Surgical prevention of progressive cerebral ischemia after ischemic stroke

Gavrilenko A.V.; Kravchenko A.A.; Kuklin A.V.

doi:https://doi.org/10.17116/hirurgia202202145

Gavrilenko A.V.

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

Kravchenko A.A.

Petrovsky Russian Research Center of Surgery

Kuklin A.V.

Petrovsky Russian Scientific Center of Surgery

Surgical prevention of progressive cerebral ischemia after ischemic stroke

Authors:

Gavrilenko A.V., Kravchenko A.A., Kuklin A.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(2): 45‑49

DOI: 10.17116/hirurgia202202145

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To cite this article:

Gavrilenko AV, Kravchenko AA, Kuklin AV. Surgical prevention of progressive cerebral ischemia after ischemic stroke. Pirogov Russian Journal of Surgery. 2022;(2):45‑49. (In Russ.)
https://doi.org/10.17116/hirurgia202202145

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To evaluate the effectiveness of carotid endarterectomy after ischemic stroke and to analyze postoperative neurological status.

MATERIAL AND METHODS

There were 120 patients with carotid artery stenosis complicated by chronic cerebrovascular insufficiency (CVI). Patients with CVI grade I—III were included in the first group (n=70), 50 patients had previous ischemic stroke (the second group). Age of patients was 61—89 years. All patients underwent unilateral carotid endarterectomy.

RESULTS

Over 36-month follow-up period, postoperative stroke occurred in 5 (7.2%) and 9 (18.3%) patients in both groups, respectively. The combined end-point (stroke + mortality) was significantly less common in group I compared to group II (10 (14.5%) and 15 (30%) cases, p>0.05). Positive changes in neurological status were found in the 2^nd group (relief of focal neurological deficit, symptoms of cerebrovascular insufficiency, no progression of vascular dementia). Barthel score increased from 74.3 to 92.8 after carotid endarterectomy in the 2^nd group. Baseline FAB score <11 was observed in 9% of patients in the 1^st group and 22% in the 2^nd group. No progression of dementia was observed in long-term period.

CONCLUSION

Carotid endarterectomy is effective in prevention of primary and recurrent stroke. Moreover, this procedure slows down progression of chronic cerebral ischemia and cognitive impairment.

Keywords:

carotid endarterectomy

prevention

stroke

surgery

Authors:

Gavrilenko A.V.

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

Kravchenko A.A.

Petrovsky Russian Research Center of Surgery

Kuklin A.V.

Petrovsky Russian Scientific Center of Surgery

Received:

19.01.2021

Accepted:

14.04.2021

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References:

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