Russian consensus statement on the diagnosis and treatment of patients with carotid stenosis

Chernyavsky, M. A.; Irtyuga, Olga; Yanishevskiy, S. N.; Alieva, A.; Samochernych, Konstantin; Abramov, K. B.; Вавилова, Т. В.; Lukyanchikov, V. A.; Kurapeev, Dmitry; Vanyurkin, A.G.; Чернова, Д. В.; Shelukhanov, N. K.; Козленок, А. В.; Kavteladze, Z. A.; Malevannyy, M. V.; Виноградов, Р. А.; Хафизов, Т. Н.; Ivanova, Galina E.; Zhukovskaya, Natalya V.; Фокин, А. А.; Ignatiev, I. M.; Karpenko, Andrey; Ignatenko, Pavel; Астапов, Д. А.; Semenov, V. Yu.; Порханов, В. А.; Krylov, V. V.; Usachev, D Yu; Светликов, А. В.; Alekyan, B. G.; Акчурин, Р. С.; Cherniavsky, Alexander; Конради, А. О.; Shlyakhto, Е. V.

doi:10.15829/1560-4071-2022-5284

Cited by 19 publications

(5 citation statements)

References 36 publications

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“…Таким образом, это первое исследование, проанализировавшее результаты КЭЭ в зависимости от скорости выполнения анастомоза. Является вполне логичным тот факт, что чем дольше будет пережата ВСА, тем дольше головной мозг будет находиться в условиях неполноценной гемоциркуляции [33][34][35][36][37]. Соответственно, риск развития интраоперационного ишемического события будет также возрастать [38][39][40].…”

Section: Discussionunclassified

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

et al. 2023

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Aim. Analysis of inhospital and long-term outcomes of conventional carotid endarterectomy (CEA) depending on vessel suturing speed.Material and methods. The present prospective multicenter study for the period from March 1, 2017 to October 1, 2020 included 2366 patients who underwent conventional CEA with patch angioplasty. Depending on the time required to apply 1 stitch, 4 groups of patients were formed: group 1 (n=471; 19,9%) — 1 stitch per 2 seconds; group 2 (n=865; 36,5%) — 1 stitch per 3 seconds; group 3 (n=692; 29,2%) — 1 stitch per 4 seconds; group 4 (n=338; 14,3%) — 1 stitch per 5 seconds. The term "stitch" refers to two needle punctures. The follow-up postoperative period was 18,5±11,0 months.Results. There were no deaths and myocardial infarctions (MI) in the inhospital postoperative period. In group 1, anastomotic bleeding (n=93; 19,7%; p<0,0001) and stroke (n=3; 0,63%; p=0,02) due to internal carotid artery (ICA) thrombosis were more common. In the long-term follow-up period, there were no significant differences in mortality and MI rates. However, ICA restenosis requiring repeated CEA (n=37; 7,85%; p<0,0001) and related stroke/transient ischemic attack (n=13; 2,8%; p=0,0001) were more often diagnosed in 1 group of patients. According to Kaplan-Meier curves, restenosis was most often revealed 6 months after CEA in the general sample.Conclusion. 1. Vessel suturing at a speed of 1 stitch per 2 seconds is associated with an increased risk of intraoperative ICA thrombosis, bleeding along the anastomosis, stroke, as well as restenosis and stroke in the long-term follow-up period. 2. Vessel suturing at a speed of 1 stitch per 5 seconds is not accompanied by an increase in inhospital stroke rate, despite the maximum ICA occlusion time relative to other groups of patients. 3. Vessel suturing at a speed of 1 stitch per 3 or 4 seconds characterized by the lowest incidence of all complications at the inhospital and long-term stages of postoperative follow-up.

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Section: Discussionunclassified

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

et al. 2023

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“…Проведены инструментальные исследования: УЗДГ БЦС с определением толщины комплекса интима-медиа (ТКИМ) и процента стеноза сонных артерий по диаметру (с использованием международных шкал ESCT, NASCET, St.Mary's ratio); КАГ на ангиографическом комплексе General Electric Innova 3100 [10,11].…”

Section: материалы и методыunclassified

Improvement of quality of life indicators in patients with metabolic syndrome after correction of hemodynamically significant coronary stenoses and dyslipidemia

