Prevention of ischemic brain damage in surgery for cerebrovascular disease

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OBJECTIVE

To evaluate an effectiveness of perioperative algorithm of combined brain preconditioning in patients with occlusive lesion of supra-aortic vessels.

MATERIAL AND METHODS

There were 43 patients with internal carotid artery stenosis and concomitant subclavian artery occlusion. All patients were divided into 2 groups. In the main group, original method of brain preconditioning was used for neuroprotection before reconstructive surgery. Intraoperative controlled arterial hypertension was used in both groups. The study included patients with brain ischemia stage III—IV.

RESULTS

Partial oxygen pressure was significantly higher in the main group. There were 33 carotid endarterectomies, 8 carotid-subclavian bypass procedures and 2 simultaneous endarterectomies and bypass procedures. Postoperative perfusion complications were analyzed. One episode of transient ischemia occurred in the main group. The control group was characterized by 2 transient ischemia episodes and one fatal ischemic stroke.

CONCLUSION

Brain preconditioning increases blood partial oxygen pressure and can be used as one of the methods of neuroprotection in surgery of supra-aortic vessels.

Keywords:

brain

ischemia

carotid artery

blood oxygen

Authors:

Zavaruev A.V.

Amur State Medical Academy

ORCID: 0000-0002-2906-0440

Received:

30.11.2020

Accepted:

25.02.2021

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