This literature review shows the essence of the problem of extracranial carotid artery stenosis, since this disease is a treatable cause of ischemic stroke and can be reliably detected and assessed by using vascular ultrasound. In Kazakhstan, due to acute disorders of cerebral circulation, 11.1 thousand patients die every year. The reliability of the information in the article was obtained by using the literature data of the last 10 years. The reflection of the criteria for diagnosing stenosis of the extracranial carotid artery, the use of which, in conjunction with standard tests and other sensitive methods, makes it possible to determine the lesion of the extracranial carotid artery at an early stage, as well as a detailed description of diagnostic methods of this complication and evaluation of their effectiveness. Screening for carotid stenosis is important, and whether routine carotid ultrasound is recommended in general population for the prevention of ischemic stroke remains controversial. Screening for carotid stenosis by ultrasound is crucial not only for the daily clinical setting, but also for the management of patients with acute ischemic stroke.
Stroke is the second leading cause of death and the third leading cause of disability globally. This literature review described risk factors and diagnostic aspects of ischemic stroke prevention. Carotid stenosis and occlusion is a treatable cause of ischemic stroke, which can be diagnosed by duplex scanning of the brachiocephalic arteries. The reasons for the low effectiveness of preventive measures for ischemic stroke are the incomplete collection of anamnesis for risk factors that affect the clinical prognosis, the low use of modern diagnostic methods by primary health care general practitioners in the screening of patients.
Central venous catheters (CVCs), such as the tunneled catheters and the totally implanted ports, play a major role in general medicine and oncology. Thrombosis associated with CVCs is a common complication in cancer patients. Thus, in order to more widely study the problem of catheter-associated thrombosis in cancer patients, we initiated a study for 2022-2023 within one region. Purpose. Evaluation of the efficacy and safety of thromboprophylaxis of catheter-associated thrombosis with rivaroxaban in cancer patients. Material and methods. Prospective multicenter study, conducted since 01/05/2022 and planned to be completed by the end of 2022, on the basis of three centers. The subjects are divided into 2 groups to randomize 60 participants in each. The first group: receive DOACs (rivaroxaban) at a dosage of 20 mg per day the day before the inserting of the CVC. Second group: treatment of the underlying disease without the use of DOACs. Results. None of the patients developed submassive or massive pulmonary embolism. There were no cases of CAT in the thromboprophylaxis group compared to the non-thrombotic prophylaxis group (0% vs 15.7%). The relative risk of developing CAT is 0.86, which indicates the effectiveness of thromboprophylaxis with rivaroxaban. Conclusion. Our interim results show the efficacy of rivaroxaban at a dosage of 20 mg per day in cancer patients. The final results are planned to be published at the end of the study
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