Immediate and long-term results of carotid endarterectomy in different periods of ischemic stroke

Anton N Kazantsev,Aleksander E Chikin,Yuriy P Linets,Roman Yu Lider,Tatyana E Zaitseva,Goderzi Sh Bagdavadze,Konstantin P Chernykh,Kubach G Kubachev,Nona E Zarkua,Evgeny Yu Kalinin,Ekaterina A Burkova

doi:10.23888/pavlovj2020283312-322

Abstract

Aim. Analysis of hospital and long-term results of carotid endarterectomy (CEA) in different periods of acute cerebrovascular event (ACVE). Materials and Methods. The given study was retrospective and was conducted using the method of patients sampling. In the period from 2010 to 2019, 1113 patients with ACVE in history who were later conducted CEA, were selected. Depending on the time interval between the last ACVE and CAE, all the patients were divided into 4 groups: the 1st group in the acutest period of ACVE (1-3 days) (n=24; 2.2%); the 2nd group in the acute period of ACVE (up to 28 days) (n=493; 44.3%); the 3rd group in the early rehabilitation period of ACVE (up to 6 months) (n=481; 43.2%); the 4th group in the late rehabilitation period of ACVE (up to 2 years) (n=115; 10.3%). The long-term period was 34.812.5 months. Results. In the hospitalization period of observation the following complications were found: lethal outcome ((group 1 0%; group 2 0.4% (n=2); group 3 0.2% (n=1); group 4 0%; р=0.16)); myocardial infarction ((group 1 0%; group 2 0.4% (n=2); group 3 0%; group 4 0.9% (n=1); р=0.35)); ACVE/transient ischemic attack (TIA), ((group 1 4.2% (n=1); group 2 0.4% (n=2); group 3 0.2% (n=1); group 4 0%; р1-2=0.01; р1-3=0.009; р1-4=0.01)). By the end of hospitalization period the composite endpoint consisting of lethal outcome + myocardial infarction + ACVE/TIA made in group 1 4.2% (n=1), in group 2 1.2% (n=6), in group 3 0.4% (n=2), in group 4 2.6% (n=3), р=0.08. Complications of the long-term follow-up period were: lethal outcome from all causes ((group 1 25% (n=6); group 2 5.5% (n=27); group 3 7.3% (n=35); group 4 14% (n=16); р1-2=0.002; р1-3=0.008; р2-4=0.012)); lethal outcome from cardiovascular causes ((group 1 4.2% (n=1); group 2 3.6% (n=18); group 3 4.8% (n=23); group 4 5.2% (n=6); р=0.79)), myocardial infarction ((group 1 12.5% (n=3); group 2 3.6% (n=18); group 3 5.4% (n=26); group 4 6.1% (n=7); р=0.15)), ACVE/TIA ((group 1 16.6% (n=4); group 2 6.3% (n=31); group 3 6% (n=29); group 4 11.3% (n=13); р=0.05)); composite endpoint including lethal outcome + myocardial infarction + ACVE/TIA ((group 1 54.2% (n=13); group 2 15.4% (n=76); group 3 18.7% (n=90); group 4 31.3% (n=36); р1-2=0.0001; р1-3=0.0001; р1-4=0.005; р2-4=0.0006; р3-4=0.012)). Conclusion. Application of CEA demonstrated effectiveness and safety in the acute and early rehabilitation period of ACVE.

Highlights

Depending on the time interval between the last acute cerebrovascular event (ACVE) and CAE, all the patients were divided into 4 groups: the 1st group – in the acutest period of ACVE (1-3 days) (n=24; 2.2%); the 2nd group – in the acute period of ACVE (n=493; 44.3%); the 3rd group – in the early rehabilitation period of ACVE (n=481; 43.2%); the 4th group – in the late rehabilitation period of ACVE (n=115; 10.3%)
By the end of hospitalization period the composite endpoint consisting of lethal outcome + myocardial infarction + ACVE/transient ischemic attack (TIA) made in group 1 – 4.2% (n=1), in group 2 – 1.2% (n=6), in group 3 – 0.4% (n=2), in group 4 – 2.6% (n=3), р=0.08
Цель – сравнительный анализ госпитальных и отдаленных исходов каротидной эндартерэктомии в разные периоды острого нарушения мозгового кровообращения

Summary

Introduction

Анализ госпитальных и отдаленных результатов каротидной эндартерэктомии (КЭЭ) в разные периоды острого нарушения мозгового кровообращения (ОНМК). Настоящее исследование являлось ретроспективным и проводилось методом сплошной выборки пациентов. В было отобрано 1113 пациентов с ОНМК в анамнезе, которым в последствии выполнялась КЭЭ. В зависимости от срока между последним ОНМК и КЭЭ все больные были распределены на 4 группы: 1-ая группа – в острейшем периоде (1-3 сут.) ОНМК (n=24; 2,2%); 2-ая группа – в остром периоде (до 28 сут.) ОНМК (n=493; 44,3%); 3-я группа – в раннем восстановительном периоде (до 6 мес.) ОНМК (n=481; 43,2%); 4-ая группа – в позднем восстановительном периоде (до 2-х лет) ОНМК (n=115; 10,3%).

Methods

Results

Conclusion