikh vrachei i nauchnykh rabotnikov [Scales, tests and questionnaires in neurology and neurosurgery: a guide for practitioners and researchers]. Мoscow, 2004. 432 p. (In Russian)

Robert L. G rubb Jr., William J. Powers. Surgical results of the Carotid Occlusion Surgery Studys.J. Neurosurgery, 2013, no. 2, pp. 25–33.

Вестник Санкт-Петербургского университета. Медицина

Downloads

Published

2017-01-16

How to Cite

Фокин, А. А., & Мудрякова, М. В. (2017). Comparative Results of Surgical Treatment of Bilateral Atherosclerotic Occlusive Stenotic Carotid Artery Disease. Vestnik of Saint Petersburg University. Medicine, 11(3), 71–78. https://doi.org/10.21638/11701/spbu11.2016.305

Issue

Vol. 11 No. 3 (2016)

Section

Cardiology

License

Articles of "Vestnik of Saint Petersburg University. Medicine" are open access distributed under the terms of the License Agreement with Saint Petersburg State University, which permits to the authors unrestricted distribution and self-archiving free of charge.