Dynamic of cerebrovascular disorders in patients with carotid stenosis

Pyshkina, L I; Абиева, А.Р.; Yasamanova, A N; Дарвиш, Н.А.; Камчатнов, П Р; Kabanov, A. A.; Tyazhelnikov, Andrey A.; Silina, Ekaterina; Шурыгин, С. Н.; Osmaeva, Z H

doi:10.17116/jnevro20181180928

Z. nevrol. psikhiatr. im. S.S. Korsakova

2018

DOI: 10.17116/jnevro20181180928

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Dynamic of cerebrovascular disorders in patients with carotid stenosis

L I Pyshkina¹,

А.Р. Абиева²,

A N Yasamanova³

et al.

Abstract: Цель исследования. Изучение состояния церебральной гемодинамики и тромбоцитарного гемостаза у пациентов с каротидным стенозом (КС). Материал и методы. Обследовали 123 пациентов с атеросклеротическим поражением сосудов каротидной системы. В 1-ю группу были включены 53 пациента (средний возраст 52±12,5 года), перенесшие каротидную эндартерэктомию (КЭАЭ), во 2-ю-70 больных с КС, которые лечились консервативно (средний возраст 58,5±15,9 года). Оценивали состояние кровотока по магистральным артериям головы (УЗДГ), … Show more

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Cited by 8 publications

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Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis

Грибачева

Petrova

Звонкова

2023

RJTAO

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hronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. Correct and timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are important, among other things, for slowing down the progression of cognitive deficits. Objective: to study the efficacy and safety of Mexidol administered intravenously by drip infusion (500 mg 1 time per day) for 14 days, followed by oral administration of the drug Mexidol FORTE 250 at a dose of 250 mg 3 times a day for 60 days in middle-aged patients with chronic cerebral ischemia (CCI) on the background of arterial hypertension and atherosclerosis. Material and methods. The open observational program included 60 patients aged 45 to 59 years with CCI, confirmed by the results of a neuropsychological and neuroimaging examination. Patients received Mexidol first intravenously (14 days), and then orally in pills – Mexidol FORTE 250 (60 days). Patients underwent neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger–Khanin scale), of vegetative disfunction (A.M. Wayne's autonomic response scale modified by V.L. Golubev), of the severity of general, mental and physical asthenia (MFI-20) and quality of life (MOS SF-36 questionnaire). Results. The results of the treatment made it possible to establish relief of asthenic syndrome and vegetative dysfunction on the background of Mexidol use. The differences were statistically significant both when comparing with the baseline and with the comparison group (p<0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The combination of positive effects led to an increase in indicators of quality of life (p<0.05). The treatment was well tolerated. Conclusion. Patients with CCI have significant emotional, vegetative and asthenic disorders. The use of Mexidol can reduce the severity of these disorders, which gives reason to recommend it for the treatment of such patients.

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Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis

Грибачева

Petrova

Звонкова

2023

RJTAO

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Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study

et al. 2021

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Aim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients who underwent CE. Depending on the technique of operation, the following groups were formed: group 1 (n=18362) — eversion CE; group 2 (n=6744) — conventional CE with patch angioplasty. The long-term follow-up period was 124,7±53,8 months.Results. In the hospital postoperative period, the groups were comparable in incidence of all complications: lethal outcome (group 1: 0,19%, n=36; group 2: 0,17%, n=12; p=0,89; odds ratio (OR) =1,1; 95% confidence interval (CI) =0,57- 2,11); myocardial infarction (MI) (group 1: 0,15%, n=28; group 2: 0,13%, n=9; p=0,87; OR=1,14; 95% CI=0,53-2,42); stroke (group 1: 0,33%, n=62; group 2: 0,4%, n=27; p=0,53; OR=0,84; 95% CI=0,53-1,32); bleeding with hematoma formation (group 1: 0,39%, n=73; group 2: 0,41%, n=28; p=0,93; OR=0,95; 95% CI=0,61-1,48); internal carotid artery (ICA) thrombosis (group 1: 0,05%, n=11; group 2: 0,07%, n=5, p=0,9; OR=0,8; 95% CI=0,28-2,32). In the long-term follow-up, the groups were comparable only in MI incidence: group 1: 0,56%, n=103; group 2: 0,66%, n=45; p=0,37; OR=0,84; 95% CI=0,59-1,19. All other complications were more frequent after conventional CE with patch angioplasty: all-cause death (group 1: 2,7%, n=492; group 2: 9,1%, n=616; p<0,0001; OR=0,27; 95% CI=0,24-0,3); lethal ischemic stroke (group 1: 1,0%, n=180; group 2: 5,5%, n=371; p<0,0001; OR=0,17; 95% CI=0,14-0,21); non-lethal ischemic stroke (group 1: 0,62%, n=114; group 2: 7,0%, n=472; p<0,0001; OR=0,08; 95% CI=0,06-0,1); ICA restenosis >60%, requiring re-revascularization (group 1: 1,6%, n=296; group 2: 12,6%, n=851; p<0,0001; OR=0,11; 95% CI=0,09-0,12). Thus, the composite endpoint (lethal ischemic stroke + non-lethal ischemic stroke + MI) after conventional CE with patch angioplasty was more than 6 times higher than this parameter of eversion CE: group 1: 2,2%, n=397; group 2: 13,2%, n=888; p<0,0001; OR=0,14; 95% CI=0,12-1,16.Conclusion. Conventional CE with patch angioplasty is not prefer for cerebral revascularization in the presence of hemodynamically significant ICA stenosis due to the high prevalence of deaths, stroke, and ICA restenosis in the long-term follow-up.

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Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with chronic cerebral ischemia

Журавлева

Prokofiev

Serebrova

et al. 2020

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Dynamic of cerebrovascular disorders in patients with carotid stenosis

Cited by 8 publications

References 17 publications

Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis

Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis

Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study

Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with chronic cerebral ischemia

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