The efficacy of pharmacological preconditioning in carotid endarterectomy

Kuznetsov M.R.

L.L. Levshina Institute of Cluster Oncology Russian Academy of Sciences — «First Moscow State Medical University named after I.I. Sechenov» of the Ministry of Health of Russia (Sechenov University);
N.V. Sklifosovsky Institute of Clinical Medicine Federal State Autonomous Educational Institution of Higher Education «Sechenov First Moscow State Medical university of the Ministry of Health of Russia» (Sechenov University)

ORCID: 0000-0001-6926-6809

Fedin A.I.

Pirogov Russian National Research Medical University

SPIN RSCI: 8834-0085
Scopus AuthorID: 7007163263
ORCID: 0000-0002-6996-2828

Karalkin A.V.

Pirogov City Hospital No. 1

Frolov K.B.

Pirogov Moscow City Hospital No. 1

Kunitsin N.V.

Pirogov City Hospital No. 1

Yumin S.M.

Pirogov Russian National Research Medical University

Kholopova E.A.

Pirogov Russian National Research Medical University

Knyazev A.V.

Pirogov Russian National Research Medical University

The efficacy of pharmacological preconditioning in carotid endarterectomy

Authors:

Kuznetsov M.R., Fedin A.I., Karalkin A.V., Frolov K.B., Kunitsin N.V., Yumin S.M., Kholopova E.A., Knyazev A.V.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(2): 34‑41

DOI: 10.17116/jnevro20161162134-41

Read: 560 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Kuznetsov MR, Fedin AI, Karalkin AV, et al. . The efficacy of pharmacological preconditioning in carotid endarterectomy. S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(2):34‑41. (In Russ.)
https://doi.org/10.17116/jnevro20161162134-41

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

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To assess the efficacy of pharmacological preconditioning with actovegin in carotid endarterectomy.

MATERIAL AND METHODS

The study was based on the results of surgical treatment of 80 patients with hemodynamically significant uni- and bilateral lesions of carotid arteries. Half of the patients was operated immediately and others after pharmacological preconditioning with actovegin in dose of 1200 mg/daily during 1.5 months.

RESULTS

Pharmacological preconditioning with actovegin increased the cerebral perfusion determined with one-photon emission computed tomography that improved significantly results of the surgery. There were significant changes in patient’s state 7 days and 6 months after surgery. The improvement was correlated with the less number of asymptotic post-surgery ischemic strokes in different brain areas.

CONCLUSION

A positive role of pharmacological preconditioning with actovegin in surgical treatment of carotid artery stenosis has been demonstrated.

Keywords:

cerebrovascular insufficiency

carotid endarterectomy

preconditioning

cognitive function

cerebral blood flow autoregulation

reperfusion syndrome

actovegin

Authors:

Kuznetsov M.R.

ORCID: 0000-0001-6926-6809

Fedin A.I.

Pirogov Russian National Research Medical University

SPIN RSCI: 8834-0085
Scopus AuthorID: 7007163263
ORCID: 0000-0002-6996-2828

Karalkin A.V.

Pirogov City Hospital No. 1

Frolov K.B.

Pirogov Moscow City Hospital No. 1

Kunitsin N.V.

Pirogov City Hospital No. 1

Yumin S.M.

Pirogov Russian National Research Medical University

Kholopova E.A.

Pirogov Russian National Research Medical University

Knyazev A.V.

Pirogov Russian National Research Medical University

List of references:

