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Zharova A.S.

Mechnikov North-Western State Medical University

Abramov O.O.

Mechnikov North-Western State Medical University

Golets K.O.

Mechnikov North-Western State Medical University

Gaganova T.S.

Mechnikov North-Western State Medical University

Ryl’skiy R.M.

Mechnikov North-Western State Medical University

Kokaya R.V.

Mechnikov North-Western State Medical University

Buksayev D.S.

Mechnikov North-Western State Medical University

Solotenkova K.N.

Mechnikov North-Western State Medical University

Golokhvastov S.V.

Kemerovo State Medical University

Klimova A.I.

Mechnikov North-Western State Medical University

Puchnina L.I.

Mechnikov North-Western State Medical University

Results of carotid endarterectomy in the acutest period of ischemic stroke

Authors:

Zharova A.S., Abramov O.O., Golets K.O., Gaganova T.S., Ryl’skiy R.M., Kokaya R.V., Buksayev D.S., Solotenkova K.N., Golokhvastov S.V., Klimova A.I., Puchnina L.I.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(12‑2): 55‑59

DOI: 10.17116/jnevro202212212255

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Table of contents

RESULTS OF CAROTID ENDARTERECTOMY IN THE ACUTEST PERIOD OF ISCHEMIC STROKE
RESULTS OF CAROTID ENDARTERECTOMY IN THE ACUTEST PERIOD OF ISCHEMIC STROKE

To cite this article:

Zharova AS, Abramov OO, Golets KO, et al. . Results of carotid endarterectomy in the acutest period of ischemic stroke. S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(12‑2):55‑59. (In Russ.)
https://doi.org/10.17116/jnevro202212212255

Подписка 2025-2 (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))
 
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OBJECTIVE

Analysis of the results of carotid endarterectomy (CEE) in the acute period of ischemic stroke (IS).

MATERIAL AND METHODS

This retrospective study included 128 patients (mean age 65.2±4.7 years, 84 (65.6%) men) who underwent CEE in the acute period. Inclusion criteria were: an ischemic focus in the brain with a diameter of no more than 2.5 cm according to MRI; mild neurological deficit (from 3 to 8 points on NIHSS); ≤3 points on the modified Rankin Scale (mRS); stenosis of ICA over 60%. Exclusion criteria were: severe neurological deficit; presence of decompensated comorbid dependence; contraindications to CEE.

RESULTS

In the hospital postoperative period, 3.9% of patients were diagnosed with hemorrhagic transformation of the ischemic focus in the brain with progression of neurological deficit and level of consciousness to coma II. In 3.1% cases, a lethal outcome developed on 4—7 days after the operation. In 2.3% patients after CEE, the progression of neurological deficit was noted with the development of new ischemic foci according to postoperative neuroimaging. The probable cause of this event was a distal embolism that developed during the installation of a temporary shunt. Myocardial infarction was diagnosed in 3.9% of patients. The combined end point (death + myocardial infarction + ischemic stroke + hemorrhagic transformation) was 10.1%.

CONCLUSION

CEE in the most acute period of ischemic stroke is accompanied by a high risk of hemorrhagic transformation, myocardial infarction, and death, which characterizes this revascularization option as unsafe.

Keywords:

carotid endarterectomy
acutest period of ischemic stroke
ischemic stroke
acute cerebrovascular accident
hemorrhagic transformation
hyperperfusion syndrome

Authors:

Zharova A.S.

Mechnikov North-Western State Medical University

Abramov O.O.

Mechnikov North-Western State Medical University

Golets K.O.

Mechnikov North-Western State Medical University

Gaganova T.S.

Mechnikov North-Western State Medical University

Ryl’skiy R.M.

Mechnikov North-Western State Medical University

Kokaya R.V.

Mechnikov North-Western State Medical University

Buksayev D.S.

Mechnikov North-Western State Medical University

Solotenkova K.N.

Mechnikov North-Western State Medical University

Golokhvastov S.V.

Kemerovo State Medical University

Klimova A.I.

Mechnikov North-Western State Medical University

Puchnina L.I.

Mechnikov North-Western State Medical University

Received:

11.04.2022

Accepted:

20.04.2022

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