The Efficiency of Carotid Endarterectomy in the Treatment of Symptomatic and Asymptomatic Carotid Stenosis
- #VS 02-O-4
- Vascular Surgery. SESSION-2
- Oral
The Efficiency of Carotid Endarterectomy in the Treatment of Symptomatic and Asymptomatic Carotid Stenosis
Anastasia Artemova 1, Nikolay Lukianchikov 2, Petr Puzdryak 1, Michael Ivanov 1, Anastasia Uryupina 1, Anastasia Gorovaya 1
1 Department of General Surgery of North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia; 2 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation, Moscow, Russia;
Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–B
Abstract
The effects of the carotid endarterectomy are still examined, and theindicationsforthe named operative intervention have not been established yet.
The aim was to study the associations between the features of brachiocephalic artery stenosis and the effects of the carotid endarterectomy.
Subjects and Methods. The research relies on the observation of 83 patients, which were operated because of carotid stenosis. The main group includes 23 patients with an asymptomatic lesion, in the control group - 60 patients with symptomatic critical stenosis. We analyzed the features of intervention,characteristics of lesions of brachiocephalic vessels, comorbid pathology, metabolic changes, cognitive disorders (using MoCa scale) and other effects during 30 days after surgery.
Statistical processing was performed using “STATISTICA-10” software package. The value "p <0.05" is indicated as statistically significant.
Results.The concomitant lesion of other arteries of the brachiocephalic vessels was more often in the control group:contralateral carotid (1 v/s 25; χ2=10,76, p<0,05) and subclavian (5 v/s 27; χ2=3,8, p<0,05) arteries. Patients with symptomatic carotid stenosis hadhigher values of systolic blood pressure(133,39±14,02 v/s 150,2±14,82; p<0,05) and obvious fluctuations of the arterial pressure level (35,6±20,1 v/s 59,6±13,7; p<0,05) during the perioperative period. 2 patients from main and 18 patients from the control group had the hyperfusion syndrome after intervention (p<0,05). A persistent rhythm disorder on the first day of the postoperative period was recorded only in patients with symptomatic stenosis (8 patients, p <0.05). Transient ischemic attacks and stroke were registered only in patients with neurological symptoms(p<0,05).
Conclusions.Surgical interventions on symptomatic carotid stenosis are associated with the risk of neurological disorders.Possible correction of metabolic disturbances and taking into account multifocal lesions of brachiocephalic arteries can directly affect the outcome of carotid endarterectomy.