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Kazantsev AN, Korotkikh AV, Wang S, Gloria Nonye O, Artyukhov SV, Mukhtorov OS, Roshkovskaya LV, Zakharova KL, Unguryan VM, Shmatov DV, Urokov DA, Choriev AA, Zabolotniy VN, Lebedev OV, Zarkua NE, Kravchuk VN, Alekseyeva EO, Bagdavadze GS, Chernyavin MP, Leader RY, Solobuev AI, Vaiman EF, Kazantseva EG, Lutsenko VA, Sultanov RV, Matusevich VV, Zakeryaev AB, Sukhoruchkin PV. Carotid endarterectomy for symptomic and asymptomic stenosis: Report of 65388 cases (Russian register). Vascular 2024:17085381241259928. [PMID: 38848729 DOI: 10.1177/17085381241259928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
AIM Analysis of in-hospital and long-term results of carotid endarterectomy in patients with asymptomatic and symptomatic stenoses. MATERIALS AND METHODS The sample was formed by completely including all cases of carotid endarterectomy (n = 65,388) performed during the period from May 1, 2015 to November 1, 2023. Depending on the symptomatic/asymptomatic nature of the stenosis, all patients were divided into two groups: group 1 - n = 39,172 (75.2%) - patients with asymptomatic stenosis; Group 2 - n = 26216 (24.8%) - patients with symptomatic stenosis. The postoperative follow-up period was 53.5 ± 31.4 months. RESULTS In the hospital postoperative period, the groups were comparable in the incidence of death (group 1: n = 164 (0.41%); group 2: n = 124 (0.47%); p = .3), transient ischemic attack (group 1: n = 116 (0.29%); group 2: n = 88 (0.33%); p = .37), myocardial infarction (group 1: n = 32 (0.08%); group 2: n = 19 (0.07%); p = .68), thrombosis of the internal carotid artery (group 1: n = 8 (0.02%); group 2: n = 2 (0.007%); p = 0, 19), bleeding (group 1: n = 58 (0.14%); group 2: n = 33 (0.12%); p = .45). In group 2, ischemic stroke developed statistically more often (group 1: n = 328 (0.83%); group 2: n = 286 (1.09%); p = .001), which led to a higher value of the combined endpoint (group 1: n = 640 (1.63%); group 2: n = 517 (1.97%); p = .001). In the long-term postoperative period, the groups were comparable in cases of death (group 1: n = 65 (0.16%); group 2: n = 41 (0.15%); p = .76) and death from cardiovascular causes (group 1: n = 59 (0.15%); group 2: n = 33 (0.12%); p = .4). A greater number of ischemic strokes were detected in patients of group 2 (group 1: n = 213 (0.54%); group 2: n = 187 (0.71%); p = .006). In group 1, hemodynamically significant restenosis (≥70%) of the internal carotid artery was more often diagnosed (group 1: n = 974 (2.49%); group 2: n = 351 (1.34%); p < .0001) and myocardial infarction (group 1: n = 66 (0.16%); group 2: n = 34 (0.13%); p < .0001). When analyzing stroke-free survival, analysis of Kaplan-Meier curves showed that a statistically larger number of strokes were diagnosed in group 2 (p < .0001). CONCLUSION Due to the fact that the patients were initially not comparable for a number of indicators, to achieve balance, we applied propensity score matching analysis. Thus, group 1 consisted of 24,381 patients, and group 2 consisted of 17,219 patients. In the hospital postoperative period, statistically significant differences were obtained only in the combined end point, which was greater in group 2 (group 1: n = 465 (1.9%); group 2: n = 382 (2.2%); p = .02). In the long-term follow-up period, after applying propensity score matching, no statistically significant differences were obtained between groups.
