Comparative results of surgical treatment of bilateral atherosclerotic occlusive stenotic carotid artery disease

Abstract

ICA occlusion leads to stroke at a frequency of up to 40% during the first year after the occlusion, and then at a rate of about 7% per year. The occlusion of the internal carotid artery in the neck is observed in 90% of cases, in other cases, occlusion takes place in the cavernous terminal part of the internal carotid artery. Improved treatment results, taking into account the information obtained in the prevention of ischemic stroke in patients with occlusion of the internal carotid artery in the remote period of observation. During the period from 2007 to 2015 in the department of vascular surgery OKB №3 530 patients were treated with lesions of brachiocephalic arteries. The number of patients with occlusion of the internal carotid artery on one side and stenosis on the other was 93 (17.5%). The group of patients treated only conservatively maintained a high incidence of TIA, 20.5% over the first year of observation. Within 8 years, 26.6% had ipsilateral stroke in the pool, this marked the occurrence of the two deaths due to myocardial infarction, and 8 due to ischemic stroke; Two patients had concomitant death due to cancer. The results of 8 years observation on operated and non-operated patients show that in patients who were operated on in most cases the marked signs of impairment of cerebral circulation in ipsilateral hemisphere were not developed. The results of observation over a group of patients who were not operated coincide with the average data according to which the patients who suffered an ischemic stroke have the risk development of the subsequent stroke at a level of 5–9% in a year, and approximately 40% of them have a repeated stroke over a 5 year period after the first stroke. The best clinical effect belonged to carotid endarterectomy, performed on patients with transitional ischemic attacks. The analysis of the results of the research testifies to the stable and long-term effect of the procedure. Refs 8. Fig 1. Tables 2.