Carotid endarterectomy in early period after systemic thrombolysis for acute cerebrovascular accident

Vinokurov I.A.

Petrovsky Russian Research Center of Surgery;
Sechenov First Moscow State Medical University

ORCID: 0000-0003-0433-2523

Yasnopolskaya N.V.

Yudin Moscow City Clinical Hospital

ORCID: 0000-0002-4388-7890

Gasanov E.N.

Topchibashov Research Center of Surgery

Mutaev O.M.

Sechenov First Moscow State Medical University

Ropova A.I.

Sechenov First Moscow State Medical University

Carotid endarterectomy in early period after systemic thrombolysis for acute cerebrovascular accident

Authors:

Vinokurov I.A., Yasnopolskaya N.V., Gasanov E.N., Mutaev O.M., Ropova A.I.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(5): 370‑375

DOI: 10.17116/kardio202114051370

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To cite this article:

Vinokurov IA, Yasnopolskaya NV, Gasanov EN, Mutaev OM, Ropova AI. Carotid endarterectomy in early period after systemic thrombolysis for acute cerebrovascular accident. Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(5):370‑375. (In Russ.)
https://doi.org/10.17116/kardio202114051370

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

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OBJECTIVE

To estimate the results of carotid endarterectomy in early period after systemic thrombolysis.

MATERIAL AND METHODS

The study included 69 patients who underwent carotid endarterectomy within 14 days after stroke. The main group consisted of 15 patients (thrombolysis followed by carotid endarterectomy), the control group — 54 patients (no thrombolysis before carotid endarterectomy). Mean age of patients in the 1^st group was 71±7.9 years, in the second group — 67.6±8.6 years. Patients were comparable by comorbidities.

RESULTS

Systemic thrombolysis increased time to carotid endarterectomy by 2.2 days (p<0.017). We found no between-group difference in the incidence of postoperative complications. Mortality after carotid endarterectomy had a strong correlation with recurrent stroke and bleeding (r=0.71, p<0.05). No correlation was found between postoperative bleeding and antiplatelet therapy and thrombolysis within 7—14 days after ischemic stroke. At the same time, only postoperative complications affected treatment outcomes, and the factors of patients’ preoperative condition were not associated with higher mortality.

CONCLUSION

Carotid endarterectomy within 14 days after ischemic stroke did not increase the number of complications in patients with previous thrombolysis.

Keywords:

acute cerebrovascular accident

stroke

carotid endarterectomy

thrombolytic therapy

Authors:

Vinokurov I.A.

Petrovsky Russian Research Center of Surgery;
Sechenov First Moscow State Medical University

ORCID: 0000-0003-0433-2523

Yasnopolskaya N.V.

Yudin Moscow City Clinical Hospital

ORCID: 0000-0002-4388-7890

Gasanov E.N.

Topchibashov Research Center of Surgery

Mutaev O.M.

Sechenov First Moscow State Medical University

Ropova A.I.

Sechenov First Moscow State Medical University

Received:

14.06.2021

Accepted:

10.07.2021

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