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Affiliation(s)
- Anton N Kazantsev
- Kostroma Regional Clinic, Kostroma, Russian Federation
- Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky, Moscow, Russian Federation
- Kostroma Oncology Dispensary, Kostroma, Russian Federation
| | - Alexander V Korotkikh
- Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation
| | - Showen Wang
- First Moscow State Medical University. THEM. Sechenov, Moscow, Russian Federation
| | | | - Sergey V Artyukhov
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | | | - Lyudmila V Roshkovskaya
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | - Kristina L Zakharova
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | | | - Dmitry V Shmatov
- St. Petersburg State University, St. Petersburg, Russian Federation
| | | | | | | | | | - Nona E Zarkua
- Northwestern State Medical University Named After Mechnikov, St. Petersburg, Russian Federation
| | - Vyacheslav N Kravchuk
- Northwestern State Medical University Named After Mechnikov, St. Petersburg, Russian Federation
| | - Elena O Alekseyeva
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russian Federation
| | | | - Maxim P Chernyavin
- Clinical Hospital of the Administration of the President of the Russian Federation, Moscow, Russian Federation
| | - Roman Yu Leader
- Kemerovo State Medical University, Kemerovo, Russian Federation
| | | | | | | | - Viktor A Lutsenko
- Kemerovo Regional Clinical Hospital Named After S.V. Belyaev, Kemerovo, Russian Federation
| | - Roman V Sultanov
- Kemerovo Regional Clinical Hospital Named After S.V. Belyaev, Kemerovo, Russian Federation
| | - Vyacheslav V Matusevich
- Scientific Research Institute - Ochapovsky Regional Clinic Hospital №1, Krasnodar, Russian Federation
| | - Aslan B Zakeryaev
- Scientific Research Institute - Ochapovsky Regional Clinic Hospital №1, Krasnodar, Russian Federation
| | - Pavel V Sukhoruchkin
- Scientific Research Institute - Ochapovsky Regional Clinic Hospital №1, Krasnodar, Russian Federation
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Kazantsev AN, Korotkikh AV, Wang S, Nonye OG, Artyukhov SV, Mukhtorov OS, Roshkovskaya LV, Unguryan VM, Shmatov DV, Urokov DA, Choriev AA, Zabolotniy VN, Lebedev OV, Zarkua NE, Kravchuk VN, Koplik VO, Kudryavtsev ME, Bagdavadze GS, Chernyavin MP, Leader RY, Kazantseva EG, Belov YV. Hospital and long-term results of carotid endarterectomy in patients with different severity of coronary artery lesion according to syntax score. Curr Probl Cardiol 2024; 49:102244. [PMID: 38043882 DOI: 10.1016/j.cpcardiol.2023.102244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
AIM Analysis of in-hospital and long-term results of carotid endarterectomy (CEE) in patients with different severity of coronary atherosclerosis. MATERIAL AND METHODS This comparative, retrospective, open study for the period from January 2013 to April 2020 included 1719 patients operated on for occlusive-stenotic lesions of the internal carotid arteries (ICA). Classical and eversion CEA were used as revascularization strategies. The criteria for inclusion in the study were: 1. Presence of coronary angiography within six months before the present CEE; 2. A history of myocardial revascularization in patients with severe coronary lesions. Depending on the severity of coronary atherosclerosis, all patients were divided into 3 groups: Group 1-871 (50.7 %) patients - with the presence of hemodynamically significant stenosis of the coronary arteries (CA) with a history of myocardial revascularization; Group 2-496 (28.8 %) patients - with the presence of hemodynamically insignificant lesions of the coronary artery (up to 70 %, not inclusive, and the trunk of the left coronary artery, up to 50 %, not inclusive); Group 3-352 (20.5 %) patients - without signs of atherosclerotic lesions of the coronary artery. In group 1, the observation period was 56.8±23.2 months, in group 2-62.0±15.6 months, in group 3-58.1±20.4 months. RESULTS During the hospital observation period, there were no significant intergroup differences in the number of complications. All cardiovascular events were detected in isolated cases. The most common injury was damage to the cranial nerves, diagnosed in every fifth patient in the total sample. The combined endpoint (CET), including death + myocardial infarction (MI) + acute cerebrovascular accident/transient ischemic attack (stroke/TIA), was 0.75 % (n=13). In the long-term follow-up period, when comparing survival curves, group 3 revealed the largest number of ischemic strokes (p = 0.007), myocardial infarction (p = 0.03), and CCT (p = 0.005). There were no intergroup differences in the number of deaths (p=0.62). CONCLUSION The results of the study showed that there was no significant intergroup difference in the development of complications at the hospital postoperative stage. However, in the long-term follow-up period, a group of patients with isolated lesions of the ICA demonstrated a rapid increase in the number of MI, stroke/TIA, and a combined endpoint, which was apparently associated with low compliance and progression of atherosclerosis in previously unaffected arteries.
