Evaluation of effectiveness of surgical correction of high degree carotid artery stenosis via duplex sonography

Abstract

Stroke is at the third place after cardiologic disorders and cancer among causes of death in economically developed countries [1,2]. In Ukraine, cerebrovascular mortality occupies second place among causes of overall mortality [3], whereas adult population disability is often associated with sequelae of previous acute cerebrovascular disorder (ACVD). During recent years, incidence rate of stroke in the country has been exceeding 100000 cases per year.
 In accordance with epidemiologic data, in vast majority of cases (70-80%) strokes are of ischemic origin, which in 25% cases is caused by atherosclerotic changes in extracranial segments of carotid arteries (СА) [4,5,6].
 Based on established indications, surgical treatment methods have indisputable advantages over medicinal prevention of ischemic CVD upon atherosclerotic stenosis of main cerebral arteries (MCA) of high degree. Operative remodeling of arterial lumen allows elimination of source of thromboembolism (microthrombs, atheromatous plaque fragments) in brain arteries, prevents development of occlusion in stenosis site (thromb formation, dissection, hemorrhage into atherosclerotic plaque) and normalizes blood circulation in relevant vascularization area. Technologic advances during the last decade contributed to application of endovascular intervention methods in clinical practice, which significantly broadens capabilities of surgical correction of stenotic damages in MCA.