Email this article Reconstructive operations on carotid arteries as a crucial part of the comprehensive treatment of acute ischemic stroke
- Authors: Dudanov IP1, Belinskaya VG1, Laptev KV1, Vasilchenko NO1, Koblov ES1, Sterlin OV1
-
Affiliations:
- Regional Vascular Center of the St. Petersburg Mariinski Hostipal
- Issue: Vol 11, No 2 (2011)
- Pages: 109-116
- Section: Articles
- URL: https://bakhtiniada.ru/MAJ/article/view/10012
- DOI: https://doi.org/10.17816/MAJ112109-116
- ID: 10012
Cite item
Full Text
Abstract
Here we have analyzed the results of 51 carotid reconstructions in 51 symptomatic patients with acute stroke.This group amounted to 17.3% of all the hospitalized patients with various acute cerebral circulation disturbances (ACCD). Among the operated patients, 40 (78.43%) suffered of ischemic stroke, and 11 (21.57%) showed transitory ischemic attacks. The patients were divided into three groups: group 1,24 (47.05%) patients suffering an ischemic stroke or transitory ischemic attack and operated on within 2 weeks (usually 2 to 12 days) after the beginning of disease; group II, 15 (29.41%) patients who have suffered an ischemic stroke or transitory ischemic attack and were operated on 2 to 4 weeks after the beginning of disease; group III, 12 (23.53%) patients who have suffered an ischemic stroke and were operated on later than one month after the beginning of disease. In these three groups, we have compared the results of carotid reconstructions considering the patients'age, gender, degree of stenosis, Charlson's co-morbidity index, and presence and severity of accompanying diseases. The patients of all the groups were assessed according to NIHHS score, Rivermide an modified RAnkin score before the operation and after the operation in 24 hours, 7 days and when leaving the hospital. Our analyzes reveal a low risk of reconstructive operation on carotid arteries performed within the first 14 days after an acute ischemic stroke in the carotid basin. They furthermore show that endarterectomy in the acute period results in the majority of cases in an early regress of the neurological symptoms.
Full Text
##article.viewOnOriginalSite##About the authors
I P Dudanov
Regional Vascular Center of the St. Petersburg Mariinski HostipalЧлен-корреспондент РАМН Санкт-Петербург, 191110, Литейный проспект, 56; Петрозаводск, 185910, пр. Ленина, 33
V G Belinskaya
Regional Vascular Center of the St. Petersburg Mariinski HostipalСанкт-Петербург, 191110, Литейный проспект, 56; Петрозаводск, 185910, пр. Ленина, 33
K V Laptev
Regional Vascular Center of the St. Petersburg Mariinski HostipalСанкт-Петербург, 191110, Литейный проспект, 56; Петрозаводск, 185910, пр. Ленина, 33
N O Vasilchenko
Regional Vascular Center of the St. Petersburg Mariinski HostipalСанкт-Петербург, 191110, Литейный проспект, 56; Петрозаводск, 185910, пр. Ленина, 33
E S Koblov
Regional Vascular Center of the St. Petersburg Mariinski Hostipal
Email: febris@yahoo.com
Санкт-Петербург, 191110, Литейный проспект, 56; Петрозаводск, 185910, пр. Ленина, 33
O V Sterlin
Regional Vascular Center of the St. Petersburg Mariinski HostipalСанкт-Петербург, 191110, Литейный проспект, 56; Петрозаводск, 185910, пр. Ленина, 33
References
- Вардугин И.В., Фокин Ал. Ан. Экстренная хирургия сонных артерий при острой ишемии головного мозга и нестабильности неврологического дефицита / 4-й Всероссийский съезд сердечно-сосудистых хирургов: Тезисы докладов и сообщений. М., 1998. С. ПО.
- Дуданов И.П., Субботина Н.С. Диагностика облитерирующих поражений экстракраниальных артерий с ишемическими церебральными осложнениями: Учебное пособие. Петрозаводск: Изд-во ПетрГУ, 2005. 140 с.
- Лаптев К.В., Фокин А.А., Бабкин Е.В., Киреев К.А., Кругляков В.А. Особенности диагностики и лечения стенозирующего атеросклероза сонных артерий у больных сахарным диабетом II типа на основе морфофункциональных критериев // Медицинская наука и образование Урала. 2008. № 2 (52). С. 91-95.
