Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery

Gavrilenko A.V.

Russian Scientific Center for Surgery named after Academician B.V. Petrovsky;
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

ORCID: 0000-0001-7267-7369

Abramyan A.V.

Russian Scientific Center for Surgery named after Academician B.V. Petrovsky

ORCID: 0000-0003-1091-2639

Kochetkov V.A.

Russian Scientific Center for Surgery named after Academician B.V. Petrovsky

ORCID: 0000-0003-1410-839X

Tarabrin E.A.

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

ORCID: 0000-0001-8368-1056

Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery

Authors:

Gavrilenko A.V., Abramyan A.V., Kochetkov V.A., Tarabrin E.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2024;(1): 64‑70

DOI: 10.17116/hirurgia202401164

Downloaded: 8

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To cite this article:

Gavrilenko AV, Abramyan AV, Kochetkov VA, Tarabrin EA. Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery. Pirogov Russian Journal of Surgery. 2024;(1):64‑70. (In Russ.)
https://doi.org/10.17116/hirurgia202401164

Подписка 2025 (Pirogov Russian Journal of Surgery)

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No multicenter randomized clinical trial has been conducted worldwide to date on indications, types of surgery and their comparison with conservative treatment in patients with PI BSA.

OBJECTIVE

Of the study is to improve the results of surgical treatment in patients with pathological tortuosity of the internal carotid artery.

MATERIAL AND METHODS

The study included 119 patients (41 (34%) men and 78 (66%) women) with PI ICA aged 34 to 71 years (average age 53.2±7.5 years) divided into 2 groups. 64 patients (54%) of group I underwent BSA resection with lower mouth and 55 patients (46%) of group II underwent BSA prosthetics. Depending on the degree of neurological disorders, patients were distributed according to the classification of A.V. Pokrovsky.

RESULTS

In the early postoperative period, TIA was noted in one patient, and transient lesions of the cranial nerves were observed in 5 patients. During 5 years of follow-up, none of the patients developed TIA, IS or other vascular events. In the early surgical period, there were no significant differences in effectiveness between the groups of patients. In the long-term period (5 years after surgery), a higher frequency of asymptomatic patients was noted in group I.

CONCLUSION

Resection and replacement of a pathologically tortuous internal carotid artery (ICA) is a safe and effective surgical treatment. A multicenter randomized trial should be conducted to compare the effectiveness of surgical treatment of PI ICA with a conservative approach to effectively treat patients.

Keywords:

pathological crimping of internal carotid artery

cerebral insufficiency

ischemic stroke

surgical treatment of patients with pathological tortuosity carotid artery

Authors:

Gavrilenko A.V.

ORCID: 0000-0001-7267-7369

Abramyan A.V.

Russian Scientific Center for Surgery named after Academician B.V. Petrovsky

ORCID: 0000-0003-1091-2639

Kochetkov V.A.

Russian Scientific Center for Surgery named after Academician B.V. Petrovsky

ORCID: 0000-0003-1410-839X

Tarabrin E.A.

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

ORCID: 0000-0001-8368-1056

Received:

10.11.2023

Accepted:

29.11.2023

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