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.

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