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Immediate and long-term results of two eversion carotid endarterectomy techniques

DOI: https://doi.org/10.29296/25877305-2022-12-11
Issue: 
12
Year: 
2022

A. Yarikov(1-4), Candidate of Medical Sciences; I. Smirnov(2); Professor A. Mukhin(5), MD; Professor A. Kletskin(5), MD; Professor V. Lyutikov(3), MD; V. Sergeev(6); Professor A. Fraerman(2), MD; K. Lipatov(1), Candidate of Medical Sciences;
M. Ostapyuk(5); S. Stolyarov(4), E. Muravina(4), M. Khasyanov(4), A. Ponomareva(4),
E. Komkova(4), T. Teleshova(4), S. Nesterenko(4), A. Shigorina(7); I. Zaletova(7);
V. Levshakov(8); N. Abramychev(9)
1-Volga District Medical Center, Federal Biomedical Agency of Russia, Nizhny Novgorod
2-City Clinical Hospital Thirty-Nine, Nizhny Novgorod
3-City Clinical Hospital One, Nizhny Novgorod
4-Central City Hospital, Arzamas, Nizhny Novgorod Region
5-Volga Research Medical University, Ministry of Health of Russia, Nizhny Novgorod
6-Federal Siberian Research and Clinical Center, Federal Biomedical Agency of Russia, Krasnoyarsk
7-Lyskovo Central District Hospital, Lyskovo, Nizhny Novgorod Region
8-Central Primary Healthcare Unit Fifty, Federal Biomedical Agency of Russia, Sarov, Nizhny Novgorod Region
9-Semenov Central District Hospital, Semenov, Nizhny Novgorod Region

Objective. To study the immediate and long-term results of the new modified technique of eversion carotid endarterectomy (ECEAE). Subjects and methods. According to the type of surgical treatment, the patients were divided into 2 groups: a study group of 61 patients who underwent ECEAE according to the method developed by V.L. Sergeev et al. and a comparison group of 89 patients who had ECEAE according to the method described by R. Kieny. The immediate and long-term results of the two ECEAE techniques were assessed. Results. No advantages of any of the ECEAE techniques were found in the immediate postoperative period. At the same time, in the long-term postoperative period, the incidence of non-fatal ischemic stroke ipsilateral to the side of surgery was 0% in the study group (ECEAE according to V.L. Sergeev) and 7.1% in the comparison group, the incidence of internal carotid artery restenosis was 1.7 and 11.7% respectively (p < 0.05). The two reconstruction methods were evaluated through mathematical modeling of blood flow. Conclusion. The new ECEAE technique (according to V.L. Sergeev) exhibited its safety and effectiveness in the immediate and long-term postoperative periods. Thus, it can be recommended for its wide application in practical medicine.

Keywords: 
surgery
carotid endarterectomy
eversion carotid endarterectomy
major cerebral arteries
internal carotid artery
carotid artery reconstruction
mathematical modeling of blood flow.



