TREATMENT OF THE PATIENTS WITH CHRONIC CEREBRОVASCULAR INSUFFICIENCY
Keywords:
brachiocephalic artery, carotid endarterectomy, stenosis of the carotid arteries, atherosclerotic plaque, linear speed of blood flowAbstract
The work purpose: improvement of the treatment results of the patients with chronic cerebral vascular insufficiency by application of various methods of diagnostics and a choice of adequate surgical tactics. In all 49 (100%) patients with the first stage of the chronic cerebral vascular insufficiency (CCVI) in the postoperative period are marked considerable improvement of haemodynamic indicators, during the remote period in patients with the first stage of the CCVI neurologic symptoms were not observed. From 120 (100%) patients with the II stage of the CCVI after surgical treatment in 82 (68,3%) patients have been completely disappeared symptoms of infringement of sensitivity. During the remote period of repeated episodes transitor ischemic attackst were not observed. From 187 (100%) patients with the III stage of the CCVI after surgical treatment in the postoperative period (3-6 months) in 115 (61,5%) patients were marked clinical improvement in the form of absence of complaints to headaches, fatigues and memory decrease, in 27 (14,4%) patients they remained. The indicator “stroke+lethality” in this group of the patients has been composed – 2,3%. From 332 (100%) patients with the IV stage of the CCVI during the remote period in 11 (3,3%) patient observed an ischemic stroke in operated carotid pooll with development of a lethal outcome in 6 (1,8 %). For 3-12 days of the postoperative period in 5 (1,5%) patients the sharp heart attack of a myocardium has developed and was a cause of death in 3 of them.
References
WHO. Annual report on epidemiology of cerebra-vascular diseases. Geneva. 2018.
Rosamond W. et al. Heart Disease and Stroke Statistics – 2008. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008; 117: 25-146.
Hardik P. Amin, Joseph L. Schindler. Vascular Neurology Board Review. An Essential Study Guide. 2017; 190.
Naylor A.R., Mackey W.C. Carotid artery surgery. London, W.B. Saunders. 2000; 408.
July J. et el. Neurovascular Surgery. Surgical Approaches for Neurovascular Diseases. 2019; 288.
Gusev Е.I., Skvortsova V.I. Brain ischemia. М. 2001; 328.
Djeyms F. Tul. Vascular diseases of the brain. Guidence for doctors.: 6 pub. – М.: GEOTAR – Меdia, 2007. 608.
Suslina Z.А. Essays of angioneurology. М. Publishing house «Аtmosfera». 2005; 368.
Gavrilenko А.V., Kuklin А.V., Petrenko P.N.. Diagnostics and surgical diseses of the patients with hemodynamic stenosis of carotids. Surgery annals. 4. 2006: 19-22.
Pokrovskiy А.V. Clinical angiology. М.: Меdicine. 2004; 1: 808.
Walker J., Naylor A.R. Ultrasound based measurement of carotid stenosis >70%: an audit of UC practice. European Journal of Vascular and Endovascular Surgery. 2006; 31: 487-490.
Berczi V., Randall M., Balamurugan R., Shaw D., Venables G.S., Cleveland T.J., Gaines P.A. Safety of arch aortography for assessment of carotid arteries. European Journal of Vascular and Endovascular Surgery. 2006; 31: 3-7.
Kuntsevich G.I., Bеloyartsev D.F., Burtseva Е.А, Fedorov Е.Е. Prothesis of carotids in restenosis after carotid endarterectomy. Аngio. and vascular surgery. N13, №4. 2007: 115-125.
