FEATURES OF POSTOPERATIVE PERIOD IN PATIENTS AFTER BRAIN REVASCULARIZATION
Abstract
The aim of the research was to compare incidence of small complications after carotid endarterectomy (CEA) versus carotid artery stenting, as well as to evaluate its application in specific clinical situations. The outcomes of1826 patients who underwent surgery for stenosis of the internal carotid artery (ICA) were analyzed. There were two groups: 1018 patients who underwent CEA and 808 patients who carried the stenting. Age of patients was greater and coronary heart disease, diabetes, chronic obstructive pulmonary disease occurs more often in group with endovascular treatment, and they had rife stroke anamnesis. The mortality rate, uncontrolled hypertension and transient ischemic attacks were similar in early postoperative period. Stroke frequency was higher in patients with carotid artery stenting (35 (4,3 %) versus 27 patients (2,6 %) with CEA (p = 0,02)), and myocardial infarction took place more often after CEA (38 (3,7 %) versus 13 (1,6 %) patients with endovascular treatment (p = 0,008)). There was no statistically significant difference in security between CEA and stenting. However, treatment of carotid stenosis should be chosen according to individual characteristics, including individual anatomy.
About the Authors
R. A. Vinogradov
Scientific Research Institute - Krasnodar Region Clinical Hospital N 1; Kuban State Medical University
Russian Federation
Russian Federation
A. N. Kosenkov
The First Sechenov Moscow State Medical University
Russian Federation
Russian Federation
I. A. Vinokurov
The First Sechenov Moscow State Medical University
Russian Federation
Russian Federation
References
1. Ahn SH, Prince EA, Dubel GJ (2013]. Carotid artery stenting: review of technique and update of recent literature. Semin. Intervent. Radiol, 30,288-296.
2. Ahn SS, Marcus DR, Moore WS (1989]. Post-carotid endarterectomy hypertension: association with elevated cranial norepinephrine./ Vase. Surg., 9,351-360.
3. Alberts M (2001]. Results of multicenter prospective randomized trial of carotid artery stenting vs. carotid endarterectomy. Stroke, 32,325.
4. Bove EL, Fry WJ, Gross WSetal. (1979]. Hypotension and hypertension as consequences of baroreceptor dysfunction following carotid endarterectomy. Surgery, 85 (6], 633-637.
5. Brott TG, Hobson RW II, Howard G et al. (2010]. CREST Investigators. Stenting versus endarterectomy for treatment of carotid artery stenosis. N. Engl.J. Med., 363 (1], 11-23
6. Cunningham EJ, Bond R, MaybergMRetal. (2004]. Risk of persistent cranial nerve injury after carotid endarterectomy./ Neurosurg., 101,445-448.
7. Ederle J, Dobson J, Featherstone RL et al. (2010]. International Carotid Stenting Study investigators. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study]: an interim analysis ofa randomized controlled trial. Lancet, 375 (9719], 985-997.
8. Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Arteiy Transluminal Angioplasty Study (CAVATAS]: a randomized trial (2001]. Lancet, 357 (9270], 1729-1737.
9. Englund R, Dean RH (1986]. Blood pressure aberrations associated with carotid endarterectomy. Ann. Vase. Surg., 1 (3], 304-309.
10. European Carotid Surgery Trialists' Collaborative Group (1988]. Randomized trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet, 351,1379-1387.
11. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study (ACAS) (1995). Endarterectomy for asymptomatic carotid artery stenosis. JAMA, 273 (18), 1421-1428.
12. Fokkema M, de Borst GJ, Nolan BWet al/ (2014). Clinical relevance of cranial nerve injury following carotid endarterectomy. Eur. J. Vase. Endovasc. Surg., 47 (1), 2-7.
13. Gupta R, Abou-Chebl A, Bajzer CT, Schumacher HC, Yadav JS (2006). Rate, predictors, and consequences of hemodynamic depression after carotid artery stenting. J. Am. Coll. Cardiol., 6 (47), 1538-1543.
14. Hans SS, Glover JL (1995). The relationship of cardiac and neurological complications to blood pressure changes following carotid endarterectomy. Am. Surg., 61, 356-359.
15. Lehv MS, Salzman EW, Silen W (1970). Hypertension complicating carotid endarterectomy. Stroke, 1 (5), 307-313.
16. Mehta M, Rahmani O, Dietzek AM etal. (2001). Eversion technique increases the risk for post-carotid endarterectomy hypertension./. Vase. Surg., 1 (34), 839- 845.
17. North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991). Benefical effect of carotid endarterectomy in symptomatic patients with highgrade carotid stenosis. New Engl.]. Med., 325, 445- 453.
18. Regina G, Angiletta D, Impedovo G et al. (2009). Dexamethasone minimizes the risk of cranial nerve injury during CEA J. Vase. Surg., 9 (49), 99-102.
19. Tuckman J, Slater SR Sr., Mendlowitz M (1965). The carotid sinus reflexes. Am. Heart]., 70,119-135.
20. Van Mook WN, Rennenberg RJ, Schurink GW et al. (2005). Cerebral hyperperfusion syndrome. Lancet Neurol., 4,877-888.
21. WongJH, FindlayJM,Suarez-Almazor ME (1997). Hemodynamic instability after carotid ndarterectomy: risk factors and associations with operative complications. Neurosurgery, 41,35-41.
22. Zannetti S, Parente B, De Rango P et al. (1998). Role of surgical techniques and operative findings in cranial and cervical nerve injuries during carotid endarterectomy. Eur. J. Vase. Endovasc. Surg., 15,528-531.
Review
For citations:
Vinogradov R.A., Kosenkov A.N., Vinokurov I.A. FEATURES OF POSTOPERATIVE PERIOD IN PATIENTS AFTER BRAIN REVASCULARIZATION. Acta Biomedica Scientifica. 2015;(5):8-12. (In Russ.)
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