Surgical treatment of false aneurysm of internal carotid artery after carotid endarterectomy

Lysenko, A.V.; IuV, Belov; Katkov, A. I.; Комаров, Р. Н.; Stonogin, A. V.

doi:10.17116/hirurgia2016780-84

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…Во всех случаях была выполнена ревизия области реконструкции с открытой тромбэктомией и пуском кровотока. Отсутствие подобных осложнений в других группах, при равных характеристиках поражения сосудов, демонстрирует вероятные технические погрешности выполнения эндартерэктомии [27]. Другой особенностью выполнения имплантации заплаты со скоростью 1 стежок в 2 сек является не всегда прямолинейный шов.…”

Section: Discussionunclassified

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

et al. 2023

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Aim. Analysis of inhospital and long-term outcomes of conventional carotid endarterectomy (CEA) depending on vessel suturing speed.Material and methods. The present prospective multicenter study for the period from March 1, 2017 to October 1, 2020 included 2366 patients who underwent conventional CEA with patch angioplasty. Depending on the time required to apply 1 stitch, 4 groups of patients were formed: group 1 (n=471; 19,9%) — 1 stitch per 2 seconds; group 2 (n=865; 36,5%) — 1 stitch per 3 seconds; group 3 (n=692; 29,2%) — 1 stitch per 4 seconds; group 4 (n=338; 14,3%) — 1 stitch per 5 seconds. The term "stitch" refers to two needle punctures. The follow-up postoperative period was 18,5±11,0 months.Results. There were no deaths and myocardial infarctions (MI) in the inhospital postoperative period. In group 1, anastomotic bleeding (n=93; 19,7%; p<0,0001) and stroke (n=3; 0,63%; p=0,02) due to internal carotid artery (ICA) thrombosis were more common. In the long-term follow-up period, there were no significant differences in mortality and MI rates. However, ICA restenosis requiring repeated CEA (n=37; 7,85%; p<0,0001) and related stroke/transient ischemic attack (n=13; 2,8%; p=0,0001) were more often diagnosed in 1 group of patients. According to Kaplan-Meier curves, restenosis was most often revealed 6 months after CEA in the general sample.Conclusion. 1. Vessel suturing at a speed of 1 stitch per 2 seconds is associated with an increased risk of intraoperative ICA thrombosis, bleeding along the anastomosis, stroke, as well as restenosis and stroke in the long-term follow-up period. 2. Vessel suturing at a speed of 1 stitch per 5 seconds is not accompanied by an increase in inhospital stroke rate, despite the maximum ICA occlusion time relative to other groups of patients. 3. Vessel suturing at a speed of 1 stitch per 3 or 4 seconds characterized by the lowest incidence of all complications at the inhospital and long-term stages of postoperative follow-up.

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Section: Discussionunclassified

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

et al. 2023

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“…[32]. За период с 2011-2019гг было прооперировано 75 па-рования [14][15][16]. Такая тактика сопровождается риском повреждения подъязычного, языкоглоточного и блуждающего нервов с характерными не всегда обратимыми последствиями в виде пареза гортани, синдрома Горнера, дисфагии и т.д.…”

Section: обзоры литературыunclassified

“…Такая тактика сопровождается риском повреждения подъязычного, языкоглоточного и блуждающего нервов с характерными не всегда обратимыми последствиями в виде пареза гортани, синдрома Горнера, дисфагии и т.д. [14][15][16]. Эти состояния значимо уменьшают качество жизни пациентов.…”

Section: обзоры литературыunclassified

Methods of carotid endarterectomy

et al. 2021

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This literature review is devoted to various carotid endarterectomy (CE) methods that exist today in Russia. The pros and cons of conventional and eversion technique of the operation are given. It is indicated that the former is associated with higher long-term rate of restenosis, aneurysm and patch infection. The second is associated with higher prevalence of intraoperative internal carotid artery (ICA) thrombosis due to intimal detachment distal to endarterectomy area. The following CE methods for patients with prolonged ICA involvement are described: neo bifurcation formation, autoarterial reconstruction, ICA autotransplantation, plastic using an occipital artery flap. The methods of CE with carotid body saving have been demonstrated: 1. Swallow tail type patch repair proposed by R.I. Izhbuldin; 2. S-shaped arteriotomy proposed by K. A. Antsupov; 3. Two types of operations proposed by R. А. Vinogradov; 4. Сutting off the ICA with sections of common and external carotid artery proposed by A. N. Kazantsev; 5. Glomus-saving ICA autotransplantation in patients with prolonged atherosclerotic involvement. The role of ICA transposition over the hypoglossal nerve in eversion CE is presented. The glomus-saving CE with ICA transposition, called Chik-Chirik CE, is described. Conclusions are drawn on the need to demonstrate all CE types in the novel Russian guidelines for the management of patients with of head and neck arterial diseases.

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Surgical repair of common carotid artery aneurysm insix years after carotid endarterectomy

Казанцев¹,

Burkov²,

Lider³

et al. 2019

Khir. Z. im. N.I. Pirogova

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Surgical treatment of false aneurysm of internal carotid artery after carotid endarterectomy

Cited by 5 publications

References 15 publications

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

"<i>Festina lente</i>" — a multicenter study on the outcomes of carotid endarterectomy, depending on vessel suturing speed

Methods of carotid endarterectomy

Surgical repair of common carotid artery aneurysm insix years after carotid endarterectomy

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