To the content
1 . 2022

Results of various methods of reconstruction in patients with extended atherosclerotic lesions of carotid arteries

Abstract

Analysed herein are the remote results of various methods of carotid reconstruction in a total of 115 patients with combined haemodynamically significant stenosis of the common and internal carotid arteries. Depending on the type of carotid reconstruction used, the patients were subdivided into 4 groups: Group I – simultaneous eversion endarterectomy from the internal and common carotid arteries – 35 (30.4%) patients, Group II – eversion carotid endarterectomy with plasty of longitudinal arteriotomy of the common carotid artery by a primary suture – 30 (26.1%), Group III – eversion carotid endarterectomy with prosthetic repair of the common carotid artery – 25 (21.7%); Group IV – angioplasty and stenting of the common and internal carotid arteries – 25 (21.7%). We assessed the remote postoperative results of surgical treatment: survival rate, incidence of acute cerebral circulation impairment, and patency of the reconstructed zone. Statistically significant differences were revealed in relation to the frequency of carotid reconstruction zone restenosis of more than 65% (according to the NASCET criteria). The best remote postoperative results were observed in patients after simultaneous eversion endarterectomy from the internal and common carotid arteries (p<0.005). Repeat operations were performed in five (16.7%) patients after plasty of the common carotid artery with primary suture due to restenosis of the reconstruction zone of more than 65% (according to the NASCET criteria).

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Kazakov Yu.I., Yakovlev A.O. Results of various methods of reconstruction in patients with extended atherosclerotic lesions of carotid arteries. Angiology and Vascular Surgery. 2022; 28 (1): 123–8. DOI: https://doi.org/10.33029/1027-6661-2022-28-1-123-128 (in Russian)

Keywords: carotid arteries; extended atherosclerotic lesions of the internal and common carotid arteries, carotid endarterectomy; carotid stenting; simultaneous eversion endarterectomy



References

1. Клинические рекомендации по ведению пациентов с сосудистой артериальной патологией (Российский согласительный документ). Часть 3. Экстракраниальные (брахиоцефальные) артерии. М.: НЦССХ им. А.Н. Бакулева РАМН. 2013; 130. [Klinicheskie rekomendacii po vedeniju pacientov s sosudistoj arterial’noj patologiej (Rossijskij soglasitel’nyj dokument). Chast’ 3. Jekstrakranial’nye (brahiocefal’nye) arterii. M.: NCSSH im. AN Bakuleva RAMN. 2013; 130. (In Russ.)]

2. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics –2016 update: a report from the American Heart Association. Circulation. 2016; 133 (4): 38–60. doi: 10.1161/CIR.0000000000000350

3. O’Brien M, Chandra A. Carotid revascularization: risks and benefits. Vasc Health Risk Manag. 2014; 10: 403–416. doi: 10.2147/VHRM.S48923

4. Georg Y, Psathas E, Alomran F, et al. Double eversion carotid endarterectomy of tandem carotid lesions. Ann Vasc Surg. 2014; 28 (5): 1186–1191. doi: 10.1016/j.avsg.2013.07.018

5. Orrapin S, Rerkasem K. Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database Syst Rev. 2017; 6 (6): 1081. doi: 10.1002/14651858.CD001081.pub3

6. Naylor AR, Ricco JB, de Borst GJ, et al. Editor’s Choice – Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018; 55 (1): 3–81. doi: 10.1016/j.ejvs.2017.06.021

7. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics – 2015 update: a report from the American Heart Association. Circulation. 2015; 131 (4): 29–322. doi: 10.1161/CIR.0000000000000152

8. Aboyans V, Ricco JB, Bartelink ME, et al. Guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018; 39 (9): 763–816. doi: 10.1093/eurheartj/ehx095

9. De Borst GJ, Naylor AR. In the end, it all comes down to the beginning! Eur J Vasc Endovasc Surg. 2015; 50 (3): 271–272. doi: 10.1016/j.ejvs.2015.04.013

10. Покровский А.В., Белоярцев Д.Ф., Талыблы О.Л. Анализ результатов эверсионной каротидной эндартерэктомии в отдаленном периоде. Ангиология и сосудистая хирургия. 2014; 20 (4): 100–108. [Pokrovsky AV, Beloyartsev DF, Talybly OL. Analysis of remote results of eversion carotid endarterectomy. Angiol Vasc Surg. 2014; 20 (4): 100–108. (In Russ.)]