- Фокин А.А., Вардугин И.В. Определение показаний к экстренным операциям на сонных артериях при острых ишемических нарушениях мозгового кровообращения // Регионарное кровообращение и микроциркуляция. 2002. № 1. С. 27-31.
- Варакин Ю.Я. Эпидемиологические аспекты профилактики нарушений мозгового кровообращения // Атмосфера. Нервные болезни. 2005. № 2. С. 4-10.
- Гусев Е.И., Скворцова Л.В., Стаховская Л.В. и др. Эпидемиология инсульта в России. Consilium medicum. 2003. Спецвыпуск. С. 5-7.
- Lopez A.D., Mathers C.D., Ezzati М., Jamison D.T., Murray C.J.L. / eds. Global Burden of Disease and Risk Factors. New York: Oxford University Press; 2006. P. 45-240.
- Rudarakanchana N., Halliday A. Why there are long delays between symptoms and carotid surgery in UK / Greenhalgh R.M. ed. Vascular and Endovascular Cha- langes. London: Biba Medical, 2004.
- Mant J., Wade D., Winner S. Health care needs assessment stroke / Stevens A., Raftery J., Mant J., Simpson S. eds. Heath care needs assessment: the epidemiology based needs assessmentreviews. 2nd ed. Oxford: Radcliffe Medical Press, 2004.P. 233.
- World Health Organisation. World Health Report 2004 - Changing History. Geneva: World Health Organisation, 2004.
- Leal J., Luengo-Fernandez R., Gray A., Petersen S., Rayner M. Economic burden of cardiovascular diseases in the enlarged European Union // Eur. Heart J. 2006. Vol. 27. P. 1610.
- Radak D., Popovic A.D., Radicevic S., Neskovic A.N., Bojic M. Immediate reoperation for perioperative stroke after 2250 carotid endarterectomies: differences between intraoperative and early postoperative stroke // J. Vase. Surg. 1999. Vol. 30 (2). P. 245.
- Radak D., Radevic B., Stcmic N. et al. Single center experience on eversion versus standard carotid endarterectomy: a prospective non-randomized study // Car- diovasc. Surg. 2000. Vol. 8 (6). P 422.
- Radak D.J., Ilijevski N.S., Nenezic D. et al. Temporal trends in eversion carotid endarterectomy for carotid atherosclerosis: single-center experience with 5,034 patients //Vascular. 2007. Vol. 15. P. 205.
- Covikovic-Stemic N.M., Radak D.j.J., Kostic V.S. Indications for carotid endarterectomy in patients with symptoms: when, where? // Srp. Arh. Celok. Lek. 1998. Vol. 126 (7-8). P 253.
- Radak D., Radevic B., Ilijevski N. et al. Perioperetive stroke after carotid endarterectomy // Vojnosanit. Pregl. 2000. Vol. 57 (5). P.521.
- Radak D., Davidovic L. Why carotid endarterectomy is method of choice in treatment of carotid stenosis // Srp. Arh. Celok. Lek. 2008. Vol. 136 (3-4). P. 181.
- European Carotid Surgery Trialists’ Collaborative Group. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis // Lancet. 1991. Vol. 337 (8752). P. 1235.
- North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis //N. Engl. J. Med. 1991. Vol. 325 (7). P. 445.
- Rothwel P.M., Eliasziw M., Gutnikov S.A. et al. Carotid Endarterectomy Trialists Collaboration. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery // Lancet. 2004. Vol. 363 (9413). P.915.
- Fairhead J.F., Mehta Z., Rothwell P.M. Population- based study of delays in carotid imaging and surgery and the risk of recurrent stroke // Neurology. 2005. Vol. 65(3). P.371.
- Canadian Stroke Network. Canadian Best Practice Recommendations for Stroke Care: 2006. Ottawa (ON): Canadian Stroke Network, 2006.
- Bond R., Rerkasem K., Rothwell P.M. Systematic review of the risks of carotid endarterectomy in relation to the clinical indication for and timing of surgery // Stroke. 2003. Vol. 34 (9). P. 290-301.
- Rerkasem K., Rothwell P.M. Systematic review of the operative risks of carotid endarterectomy for recently symptomatic stenosis in relation to the timing of surgery // Stroke. 2009. Vol. 40 (10). P. 564.
- Royal College of Physicians. Intercollegiate Stroke Working Party. National Clinical Guidelines for Stroke. 2nd ed. London: Royal College of Physicians, 2004.
Supplementary files