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Affiliation(s)
- Anton N Kazantsev
- Kostroma Regional Clinic, Kostroma, Russian Federation; Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky, Moscow, Russian Federation; Kostroma Oncology Dispensary, Kostroma, Russian Federation.
| | - Alexander V Korotkikh
- Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation
| | - Showen Wang
- First Moscow State Medical University, THEM. Sechenov, Moscow, Russian Federation
| | | | - Sergey V Artyukhov
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | | | - Lyudmila V Roshkovskaya
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | | | - Dmitry V Shmatov
- St. Petersburg State University, St. Petersburg, Russian Federation
| | | | | | | | | | - Nona E Zarkua
- Northwestern State Medical University Named After Mechnikov, St. Petersburg, Russian Federation
| | - Vyacheslav N Kravchuk
- Northwestern State Medical University Named After Mechnikov, St. Petersburg, Russian Federation
| | - Victoria O Koplik
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russian Federation
| | - Mikhail E Kudryavtsev
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russian Federation
| | | | - Maxim P Chernyavin
- Clinical Hospital of the Administration of the President of the Russian Federation, Moscow, Russian Federation
| | - Roman Yu Leader
- Kemerovo State Medical University, Kemerovo, Russian Federation
| | | | - Yuri V Belov
- Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky, Moscow, Russian Federation; First Moscow State Medical University, THEM. Sechenov, Moscow, Russian Federation
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Bedi VS, Sharma N. Carotid artery stenosis: stroke prevention procedure-indications, controversies, and challenges. Indian J Thorac Cardiovasc Surg 2024; 40:3-6. [PMID: 38125331 PMCID: PMC10728408 DOI: 10.1007/s12055-023-01603-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 12/23/2023] Open
Affiliation(s)
- Varinder Singh Bedi
- Institute of Vascular & Endovascular Sciences, Sir Ganga Ram Hospital, New Delhi, India
| | - Nikhil Sharma
- Institute of Vascular & Endovascular Sciences, Sir Ganga Ram Hospital, New Delhi, India
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Kazantsev AN, Korotkikh A, Dzhanelidze M, Kharchilava E, Zarkua N, Alekseeva E, Staroverova V, Koplik V, Leader R, Zakeryaev A, Bagdavadze G, Zakharova K, Semyin I, Kostenkov A, Chernykh K, Shmatov D, Lebedev O, Artyukhov S, Mukhtorov O, Wang S, Komarov R, Roshkovskaya L, Khetagurov M, Unguryan V, Chernyavin M, Palagin P, Sirotkin A, Belov Y. Prospective multicenter online testing of the carotid endarterectomy risk stratification calculator carotidscore.ru. Indian J Thorac Cardiovasc Surg 2023; 39:608-614. [PMID: 37885939 PMCID: PMC10597897 DOI: 10.1007/s12055-023-01538-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 10/28/2023] Open
Abstract
Aim To evaluate the incidence of complications, including fatal outcomes, ischemic strokes, and transient ischemic attacks, associated with carotid endarterectomy (CEA) in patients categorized as low-, medium-, and high-risk based on their CarotidSCORE (carotidscore.ru). Material and Methods This prospective, multicenter study was conducted from January 1, 2022, to December 20, 2022, and enrolled 5,496 patients with stenosis of the internal carotid artery (ICA), who were categorized into four groups according to their risk level. Group 1 (n=1,759) included patients at low risk; Group 2 (n=2,483) included those at medium risk; Group 3 (n=429) included those at high risk, who underwent carotid angioplasty with stenting (CAS) due to the high risk of complications associated with carotid endarterectomy (CEA); and Group 4 (n=825) did not use CarotidSCORE (carotidscore.ru). Patients in Groups 1, 2, and 4 underwent CEA. Results During the postoperative hospital stay, the highest number of complications, including fatal outcomes (p=0.0007), ischemic strokes (p<0.0001), and the combined endpoints (p<0.0001) were observed in Group 4. No complications were reported in Group 1. Conclusion The use of CarotidSCORE (carotidscore.ru) allows for the identification of high-risk patients, enabling clinicians to opt for CAS instead of CEA and reduce the incidence of complications.
