Abstract
Objective: to estimate the clinical safety of open and endovascular interventions in the carotid arteries in the treatment and prevention of ischemic stroke. Material and methods: 317 patients (61 women and 256 men) aged 41 to 82 were examined. Carotid endarterectomy (CEA) (Group 1) was performed in 246 patients. Carotid transluminal balloon angioplasty with stenting (CAS) (Group 2) was performed in 71 patients. Symptomatic stenosis of the internal carotid artery (ICA) was detected in 85 patients (in Group1 in 53 patients, in Group2 in 32 patients). Asymptomatic stenosis of the ICA was detected in 232 patients (in Group1 in 193 patients, in Group2 in 39 patients). Results: in the immediate postoperative period in Group 1 of patients 15 complications (6,1%) developed. Ischemic stroke was stated in 8 cases (3,3%), 3 of which were lethal (1,2%). Transient ischemic attack was observed in 2 patients (0,8%). Myocardial infarction developed in 5 cases (2,0%). In the immediate postoperative period in the Group 2 of patients 4 complications (5,6%) was observed. Complications were demonstrated as an ischemic stroke in 2 cases (2,8%), myocardial infarction - in 1 observation (1,4%), a transient ischemic attack - in 1 patient (1,4%). In 1 observation (1,4%) there was a fatal outcome due to myocardial infarction in the background of hemorrhagic shock because of bleeding from an unidentified source. In the late postoperative period 12 complications developed in Group 1 of patients (6,0%). Th e restenosis of the operatedICA was observed in 8 cases (4,0%). An ipsilateral ischemic stroke was registered in 2 cases (1%). A myocardial infarction was stated in 2 cases (1%). A fatal outcome occurred in 3 cases (1,5%). In the late postoperative period 4 complications (6,8%) developed in Group 2 of patients. The restenosis of the operated ICA was stated in 1 observation (1,7%). A contralateral ischemic stroke was observed in 2 patients (3,4%). A myocardial infarction was registered in 1 observation (1,7%). A fatal outcome resulted from a myocardial infarction occurred in 1 case (1,7%). Conclusions : CEA and CAS of carotid arteries have the same effi cacy and safety in the immediate and late postoperative periods.
Highlights
Цель: оценить клиническую безопасность открытых и эндоваскулярных вмешательств на сонных артериях в лечении и профилактике ишемического инсульта
Asymptomatic stenosis of the internal carotid artery (ICA) was detected in 232 patients
Complications were demonstrated as an ischemic stroke in 2 cases (2,8%), myocardial infarction - in 1 observation (1,4%), a transient ischemic attack - in 1 patient (1,4%)
Summary
Цель: оценить клиническую безопасность открытых и эндоваскулярных вмешательств на сонных артериях в лечении и профилактике ишемического инсульта. Результаты: в ближайшем послеоперационном периоде в первой группе больных развились 15 осложнений (6,1%). В ближайшем послеоперационном периоде во второй группе больных развилось 4 осложнения (5,6%). В 1 наблюдении (1,4%) наступил летальный исход вследствие инфаркта миокарда на фоне геморрагического шока по причине кровотечения из не выявленного источника. В отдаленном послеоперационном периоде в 1 группе больных развились 12 осложнений (6,0%). В 8 наблюдениях (4,0%) развился рестеноз оперированной ВСА. В 2 наблюдениях развился инфаркт миокарда (1%). В отдаленном послеоперационном периоде во второй группе больных развилось 4 послеоперационных осложнения (6,8%). В 1 наблюдении (1,7%) развился рестеноз оперированной ВСА. У 2 пациентов (3,4%) развился контралатеральный по отношению к оперируемой артерии ишемический инсульт. В 1 случае (1,7%) наступил летальный исход вследствие фатального инфаркта миокарда. Заключение: КЭЭ и ТБАС сонных артерий имеют одинаковую эффективность и безопасность в ближайшем и отдаленном послеоперационном периодах
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