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Belov YV, Kazantsev AN, Vinogradov RA, Korotkikh AV, Chernykh KP, Matusevich VV, Kachesov EY, Shmatov DV, Zakeryaev AB, Erofeev AA, Dzhanelidze MO, Karmokov IA, Kuklev AP, Andreeva AI, Taits BM, Taits DB, Bagdavadze GS, Kokaya RV, Zharova AS, Radzhabov IM, Lutsenko VA, Sultanov RV, Alizada FR, Abdullaev AD, Povtoreyko AV, Kapran TI, Lider RY, Vayman EF, Meleshin EO, Ginzburg ER, Makoeva MM, Klimova AI, Vinogradova ER, Zakharova KL, Pachkoriya MG, Alekseeva EO. [Long-term results of carotid endarterectomy and carotid artery stenting in patients with high bifurcation of common carotid artery: a multiple-center study]. Zh Vopr Neirokhir Im N N Burdenko 2022; 86:6-16. [PMID: 35758073 DOI: 10.17116/neiro2022860316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To analyze in-hospital and long-term results of eversion carotid endarterectomy (CEE), carotid endarterectomy with patch repair and carotid artery stenting (CAS) in patients with high bifurcation of common carotid artery. MATERIAL AND METHODS A retrospective multiple-center open study included 1983 patients who underwent internal carotid artery (ICA) repair for severe stenosis between 2010 and 2021. Three groups of patients were distinguished depending on revascularization option: group 1 (n=638) - eversion CEE; group 2 (n=351) - CEE with patch repair; group 3 (n=994) - CAS. RESULTS In-hospital postoperative mortality and incidence of stroke and myocardial infarction were similar. All bleedings (n=39) occurred after CEE. ICA thrombosis was diagnosed in groups 1 and 2 due to intimal detachment after insertion of temporary bypass tube. Incidence of laryngeal paresis, neuropathy of hypoglossal and glossopharyngeal nerves, Horner syndrome, damage to salivary glands was comparable in groups 1 and 2. Long-term mortality was the highest (n=10; 2.8%) after CEE with patch repair due to fatal stroke. In turn, the highest incidence of ICA restenosis and restenosis-induced ischemic stroke was observed after CEE with patch repair and CAS. CONCLUSION 1. Classical and eversion CEE in patients with high CCA bifurcation is followed by high in-hospital incidence of damage to cranial nerves and salivary glands, laryngeal paresis, Horner syndrome, bleeding and risk of ICA thrombosis. 2. In patients with high CCA bifurcation, CAS and CEE with patch repair are accompanied by high incidence of ICA restenosis, restenosis-induced stroke and mortality in long-term postoperative period. 3. Eversion CEE demonstrates the lowest rates of all adverse cardiovascular events in long-term follow-up period.
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Affiliation(s)
- Yu V Belov
- Petrovsky Russian Scientific Center of Surgery, Moscow, Russia
| | - A N Kazantsev
- City Aleksandrovskaya Hospital, St. Petersburg, Russia
| | - R A Vinogradov
- Research Institute - Ochapovsky Regional Clinical Hospital No. 1, Krasnodar, Russia
| | | | - K P Chernykh
- City Aleksandrovskaya Hospital, St. Petersburg, Russia
| | - V V Matusevich
- Research Institute - Ochapovsky Regional Clinical Hospital No. 1, Krasnodar, Russia
| | - E Yu Kachesov
- City Aleksandrovskaya Hospital, St. Petersburg, Russia
| | - D V Shmatov
- St. Petersburg State University, St. Petersburg, Russia
| | - A B Zakeryaev
- Research Institute - Ochapovsky Regional Clinical Hospital No. 1, Krasnodar, Russia
| | - A A Erofeev
- City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - M O Dzhanelidze
- Western Regional Center for Modern Medical Technologies, Kutaisi, Georgia
| | - I A Karmokov
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - A P Kuklev
- St. Petersburg State University, St. Petersburg, Russia
| | - A I Andreeva
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - B M Taits
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - D B Taits
- St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - G Sh Bagdavadze
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - R V Kokaya
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - A S Zharova
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - I M Radzhabov
- Burdenko Main Military Clinical Hospital, Moscow, Russia
| | - V A Lutsenko
- Belyaev Kuzbass Regional Clinical Hospital, Kemerovo, Russia
| | - R V Sultanov
- Belyaev Kuzbass Regional Clinical Hospital, Kemerovo, Russia
| | - F R Alizada
- Belyaev Kuzbass Regional Clinical Hospital, Kemerovo, Russia
| | - A D Abdullaev
- Pskov Regional Infectious Clinical Hospital, Pskov, Russia
| | - A V Povtoreyko
- Pskov Regional Infectious Clinical Hospital, Pskov, Russia
| | - T I Kapran
- Research Institute - Ochapovsky Regional Clinical Hospital No. 1, Krasnodar, Russia
| | - R Yu Lider
- Kemerovo State Medical University, Kemerovo, Russia
| | - E F Vayman
- Kemerovo State Medical University, Kemerovo, Russia
| | - E O Meleshin
- Podgorbunsky Kuzbass Clinical Hospital for Emergency Care, Kemerovo, Russia
| | - E R Ginzburg
- Podgorbunsky Kuzbass Clinical Hospital for Emergency Care, Kemerovo, Russia
| | - M M Makoeva
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - A I Klimova
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | | | - K L Zakharova
- City Aleksandrovskaya Hospital, St. Petersburg, Russia
| | - M G Pachkoriya
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
| | - E O Alekseeva
- Yaroslav the Wise Novgorod State University, Veliky Novgorod, Russia
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