11. Kallmayer M, Tsantilas P, Zieger C, et al. Ultrasound surveillance after CAS and CEA: what’s the evidence? J Cardiovasc Surg (Torino). 2014; 55 (2 Suppl. 1): 33–41.

12. Yu LB, Yan W, Zhang Q, et al. Carotid endarterectomy for treatment of carotid in – stent restenosis: long-term follow-up results and surgery experiences from one single centre. Stroke Vasc Neurol. 2017; 2 (3): 140–146. doi: 10.1136/svn-2017-000089

13. Белоярцев Д.Ф. Некоторые комментарии к европейским рекомендациям 2017 г. по лечению атеросклеротических поражений брахиоцефальных артерий. Ангиология и сосудистая хирургия. 2019; 25 (1): 109–114. [Beloyartsev DF. Some comments on the 2017 European guidelines on treatment of atherosclerotic lesions of brachiocephalic arteries. Angiol Vasc Surg. 2019; 25 (1): 109–114. (In Russ.)] doi: 10.33529/angio2019115

14. Paraskevas KI, Robertson V, Saratzis AN, Naylor AR. Editor’s choice an updated systematic review and meta-analysis of outcomes following eversion vs. conventional carotid endarterectomy in randomised controlled trials and observational studies. Eur J Vasc Endovasc Surg. 2018; 55 (4): 465–473. doi: 10.1016/j.ejvs.2017.12.025

15. Козырева В.С., Субботовская А.И., Шилова А.Н., Кар- пенко А.А. Иммунологические аспекты формирования рестенозов после повреждения эндотелия. Ангиология и сосудистая хирургия. 2014; 20 (1): 21–26. [Kozyreva VS, Subbotovskaya AN, Shilova AN, Karpenko AA. Immunological aspects of formation of restenosis after endothelial lesions. Angiol Vasc Surg. 2014; 20 (1): 21–26. (In Russ.)]

16. Суковатых Б.С., Сидоров Д.В., Суковатых М.Б. Реакция соединительной ткани артериальной и венозной стенок на имплантацию синтетического и биологического протезов. Ангиология и сосудистая хирургия. 2019; 25 (1): 46–51. [Sukovatykh BS, Sidorov DV, Sukovatykh MB. Reaction of connective tissue of arterial and venous walls to implantation of synthetic and biological grafts. Angiol Vasc Surg. 2019; 25 (1): 46–51. (In Russ.)]. doi: 10.33529/angio2019106

17. Бугуров С.В., Карпенко А.А., Игнатенко П.В. и др. Стентирование сонной артерии стентами CGUARD и ACCULINK: промежуточные результаты рандомизированного исследования. Ангиология и сосудистая хирургия. 2019; 25 (4): 64–69. [Bugurov SV, Karpenko AA, Ignatenko PV, et al. Stenting of the carotid artery with CGUARD and ACCULINK stents: interim results of a randomized trial. Angiol Vasc Surg. 2019; 25 (4): 64–69. (In Russ.)] doi: 10.33529/angio2019418

18. Noiphithak R, Liengudom A. Recent update on carotid endarterectomy versus carotid artery stenting. Cerebrovasc Dis. 2017; 43: 68–75. doi: 10.1159/000453282

All articles in our journal are distributed under the CC BY-NC-ND 4.0 (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International)

п?? GEOTAR-Media Publishing Group. The use of textual and illustrative content from this publication for the training of any artificial intelligence systems п?? including machine learning models and neural networks п?? is strictly prohibited without the prior written consent of the copyright holder.

  • п??п??п??п??п??п??п??п??п??п?? п??п??п??п??п??п??п??п?? п??п??п??п??п??п??п??п??п??п?? п?? п??п??п??п??п??п??п??п??п??п?? п??п??п??п??п??п??п??п??
  • п??п??п??п??п??п??п??п??п??
  • Telegram
CHIEF EDITOR
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.


Journals of «GEOTAR-Media»