Vukolova,

Gubareva,

Germanova

et al. 2024

ECG

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It is known that metabolic syndrome is currently the leading cause of the development of cardiovascular pathology, which occupies a leading position in the structure of mortality not only in the Russian population, but also in the world. The prevalence of MS is growing, which is associated with stressful professions, eating disorders. The presence of MS is associated with arterial hypertension and atherosclerosis of the arteries of any localization. In this regard, the purpose of our study was to study the quality of life in patients with MS, depending on the severity of coronary atherosclerosis. Materials and methods: The study included 239 patients (142 men, 97 women) with MS with atherosclerosis of the coronary and carotid arteries. The number of subjects in group 1 (n=141), of which 101 were men and 40 were women. The second group consisted of 84 male and 14 female patients (n=98). The control group consisted of 70 people (27 men, 43 women) with grade 1-3 hypertension. The age of the subjects was 31-56 years. All patients underwent: collection of complaints and anamnesis, assessment of body mass index (BMI); determination of the lipid spectrum, blood glucose, glycated hemoglobin. Microalbuminuria and glomerular filtration rate were determined. Instrumental studies were carried out: ultrasound examination of brachiocephalic vessels with determination of the thickness of the intima-media complex and the percentage of carotid artery stenosis; coronary angiography on the General Electric Innova 3100 angiographic complex. Based on the results of coronary angiography, the patients were divided into two subgroups: group 1 - with coronary artery stenosis of less than 50% (n=141), group 2 - with stenosis of 50% or more (n=98), group 3 (control) without stenotic lesions of the coronary arteries. A non-specific questionnaire “SF-36 Health Status Survey” was used to assess the quality of life. Results: assessing physical functioning and mental health, there was a significant decrease in these indicators in patients of group 2, in whom, according to coronary angiography, hemodynamically significant coronary artery stenoses were diagnosed, a strong correlation (r=0.730; p=0.005) was revealed between deterioration in quality of life and hemodynamically significant stenosis of the carotid and coronary arteries. Restriction of physical activity and reduction of daily activities were more significant in group 2 compared to groups 1 and 3. The feeling of uncertainty with restless expectation and fears, as well as a feeling of depression prevailed in men. However, patients after percutaneous coronary intervention, as well as with lipidogram correction, assessed the quality of life with some restriction of physical activity, but with significant social functioning. Conclusions: hemodynamically significant atherosclerosis of the carotid and coronary arteries is a predictor of deterioration in the quality of life, especially in men. The use of the international questionnaire “SF-36 Health Status Survey” is appropriate for assessing the health and vital activity in patients with MS and hypertension, with signs of atherosclerosis. The interaction of a cardiologist, an endocrinologist and a psychotherapist are justified for the most optimal management of patients with comorbid pathology.

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“…Известно, что атеросклероз БЦА в течение многих лет может протекать бессимптомно, впервые проявляясь клинически в виде ИИ [4]. Стратегии лечения атеросклероза БЦА в настоящее время базируются на основании наличия клинических проявлений и степени стеноза [5]. Традиционные факторы риска (ФР), используемые для оценки сердечно-сосудистого прогноза, хорошо работают на популяционном уровне, однако возможности их применения в принятии решений относительно конкретного пациента ограниченны [6].…”

Section: Review and Targeted Lipidomic Biomarkers In Atherosclerosisunclassified

Review and targeted lipidomic biomarkers in atherosclerosis

Lomonosova,

Gognieva,

Abdullaev

et al. 2024

Russ J Cardiol

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Ischemic cardiovascular events (ischemic stroke, myocardial infarction) are the most common complications of cardiovascular diseases. One of the leading mechanisms of these complications is atherosclerosis. Lipids play an important role in plaque development. Recently, the lipidome has been of greatest interest, since it may have a prognostic value in atherosclerosis development. With an increase in the circulation of proatherogenic lipidomic biomarkers, the risk of atherosclerosis destabilization and ischemic complications increases.The conducted studies made it possible to create additional risk stratification scales, for example, Cardiovascular Event Risk Test (CERT) 1 and 2. They make it possible to estimate the residual risk in patients taking statins. The lipidome examination in extracranial artery atherosclerosis can identify those plaques that have signs of instability, and therefore are dangerous for ischemic stroke development.The review describes the features of plasma lipidome in various cardiovascular diseases associated with atherosclerosis.

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Russian consensus statement on the diagnosis and treatment of patients with carotid stenosis

Cited by 19 publications

References 36 publications

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

Improvement of quality of life indicators in patients with metabolic syndrome after correction of hemodynamically significant coronary stenoses and dyslipidemia

Review and targeted lipidomic biomarkers in atherosclerosis

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