Internal carotid artery kinking. The clinic, diagnosis and surgical treatment

Gavrilenko A.V.

B.V. Petrovsky Russian Scientific Center of Surgery, Moscow, Russia;
Federal State Autonomous Educational Institution of Higher Education «I.M. Sechenov First Moscow State Medical University» of the Ministry of Health of the Russia, Moscow, Russia

Abramyan A.V.

B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia

Kuklin A.V.

B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia

Ofosu D.

B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia

Internal carotid artery kinking. The clinic, diagnosis and surgical treatment

Authors:

Gavrilenko A.V., Abramyan A.V., Kuklin A.V., Ofosu D.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2016;9(1): 29‑33

DOI: 10.17116/kardio20169129-33

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To cite this article:

Gavrilenko AV, Abramyan AV, Kuklin AV, Ofosu D. Internal carotid artery kinking. The clinic, diagnosis and surgical treatment. Russian Journal of Cardiology and Cardiovascular Surgery. 2016;9(1):29‑33. (In Russ.)
https://doi.org/10.17116/kardio20169129-33

Подписка 2025-2 (Russian Journal of Cardiology and Cardiovascular Surgery)

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Aim. To define optimal method of surgical treatment of ICA kinking alone and combined with stenosis. Material and methods. It was analyzed surgical results in 60 patients with ICA kinking who were operated at the Department of Vascular Surgery of acad. B.V. Petrovsky Russian Research Center of Surgery. The indications for surgical correction included symptoms of cerebrovascular insufficiency (CVI) and instrumentally confirmed hemodynamically significant kinking. The criteria for surgical treatment were velocity gradient over 2, turbulent blood flow at the site of arterial tortuosity identified by ultrasonography. Depending on surgical method patients were divided into 2 groups: group I consisted of 36 (60%) patients after ICA resection with orifice bringing down, group 2 ICA replacement - 8 (13%) patients and eversion endarterectomy with kinking resection and orifice bringing down - 16 (27%) patients. Results. There were no significant differences in CVI dynamics and velocities in reconstituted ICA (p > 0.05). Stroke + mortality caused by stroke index was higher in group 2 (p<0.05). Thrombosis developed significantly more often (p<0.05) after ICA replacement (8%) compared with resection and orifice bringing down (0%) and eversion endarterectomy with kinking resection and orifice bringing down (0%). Our results show that kinking resection with orifice bringing down should be preffered. ICA replacement is accompanied by significantly higher rate of complications. Eversion endarterectomy with kinking resection is advisable for kinking combined with stenosis because it allows to visualize distal end of plaque and to perform adequate endarterectomy.

Keywords:

ICA kinking

reconstruction techniques of ICA kinking

Authors:

Gavrilenko A.V.

Abramyan A.V.

B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia

Kuklin A.V.

B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia

Ofosu D.

B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia

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