Results of carotid endarterectomy in patients after previous stroke

Matyushkin, A V; Мустафин, А. Х.

doi:10.17116/hirurgia202103150

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…Споры о том, насколько безопасна экстренная КЭЭ у пациентов в острейшем периоде ОНМК, про-должаются [39][40][41][42][43]. С одной стороны, наличие свежего ишемического очага в головном мозге и хирургическая реперфузия могут привести к геморрагической трансформации с последующим негативным прогнозом течения заболевания [40][41][42][43][44].…”

Section: безопасна ли кээ в острейшем периоде онмк?unclassified

Carotid endarterectomy in Russia. What if current guidelines do not answer difficult questions?

et al. 2022

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This literature review covers the publications of Russian vascular surgeons in recent years and deals with debatable issues of carotid surgery, including: 1. What is the best technique for carotid endarterectomy (CEA)? 2. Why does restenosis of the internal carotid artery (ICA) develop and how to eliminate it? 3. How to operate on bilateral ICA stenosis? 4. Should carotid glomus be preserved? 5. Is CEA safe in the acute phase of cerebrovascular accident (CVA)? 6. Is CEA safe in elderly patients? 7. How to operate on patients with combined internal carotid and coronary artery involvement? The evidence presented in this publication makes it possible to draw the following conclusions: 1. When choosing a CEA technique, the classical technique with patch angioplasty should be avoided due to the high risk of ICA restenosis. 2. To eliminate ICA restenosis, carotid angioplasty with stenting (CAS) should be used. When performing primary CEA with ICA transposition over the hypoglossal nerve, reCEA can be used 3. In the absence of contraindications, bilateral ICA stenosis can be operated at the same time using CEA. 4. CEA with carotid glomus preservation is the operation of choice in the treatment of patients with hemodynamically significant ICA stenosis due to the elimination of the risks of postoperative hypertension and the formation of hemorrhagic transformation. 5. If there are indications for cerebral revascularization in the most acute period of stroke, CEA should be abandoned in favor of CAS. 6. In old age, CAS is the safest treatment strategy. 7. In the presence of a combined ICA and coronary involvement, the choice of treatment tactics should be carried out only by a multidisciplinary commission, taking into account the risk stratification of adverse cardiovascular events.

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Section: безопасна ли кээ в острейшем периоде онмк?unclassified

Carotid endarterectomy in Russia. What if current guidelines do not answer difficult questions?

et al. 2022

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“…Moreover, according to this document, the operation of choice is CEA, and CAS takes only an alternative position [11] . However, well-known domestic works are most often devoted to the analysis of the results of only one of these reconstruction methods on an emergency basis [12] , [13] , [14] , [15] , [16] . However, the only Russian multicenter study published in 2021 compared the results of both methods of revascularization [17] .…”

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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

Radiology Case Reports

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Methods of carotid endarterectomy

et al. 2021

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This literature review is devoted to various carotid endarterectomy (CE) methods that exist today in Russia. The pros and cons of conventional and eversion technique of the operation are given. It is indicated that the former is associated with higher long-term rate of restenosis, aneurysm and patch infection. The second is associated with higher prevalence of intraoperative internal carotid artery (ICA) thrombosis due to intimal detachment distal to endarterectomy area. The following CE methods for patients with prolonged ICA involvement are described: neo bifurcation formation, autoarterial reconstruction, ICA autotransplantation, plastic using an occipital artery flap. The methods of CE with carotid body saving have been demonstrated: 1. Swallow tail type patch repair proposed by R.I. Izhbuldin; 2. S-shaped arteriotomy proposed by K. A. Antsupov; 3. Two types of operations proposed by R. А. Vinogradov; 4. Сutting off the ICA with sections of common and external carotid artery proposed by A. N. Kazantsev; 5. Glomus-saving ICA autotransplantation in patients with prolonged atherosclerotic involvement. The role of ICA transposition over the hypoglossal nerve in eversion CE is presented. The glomus-saving CE with ICA transposition, called Chik-Chirik CE, is described. Conclusions are drawn on the need to demonstrate all CE types in the novel Russian guidelines for the management of patients with of head and neck arterial diseases.

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Results of carotid endarterectomy in patients after previous stroke

Cited by 5 publications

References 9 publications

Carotid endarterectomy in Russia. What if current guidelines do not answer difficult questions?

Carotid endarterectomy in Russia. What if current guidelines do not answer difficult questions?

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

Methods of carotid endarterectomy

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