Progression of atherosclerotic process in the common carotid artery after carotid endarterectomy

• Kazakov Yu.I.
• Yakovlev A.O.
• Federiakin D.V.
• Churilov I.S.

Abstract

This study was undertaken to evaluate laboratory and instrumental parameters of progression of the atherosclerotic process in the common carotid artery after eversion carotid endarterectomy in 56 patients operated on for hemodynamically significant stenosis of the ostium of the internal carotid artery. All patients had concomitant prolonged (from 35 to 70 mm), non-ostial, low-grade (35.7±0.7%) stenosis of the common carotid artery. 41% of the patients in the remote postoperative period were found to have a statistically significant correlation between the increased degree of stenosis of the common carotid artery according to the findings of ultrasound duplex angioscanning and elevated levels of biochemical markers of the endothelial functional state (hs-CRP, MMP-9, sE-selectin, sVCAM-1, sPecam-1), thus suggesting progression of the atherosclerotic process in the previously unoperated proximal segment of the common carotid artery. Given the presence of a hemodynamically significant stenosis of the common carotid artery, the patients were subjected to repeat operations, i. e., angioplasty and stenting of the common carotid artery.

An elevated level of biochemical markers (hs-CRP, MMP-9, sE-selectin, sVCAM-1, sPecam-1) in blood serum is an unfavorable prognostic sign of progression of the atherosclerotic process and increasing degree of stenosis of the common carotid artery after carotid reconstruction. Guided by the mentioned predictors of progression of the atherosclerotic process, it is possible to timely change therapeutic policy and, if necessary, to perform surgical correction in such patients.

Keywords:carotid arteries; prolonged atherosclerotic lesion of carotid arteries; carotid endarterectomy; high-sensitivity C-reactive protein; intercellular adhesion molecules; matrix metalloproteinkinases

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