The Results of Carotid Endarterectomy with Different Plastics

Arthur Ozolinsh, Nidal Darvish, Mussa Eseneev, Margarita Shumilina, Nataliya Svetlova, Ramilya Valieva, Shorena Zarandiya, Irakliy Gvetadze

A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–B

Abstract

Atherosclerotic lession of carotid arteries appears in internal, external and common carotid arteries, had different length of ateroma, may also be combined with tortuosity of internal carotid artery, that provides to different carotid endarterectomy and plastics.

Target of research was detecting tactics of carotid endarterectomy and plastics of the carotid arteries and evaluation of results of different plastics methods.

Material and methods was 284 patients, operated on carotid through 2015-2017 years. Gender Male 188 (66,2%), female 96 (33,8%), age from 52 to 83 years. Diagnostics include wide ultrasound investigation (Doppler, duplex scan, transcranial investigation, functional probes), contrast study (classic-type roentgen-contrast study with use of subtraction mode or multispiral computer tomography with contast, MSCT-angiography).

Prolonged atheroma (more than 20 mm) was found in 112 (39,4%) patients.

To detect tactics we develop the methodic of evaluation of length of atheroma, prolongation on common and internal carotid artery. Our method provides to detection of capability of different operative plastics before the operation.

Endarterectomy with patch-plastics was performed in 67 (23,6%) patients. Eversion endarterectomy from internal carotid artery 128 (45,1%) patients. Eversion from the common carotid artery (anastamosis end-to-end) 89 (31,3%) patients.

Results: in early after-operation period 1 patient after plastics with patch had transient ischemic atack (regress of neurologic symptomaticsin 8 ouhrs). 1 patient after eversion from common carotid artery had bleeding, revision with hemostasis.

In delayed postoperative period (after year) 2 patients after plastics with patch have restenosis 60-70%, they had vertigo, headaches, non-stable arterial pressure on therapy. Performed endovascular angioplastics with stent. Stroke, death didnt occurred.

Conclusion and discussion. Detection of tactics before the opertation provides to reduction of operation time, performing more comprehensive endarterectomy, and reducing the probability of restenosis, associated with operative technique, though improving results of surgical treatment of patients with carotid artery stenosis.