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Affiliation(s)
| | - Alexander Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Merab Dzhanelidze
- Western Regional Center for Modern Medical Technologies, Kutaisi, Georgia
| | - Elguja Kharchilava
- North-Western State Medical University. Named After I.I. Mechnikov, St. Petersburg, Russian Federation
| | - Nonna Zarkua
- North-Western State Medical University. Named After I.I. Mechnikov, St. Petersburg, Russian Federation
| | - Elena Alekseeva
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russia
| | - Valeria Staroverova
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russia
| | - Victoria Koplik
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russia
| | - Roman Leader
- Kemerovo State Medical University, Kemerovo, Russian Federation
| | - Aslan Zakeryaev
- Regional Clinical Hospital No. 1 Named After. Prof. S.V. Ochapovsky, Krasnodar, Russian Federation
| | - Goderzi Bagdavadze
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
| | | | - Igor Semyin
- Arkhangelsk Regional Clinical Hospital, Arkhangelsk, Russian Federation
| | - Anton Kostenkov
- Arkhangelsk Regional Clinical Hospital, Arkhangelsk, Russian Federation
| | | | - Dmitry Shmatov
- St. Petersburg State University, St. Petersburg, Russian Federation
| | - Oleg Lebedev
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
- Yaroslavl State Medical University, St. Petersburg, Yaroslavl, Russia
| | - Sergey Artyukhov
- North-Western State Medical University. Named After I.I. Mechnikov, St. Petersburg, Russian Federation
- City Alexander Hospital, St. Petersburg, Russian Federation
| | - Otabek Mukhtorov
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
| | - Shuowen Wang
- First Moscow State Medical University Named After Sechenov, Moscow, Russian Federation
| | - Roman Komarov
- First Moscow State Medical University Named After Sechenov, Moscow, Russian Federation
| | | | - Mikhail Khetagurov
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
| | | | - Maxim Chernyavin
- Clinical Hospital of the Administration of the President of the Russian Federation, Moscow, Russian Federation
| | - Petr Palagin
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
| | - Alexey Sirotkin
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
| | - Yuri Belov
- First Moscow State Medical University Named After Sechenov, Moscow, Russian Federation
- Federal State Budgetary Scientific Institution “Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky”, Moscow, Russian Federation
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Kazantsev AN, Korotkikh AV, Chernyavin MP, Domke AP, Medvedev VM, Lider RY, Mukhtorov OS, Palagin PD, Sirotkin AA, Lebedev OV, Kazantsva EG. Vertebral triangle of doctor A.N. Kazantsev - double vertebral artery in V3 segment. Radiol Case Rep 2023; 18:2370-2375. [PMID: 37179809 PMCID: PMC10172637 DOI: 10.1016/j.radcr.2023.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
We have described a variant of the structure of the vertebral artery. In the V3 segment, the vertebral artery bifurcated and then joined again. This building looks like a triangle. Such anatomy has not been previously described in the world literature. By the right of the first description, this anatomical formation was called the «vertebral triangle of Dr A.N. Kazantsev». This discovery was made during stenting of the V4 segment of the left vertebral artery in the most acute period of stroke.
