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The state assessment of carotid artery bifurcation in earliest and delayed periods after carotid endarterectomy

https://doi.org/10.17650/1683-3295-2014-0-3-35-41

Abstract

Objective: to estimate of frequency and severity of restenosis after «classical» carotid endarterectomy (CEE) depending on type of arteriotomy closure. Material and methods: we estimated the surgical treatment outcomes at 128 patients underwent «classical» CEE during period from 2 till 9 years, mean follow-up period was 4,2 years. The type of arteriotomy closure was chosen according to geometrical parameters of carotid artery bifurcation. The simple closure by running suture was performed at 70 patients (1st group), the closure with the usage of synthetical patch (polytetrafluorethylene, 0,6-0,8 mm thick) - 58 patients (2d group). Results: The thickness of intima-media complex because of intima hyperplasia at the area of operation was significantly greater at patients underwent plasty of carotid artery by synthetical patch whilst the diameter of artery lumen was significantly narrow at patients in 2d group comparing with 1st group. The volume of blood flow didn’t significantly differ in studied groups. The thrombosis of ICA was seen twice oftener among patients of 2d group comparing with 1st group during more than 5-years follow-up period (6,9% vs. 2,8%). Conclusion: the usage of primary artery suture doesn’t lead to increase of restenosis rate and stroke occurrence in postoperative period in case of ICA diameter more than 5 mm, whereas it allows avoiding the excessive enlargement of ICA ampulla and forming of mural thrombotic masses which may promote the development of restenosis. The usage of expanding patch is necessary if the ICA diameter is less than 5 mm. The UCA stenosis more than 90% or expansion of atherosclerosis plaque into ICA more than 1,5 cm are the unfavorable factors for restenosis occurrence.

About the Authors

V. L. Lemenev
НИИ скорой помощи им. Н.В. Склифосовского
Russian Federation


A. A. Shamshilin
НИИ скорой помощи им. Н.В. Склифосовского
Russian Federation


A. S. Siluyanova
НИИ скорой помощи им. Н.В. Склифосовского
Russian Federation


I. P. Mikhailov
НИИ скорой помощи им. Н.В. Склифосовского
Russian Federation


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Review

For citations:


Lemenev V.L., Shamshilin A.A., Siluyanova A.S., Mikhailov I.P. The state assessment of carotid artery bifurcation in earliest and delayed periods after carotid endarterectomy. Russian journal of neurosurgery. 2014;(3):35-41. (In Russ.) https://doi.org/10.17650/1683-3295-2014-0-3-35-41

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ISSN 1683-3295 (Print)
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