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Belov Yu.V.
Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University
Kazantsev A.N.
St. Petersburg City Alexandrovskaya Hospital
Vinogradov R.A.
Research Institute — Ochapovsky Regional Clinical Hospital No.1;
Kuban State Medical University
Matusevich V.V.
Research Institute — Ochapovsky Regional Clinical Hospital No. 1
Kachesov E.U.
City Multi-Field Hospital «Alexandrovskaya bolnitsa»
Shmatov D.V.
St. Petersburg State University
Zakeryaev A.B.
Research Institute — Ochapovsky Regional Clinical Hospital No.1
Erofeev A.A.
Saint Petersburg City Multi-field Hospital No. 2, St. Petersburg Russi
Dzhanelidze M.O.
Western Regional Center of Modern Medical Technologies
Karmokov I.A.
Mechnikov North-Western State Medical University
Kuklev A.P.
St. Petersburg State University
Andreeva A.I.
Mechnikov North-Western State Medical University
Kokaya R.V.
Mechnikov North-Western State Medical University
Zharova A.S.
Mechnikov North-Western State Medical University
Radjabov I.M.
Burdenko Military Clinical Hospital
Lutsenko V.A.
Belyaev Kemerovo Regional Clinical Hospital, Kemerovo Russi
Sultanov R.V.
Belyaev Kemerovo Regional Clinical Hospital, Kemerovo Russi
Alizada F.R.
Belyaev Kuzbass Regional Clinical Hospital
Kapran T.I.
Research Institute — Ochapovsky Regional Clinical Hospital No. 1
Lider R.Yu.
Kemerovo State Medical University
Vayman E.F.
Kemerovo State Medical University
Ginzburg E.R.
Podgorbunsky Kuzbass Clinical Hospital for Emergency Care
Makoeva M.M.
Mechnikov North-Western State Medical University
Klimova A.I.
Mechnikov North-Western State Medical University
Vinogradova E.R.
Kuban State Medical University
Zakharova K.L.
City Aleksandrovskaya Hospital
Pachkoriya M.G.
Pavlov First St. Petersburg State Medical University
Alekseeva E.O.
Yaroslav the Wise Novgorod State University
Long-term results of carotid endarterectomy and carotid artery stenting in patients with high bifurcation of common carotid artery: a multiple-center study
Journal: Burdenko's Journal of Neurosurgery. 2022;86(3): 6‑16
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To cite this article:
Belov YuV, Kazantsev AN, Vinogradov RA, et al. . Long-term results of carotid endarterectomy and carotid artery stenting in patients with high bifurcation of common carotid artery: a multiple-center study. Burdenko's Journal of Neurosurgery.
2022;86(3):6‑16. (In Russ., In Engl.)
https://doi.org/10.17116/neiro2022860316
To analyze in-hospital and long-term results of eversion carotid endarterectomy (CEE), carotid endarterectomy with patch repair and carotid artery stenting (CAS) in patients with high bifurcation of common carotid artery.
A retrospective multiple-center open study included 1983 patients who underwent internal carotid artery (ICA) repair for severe stenosis between 2010 and 2021. Three groups of patients were distinguished depending on revascularization option: group 1 (n=638) — eversion CEE; group 2 (n=351) — CEE with patch repair; group 3 (n=994) — CAS.
In-hospital postoperative mortality and incidence of stroke and myocardial infarction were similar. All bleedings (n=39) occurred after CEE. ICA thrombosis was diagnosed in groups 1 and 2 due to intimal detachment after insertion of temporary bypass tube. Incidence of laryngeal paresis, neuropathy of hypoglossal and glossopharyngeal nerves, Horner syndrome, damage to salivary glands was comparable in groups 1 and 2. Long-term mortality was the highest (n=10; 2.8%) after CEE with patch repair due to fatal stroke. In turn, the highest incidence of ICA restenosis and restenosis-induced ischemic stroke was observed after CEE with patch repair and CAS.
1. Classical and eversion CEE in patients with high CCA bifurcation is followed by high in-hospital incidence of damage to cranial nerves and salivary glands, laryngeal paresis, Horner syndrome, bleeding and risk of ICA thrombosis. 2. In patients with high CCA bifurcation, CAS and CEE with patch repair are accompanied by high incidence of ICA restenosis, restenosis-induced stroke and mortality in long-term postoperative period. 3. Eversion CEE demonstrates the lowest rates of all adverse cardiovascular events in long-term follow-up period.
Keywords:
Authors:
Belov Yu.V.
Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University
Kazantsev A.N.
St. Petersburg City Alexandrovskaya Hospital
Vinogradov R.A.
Research Institute — Ochapovsky Regional Clinical Hospital No.1;
Kuban State Medical University
Matusevich V.V.
Research Institute — Ochapovsky Regional Clinical Hospital No. 1
Kachesov E.U.
City Multi-Field Hospital «Alexandrovskaya bolnitsa»
Shmatov D.V.
St. Petersburg State University
Zakeryaev A.B.
Research Institute — Ochapovsky Regional Clinical Hospital No.1
Erofeev A.A.
Saint Petersburg City Multi-field Hospital No. 2, St. Petersburg Russi
Dzhanelidze M.O.
Western Regional Center of Modern Medical Technologies
Karmokov I.A.
Mechnikov North-Western State Medical University
Kuklev A.P.
St. Petersburg State University
Andreeva A.I.
Mechnikov North-Western State Medical University
Kokaya R.V.
Mechnikov North-Western State Medical University
Zharova A.S.
Mechnikov North-Western State Medical University
Radjabov I.M.
Burdenko Military Clinical Hospital
Lutsenko V.A.
Belyaev Kemerovo Regional Clinical Hospital, Kemerovo Russi
Sultanov R.V.
Belyaev Kemerovo Regional Clinical Hospital, Kemerovo Russi
Alizada F.R.
Belyaev Kuzbass Regional Clinical Hospital
Kapran T.I.
Research Institute — Ochapovsky Regional Clinical Hospital No. 1
Lider R.Yu.
Kemerovo State Medical University
Vayman E.F.
Kemerovo State Medical University
Ginzburg E.R.
Podgorbunsky Kuzbass Clinical Hospital for Emergency Care
Makoeva M.M.
Mechnikov North-Western State Medical University
Klimova A.I.
Mechnikov North-Western State Medical University
Vinogradova E.R.
Kuban State Medical University
Zakharova K.L.
City Aleksandrovskaya Hospital
Pachkoriya M.G.
Pavlov First St. Petersburg State Medical University
Alekseeva E.O.
Yaroslav the Wise Novgorod State University
Received:
15.12.2020
Accepted:
25.03.2022
List of references:
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