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Affiliation(s)
- Anton N. Kazantsev
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
- Corresponding author.
| | - Alexander V. Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Maxim P. Chernyavin
- Clinical Hospital №1 of the Presidential Administration of the Russian Federation, Moscow, Russian Federation
| | - Alexey P. Domke
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Vasily M. Medvedev
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Roman Yu. Lider
- Kemerovo State Medical University, Kemerovo, Russian Federation
| | - Otabek Sh. Mukhtorov
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
| | - Petr D. Palagin
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
| | - Alexey A. Sirotkin
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
| | - Oleg V. Lebedev
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
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Kazantsev AN, Zharova AS, Shmatov DV, Zakeryaev AB, Lider RY, Kazantseva EG, Bagdavadze GS, Korotkikh AV, Lutsenko VA, Sultanov RV, Lebedev OV, Sirotkin AA, Snopova EV, Palagin PD. The results of thrombectomy from the arteries of the lower extremities in patients infected with SARS-CoV-2 Omicron variant with different severity of respiratory failure. Vascular 2023:17085381231160933. [PMID: 36867526 PMCID: PMC9988629 DOI: 10.1177/17085381231160933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
GOAL Analysis of the results of thrombectomy from the arteries of the lower extremities in patients with COVID-19 against the background of different severity of respiratory failure. MATERIALS AND METHODS This retrospective, cohort, comparative study for the period from 05/01/2022 to 20/07/2022 included 305 patients with acute thrombosis of the arteries of the lower extremities against the background of the course of COVID-19 (SARS-CoV-2 Omicron variant). Depending on the type of oxygen support, 3 groups of patients were formed: group 1 (n = 168) - oxygen insufflation through nasal cannulas; group 2 (n = 92) - non-invasive lung ventilation; and group 3 (n = 45) - artificial lung ventilation. RESULTS Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5.3%, n = 9; group 2: 72.8%, n = 67; group 3: 100%, n = 45; p < 0.0001), rethrombosis (group 1 : 18.4%, n = 31; group 2: 69.5%, n = 64; group 3: 91.1%, n = 41; p < 0.0001), and limb amputations (group 1: 9.5%, n = 16; group 2: 56.5%, n = 52; group 3: 91.1%, n = 41; p < 0.0001) was recorded in group 3 (ventilated) patients. CONCLUSION In patients infected with COVID-19 and on artificial lung ventilation, a more aggressive course of the disease is noted, expressed in an increase in laboratory parameters (C-reactive protein, ferritin, interleukin-6, and D-dimer) of the degree of pneumonia (CT-4 in overwhelming number) and localization of thrombosis of the arteries of the lower extremities, mainly in the tibial arteries.
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Affiliation(s)
- Anton N Kazantsev
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Alina S Zharova
- North-Western State Medical University named after I. I. Mechnikov, Saint Petersburg, Russian Federation
| | - Dmitriy V Shmatov
- Clinic of High Medical Technologies named after N. I. Pirogov St Petersburg State University, Saint Petersburg, Russian Federation
| | - Aslan B Zakeryaev
- Research Institute Regional Clinical Hospital No. 1 named. prof. S.V. Ochapovsky, Krasnodar, Russian Federation
| | - Roman Yu Lider
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Elizaveta G Kazantseva
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Goderzi S. Bagdavadze
- North-Western State Medical University named after I. I. Mechnikov, Saint Petersburg, Russian Federation
| | - Alexander V Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Victor A Lutsenko
- Kemerovo Regional Clinical Hospital named after S. V. Belyaeva, Kemerovo, Russian Federation
| | - Roman V Sultanov
- Kemerovo Regional Clinical Hospital named after S. V. Belyaeva, Kemerovo, Russian Federation
| | - Oleg V Lebedev
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Alexey A Sirotkin
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Elena V Snopova
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Petr D Palagin
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
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