Early results of combined carotid endarterectomy and coronary artery revascularization in patients older than 70 years with multifocal lesions of the coronary and brachiocephalic arteries

Morchadze, B.D.; Sigaev, I.Yu.; Дарвиш, Н.А.; Kazaryan, A.V.; Keren, Metin; Kudashev, I.F.; Pilipenko, I. V.; Убушиев, С.Д.

doi:10.24022/1810-0694-2019-20-2-135-140

Cited by 2 publications

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“…Размер заплаты подбирается "на глазок" [44][45][46][47]. Кровотечение по ходу анастомоза чаще всего останавливают путем наложения вторичного шва [53][54][55][56][57]. Как поведет себя атеросклеротическая бляшка или интима за зоной эндартерэктомии после пуска кровотока: методов, способных спрогнозировать это состояние, не существует [58][59][60][61][62].…”

Section: Discussionunclassified

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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Section: Discussionunclassified

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

et al. 2021

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“…The frequency of its diagnosis in the general population does not exceed 0.3%, and with concomitant atherosclerosis of extracranial arteries, it is a rare exception [18] . To date, none of the major studies of the leading vascular centers in Russia have reported CEE or CAS in the presence of PEHA, which creates uncertainty in the choice of treatment strategy for this complex cohort of patients [19] , [20] , [21] , [22] , [23] .…”

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confidence: 99%

Stenting of the artery of Dr A.N. Kazantsev in the acute period of ischemic stroke

Казанцев¹,

Zharova

Sokolova

et al. 2022

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Early results of combined carotid endarterectomy and coronary artery revascularization in patients older than 70 years with multifocal lesions of the coronary and brachiocephalic arteries

Cited by 2 publications

References 0 publications

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

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

Stenting of the artery of Dr A.N. Kazantsev in the acute period of ischemic stroke

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