<p>This review investigates the various methods used for carotid endarterectomy (CEE). These methods are presented, and allow us to analyse effective revascularisation with extended damage to the internal carotid artery. The data of studies comparing the results of eversion and classical carotid endarterectomy with plasty of the reconstruction zone with a patch made of diepoxy-treated pericardium are presented. Special attention is paid to emergency carotid endarterectomy and carotid endarterectomy in the acute period of ischemic stroke. The important and main aspects of the glomus-saving species of CEE are also demonstrated. The main complications behind operations, and causes of restenosis in long-term follow-up periods are also duly noted. Similarly, suggestions to eliminate these issues are also proposed. This review comprehensively covers the state of the art of carotid endarterectomy and dissects current techniques and methods in the area.</p><p>Received 16 July 2020. Revised 24 August 2020. Accepted 25 August 2020.</p><p><strong>Conflict of interest:</strong> Authors declare no conflicts of interest.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Author contributions</strong><br />Conception and study design: G.G. Khubulava<br />Drafting the article: A.N. Kazantsev<br />Critical revision of the article: A.A. Erofeev, V.N. Kravchuk, K.P. Chernykh<br />Final approval of the version to be published: G.G. Khubulava, A.N. Kazantsev, A.A. Erofeev, V.N. Kravchuk, K.P. Chernykh</p>

Изучение госпитальных результатов экстренной каротидной эндартерэктомии (КЭЭ) и каротидной ангиопластики со стентированием (КАС) в острейшем периоде острого нарушения мозгового кровообращения (ОНМК). МАТеРИАЛ И МеТОдыC января 2008 по август 2020 г. в исследование вошли 615 пациентов с гемодинамически значимыми стенозами внутренних сонных артерий (ВСА), оперированными в острейшем периоде ишемического инсульта (в течение 3 суток от дебюта ОНМК). В зависимости от реализованного вида реваскуляризации все больные были распределены на две группы: 1-я группа -КАС (n=312); 2-я группа -КЭЭ (n=357). Критериями включения стали: 1. Неврологические нарушения легкой степени: от 3 до 8 баллов по шкале NIHSS; не более 2 баллов по модификационной шкале Рэнкина; более 61 балла по шкале Бартел; 2. Показания для КЭЭ/КАС согласно действующим национальным рекомендациям; 3. Ишемический очаг в головном мозге не более 2,5 см в диаметре.

No abstract

Goal Presentation of the first Russian computer program ( www.carotidscore.ru ) for risk stratification of postoperative complications of carotid endarterectomy (CEE). Material and methods The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE. Results In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%—myocardial infarction, 0.35%—stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in “%” and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework ( https://www.qt.io ), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient’s personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person. Conclusion CarotidSCORE ( www.carotidscore.ru ) is able to determine the likelihood of postoperative complications in patients undergoing CEE.

No abstract