References: 
  1. Lukyanchikov V.A., Sinkin M.V., Preobrazhenskaya I.S. et al. Algorithm of preoperative examination and intraoperative monitoring in patients with reconstructive interventions on brain vessels. Russian Journal of Neurosurgery. 2021; 13 (S1): 206–7 (in Russ.).
  2. Lukyanchikov V.A., Udodov E.V. Tactics of surgical treatment of acute brain ischemia caused by atherosclerotic damage of the brachiocephalic arteries. Russian journal of neurosurgery. 2020; 22 (3): 31–41 (in Russ.). DOI: 10.17650/1683-3295-2020-22-3-31-41
  3. Usachev D.Yu., Azizyan R.I., Lukshin V.A. et al. Metastatic lymph node conglomerate removal with immediate carotid endarterectomy. Head and Neck. 2018; 2: 50–4 (in Russ.). DOI: 10.25792/HN.2018.6.2.50-54
  4. Antonov G.I., Shchigolev Yu.S., Kim E.A. et al. Urgical approach in pathological deformities of the great arteries of head and neck in the neurosurgical hospital. Russian Journal of Neurosurgery. 2014; 6 (4): 5–10 (in Russ.).
  5. Krylov V.V.1, Lemenev V.L.1, Dashyan V.G. et al. Surgical treatment of patients with intracranial aneurysms associated with atherosclerotic damage of brachiocephalic arteries. Russian Journal of Neurosurgery. 2014; 6 (2): 44–53 (in Russ.).
  6. Antonov G.I., Chmutin G.E., Miklashevich E.R. et al. Carotid artery dissection and blowout as a brachiocephalic arteries stenting complications. Hospital medicine: Science and practice. 2021; 4 (1): 5–9 (in Russ.). DOI: 10.34852/GM3CVKG.2021.91.75.001
  7. Kim A.V., Antonov G.I., Perekhodov S.N. et al. Results of surgical treatment of ischemic stroke in the basin of the middle cerebral artery in acute period. Hospital medicine: Science and practice. 2018; 1 (S): 18–26 (in Russ.).
  8. Lukianchikov V.A., Udodov E.V., Dalibaldyan V.A. et al. Surgical treatment of the patients with brachiocephalic arteries pathology in acute stroke. Russian Journal of Neurosurgery. 2017; 9 (2): 22–9 (in Russ.).
  9. Zakondyrin D.E., Polunina N.A., Luk’yanchikov V.A. et al. Implementation of a simulation training results in the practice of rendering neurosurgical care to patients with aneurysmatic intracranial hemorrhages. Russian journal of neurosurgery. 2018; 20 (1): 103–8 (in Russ.). DOI: 10.17650/1683-3295-2018-20-1-103-108
  10. Dalibaldyan V.A., Luk’yanchikov V.A., Shalumov A.Z. et al. The temporary mandible subluxation during surgical treatment of high-level atherosclerotic damages of extracranial part of internal carotid artery. Russian journal of neurosurgery. 2016; 1: 60–7 (in Russ.).
  11. Cherepanov A.V., Guzhin V.E.1, Dubovoy A.V. et al. Experience of surgical treatment of patients with concomitant carotid stenosis and cerebral aneurysms. Russian Journal of Neurosurgery. 2017; 9 (4): 48–53 (in Russ.).
  12. Kim A.V., Antonov G.I., Lazarev V.A. et al. The surgical treatment of patients with ischemic stroke within the territory of middle cerebral artery in acute period. Russian journal of neurosurgery. 2014; 1: 126–31 (in Russ.).
  13. Khamidova L.T., Rybalko N.V., Krylov V.V. et al. Estimation of instability of plaque in carotid arteries due to data of contrast-enhanced ultrasonic diagnostics and its correlation with histological examination after carotid endarterectomy. Journal Diagnostic & Interventional Radiology. 2019; 13 (3): 26–35 (in Russ.). DOI: 10.25512/DIR.2019.13.3.04
  14. Dudanov I.P., Vasil’chenko N.O., Pavlov O.A. et al. Influence of time period of surgical treatment of carotid artery stenosis on dynamics of neurological status of patients in acute period of ischemic stroke. Russian journal of neurosurgery. 2017; 4: 36–41 (in Russ.).
  15. Semenyutin V.B., Asaturyan G.А., Nikiforova А.А. et al. Severe carotid stenosis: cerebral autoregulation in the ipsilateral region. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2017; 117 (8): 76–84 (in Russ.). DOI: 10.17116/jnevro20171178176-84
  16. Krylov V.V., Dash’Yan V.G., Lemenev V.L. et al. Surgical treatment of patients with bilateral occlusive and stenotic diseases of brachiocephalic arteries. Russian journal of neurosurgery. 2014; 4: 16–25 (in Russ.). DOI: 10.17650/1683-3295-2014-0-4-16-25
  17. Nikitin A.S., Asratyan S.A., Nakhabin O.Yu. The surgical treatment of symptomatic occlusion of carotid artery. Russian journal of neurosurgery. 2014; 3: 71–7 (in Russ.). DOI: 10.17650/1683-3295-2014-0-3-71-77
  18. Semeniutin V.B., Aliev V.A., Nikiforova A.A. et al. Role of cerebral blood flow autoregulation in internal carotid artery stenosis surgery. Grekov's Bulletin of Surgery. 2018; 177 (6): 81–6 (in Russ.). DOI: 10.24884/0042-4625-2018-177-6-81-86
  19. Semenyutin V.B., Asaturyan G.A., Nikiforova A.A. et al. Predictors of stroke in patients with stenosis of the internal carotid arteries. Bulletin of the Russian Military Medical Academy. 2016; 4 (56): 27–31 (in Russ.).
  20. Antonov G.I., Schigolev Y.S., Kim E.A. et al. Algorithm use survey methods in the surgical treatment of cerebrovascular insufficiency and ischemic stroke prevention. Clinical neurology. 2014; 1: 3–8 (in Russ.).
  21. Antonov G.I., Mntroshin G.E., Miklashevich E.R. Surgical possibilities in atherosclerotic lesions of the main arteries of the head. Angiology and vascular surgery. 2008; 14 (3): 182 (in Russ.).
  22. Nemirovsky A.M., Bulgakov E.P., Volodyukhin M.Yu. et al. Principles of evaluation and surgical treatment of patients with constrictive atherosclerotic lesions of cerebral arteries in neurosurgical department of interregional clinical diagnostic center (Kazan). Russian Journal of Neurosurgery. 2015; 7 (2): 38–42 (in Russ.).
  23. Usachev D.Iu., Lukshin V.A., Shmigel'skii A.V. et al. Carotid endarterectomy in patients with symptomatic occlusions of the contralateral internal carotid artery. Zhurnal Voprosy Neirokhirurgii Imeni N.N. Burdenko. 2017; 81 (6): 5–15 (in Russ.). DOI: 10.17116/neiro20178165-15
  24. Krylov V.V., Luk'ianchikov V.A. Cerebral revascularization for the treatment of patients with acute ischemic stroke. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2014; 114 (12‑2): 46–52 (in Russ.). DOI: 10.17116/jnevro201411412246-52
  25. Yarikov A.V., Balyabin A.V., Yashin K.S. et al. Surgical treatment modalities of carotid artery stenosis (review). Modern technologies in medicine. 2015; 7 (4): 189–200 (in Russ.). DOI: 10.17691/stm2015.7.4.25
  26. Yarikov A.V., Mukhin A.S., Lyutikov V.G. et al. Nearest and farthest results of the new method of eversional carotid endarterectomy. Medical Almanac. 2017; 3 (48): 82–6 (in Russ.).
  27. Sergeev V.L., Mukhin A.S., Lyutikov V.G. Method of surgical correction of internal carotid artery stenosis. Patent for the invention RU 2525529 C1, 08/20/2014. Application no. 2013121604/14 dated 07.05.2013 (in Russ.).
  28. Akhmedov A.D., Usachev D.Iu., Lukshin V.A. et al. Carotid endarterectomy in patients with high surgical risk. Zhurnal Voprosy Neirokhirurgii Imeni N.N. Burdenko. 2013; 77 (4): 36–42 (in Russ.).
  29. Rotkov S.I., Popov E.V., Mukhin A.S. et al. Modeling the influence of geometry on anastomotic blood flow in the internal carotid artery. Modern problems of science and education. 2016; 2: 47 (in Russ.).