Carotid body tumors, also commonly known as nonchromaffin paragangliomas and chemodectomas, is a slowly growing neoplasm originating from carotid body chemoreceptors. Herein we have presented a case series of surgical treatment of patients with carotid body tumors in National Scientific Center of Surgery named after AN Syzganov (2009-2020). Total number of patients was 10 with 11 neck mass, of which 7 (70%) were women, the average age was 47 (31-73) years, one case we faced with a bilateral location. The main complaint was slow-growing neck mass. On computed tomography angiography most of cases (70%) were of the 3th type according to the Shamblin grade with average size of 5.9 (4-8) cm. The main treatment was surgical excision in all cases. Mean duration of surgery 111.5 (75-190) min and hospital stay days 12.1(8-20) were registered. Total number of complications were 2 (20%), where in 1 case surgery complicated by bleeding more than 500 ml, and 1 patient presented dysphonia after the surgery, which resolved by time. Duration of surgery and hospital stay days were directly associated with size of mass and distance to base of skull. Pathology results showed that two patients (20%) had malignant cells, one of them with metastases to the nearest lymph nodes. Surgical resection is the treatment of choice for carotid body tumors. The large size of the masses and involvement of the carotid arteries and cranial nerves in the process directly affect the surgical approach and increase the risk of complications.
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.
Critical lower limb ischemia (CLI) is the final stage of peripheral arterial disease and occurs with chronic pain at rest, loss of tissue and limb. Despite the active development of new technologies, including endovascular and open surgical methods of treatment, and the development of various guidelines, CLI still remains an unresolved burden of vascular surgery around the world. The second part of the review describes large randomized trials, open and endovascular methods of lower limb revascularization in CLI. Also, the use of deep vein arterialization technology in No-option cases for conventional methods of revascularization.
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.
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