Suslina Z.A., Varakin Yu.Ya., Vereshchagin N.V. Vascular diseases of the brain. 2nd ed. updated and revised. Moscow: Medpress-Inform; 2009.
Pokrovsky A.V., Beloyartsev D.F., Tylybly O.L. Analysis of the results of eversion carotid endarterectomy in the remote period. Angiology and Vascular Surgery. 2014;20(4):100-108.
Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, Thomas D. MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet. 2004;363(9420):1491-1502. https://doi.org/10.1016/s0140-6736(04)16146-1
Bakker SL, de Leeuw FE, de Groot JC, Hofman A, Koudstaal PJ, Breteler MM. Cerebral vasomotor reactivity and cerebral white matter lesions in the elderly. Neurology. 1999;52(3):578-583. https://doi.org/10.1212/wnl.52.3.578
Lamers LJ, Rowland DG, Seguin JH, Rosenberg EM, Reber KM. The effect of common origin of the carotid arteries in neurologic outcome after neonatal ECMO. J Pediatr Surg. 2004;39(4):532-536. https://doi.org/10.1016/j.jpedsurg.2003.12.005
Gaidar B.V., Dudanov I.P., Parfyonov V.E., Svistov D.V. Ultrasound methods of investigation in diagnostics of lesions of aortic arch branches. Petrozavodsk. 1994.
Shmyrev VSh, Gajonova VE, Bobrova TA, Martynov AI. Study of cerebrovascular reactivity in elderly patients with essential arterial hypertension. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2002;2:1027:48-53.
Tikhomirova O.V., Mashkova N.P., Mamatova N.T., Kotlyarova B.V., Sorokoumov V.A. Doppler diagnostic of functional state of cerebral circulation in lacunar infarcts and arterial hypertension. Arterial hypertension. 2003;9(5):174-177
Baumbach GL, Heistad DD. Cerebral circulation in chronic arterial hypertension. Hyperstension. 1998;12(2): 89-95. https://doi.org/10.1161/01.hyp.12.2.89
Markus H, Cullinane M. Severely impaired cerebrovascular reactivity predicts stroke and TIA risk in patients with carotid artery stenosis and occlusion Brain. 2001;124(3):457-467. https://doi.org/10.1093/brain/124.3.457
Davis S, Babikian VL, Wechsler LR. Transcranial doppler ultrasonography and cerebral blood flow. Mosby: Year Book, Inc.; 1993.
Strandgaard S, Paulson OB. Cerebral Autoregulation. Stroke. 1983;14(5):7030-7095.
Reinhard M, Schumacher FK, Rutsch S, Oeinck M, Timmer J, Mader I, Schelter B, Weiller C, Kaller CP. Spatial mapping of dynamic cerebral autoregulation by multichannel near-infrared spectroscopy in high-grade carotid artery disease. J Biomed Opt. 2014;19(9):97005. https://doi.org/10.1117/1.jbo.19.9.097005
Reinhard M, Roth M, Müller T, Guschlbauer B, Timmer J, Czosnyka M, Hetzel A. Effect of carotid endarterectomy or stenting on impairment of dynamic cerebral autoregulation. Stroke. 2004;35(6):1381-1387. https://doi.org/10.1161/01.str.0000127533.46914.31
Shakhnovich V.A. Ischemic Stroke. Neurosonology. Scientific and Methodological Literature. Moscow: Publishing house "AST"; 2006.
Lupanov V.P., Maksimenko A.V. Protective ischemia in cardiology. Forms of myocardial conditioning. Cardiovascular Therapy and Prevention. 2011;10(1):111-119.
Murry CE, Jenning RD, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation. 1986;74(5):1124-1136. https://doi.org/10.1161/01.cir.74.5.1124
Yellon DM, Alkhulaifi AM, Pugsley WB. Preconditioning the human myocardium. Lancet. 1993;342(8866):276-277. https://doi.org/10.1016/0140-6736(93)91819-8
Leesar MA, Stoddard M, Ahmed M, Broadbent J, Bolli R. Preconditioning of human myocardium with adenosine during angioplasty. Circulation. 1997;95(11):2500-2507. https://doi.org/10.1161/01.cir.95.11.2500
Heidland UE, Heintzen MP, Michel CJ, Strauer BE. Effect of adjunctive intracoronary adenosine on myocardial ischemia, hemodynamic function and left ventricular performance during percutaneous transluminal coronary angioplasty: clinical access to ischemic preconditioning? Coron Artery Dis. 2000;11(5):421-428. https://doi.org/10.1097/00019501-200007000-00007
Dieckmann A, Kriebel M, Andriambeloson E, Ziegler D, Elmlinger M. Treatment with Actovegin improves sensory nerve function and pathology in streptozotocin- diabetic rats via mechanisms involving inhibition of PARP activation. Exp. Clin. Endocrinol Diabetes. 2011;120(3):132-138. https://doi.org/10.1055/s-0031-1291248
Elmlinger MW, Kriebel M, Ziegler D. Neuroprotective and anti-oxidative effects of the hemodialysate actovegin on primary rat neurons in vitro. Neuromolecular Med. 2011;13(4):266-274. https://doi.org/10.1007/s12017-011-8157-7
Meilin S, Machicao F, Elmlinger M. Treatment with Actovegin improves spatial learning and memory in rats following transient forebrain ischaemia. J Cell Mol Med. 2014;18(8):1623-1630. https://doi.org/10.1111/jcmm.12297
National Guidelines for Radionuclide Diagnostics. Edited by Yu.B. Lishmanov, V.I. Chernov. Tomsk. 2010;1:189-247.
Sokolova L.P. Peculiarities of cerebral blood circulation in premenstrual cognitive disorders of different genesis. Modern problems of science and education. 2011;4:28-34.
Kacheishvili M.Y. Assessment of cerebral blood flow and cerebrovascular reserve in patients with acquired cardiac defects before and after surgical treatment according to 99ts-Ceretek SPECT: Author's abstract... D. in medical sciences. 2005.

Close metadata