Authors
Marynich A.A.1, Akhmetov V.V.1, Batrashov V.A.2, Kostina E.V.2
1 Municipial Clinical Hospital named after A.K. Eramishantsev, Moscow
2 Pirogov National Medical and Surgical Center, Moscow
Abstract
Objective. Improving the results of surgical treatment of patients with atherosclerotic lesions of the internal carotid artery by a comprehensive assessment of the correlation between the intraoperative use of a temporary intraluminal shunt as a possible source of microembolism of the middle cerebral artery and the dynamics of cognitive dysfunction after carotid revascularization.
Material and methods. The article analyzes the results of surgical treatment of 110 patients with hemodynamically significant carotid stenoses. 75 patients underwent eversion, 35 – classical carotid endarterectomy, 10 of which were performed using a temporary intraluminal shunt.
Results. The results of the analysis proved the effectiveness of eversion and classical methods of carotid endarterectomy in relation to the regression of cognitive dysfunction in the immediate and long-term postoperative period. On the contrary, operations with the use of a temporary intraluminal shunt do not have a positive effect on the regression of cognitive deficits, the level of cognitive dysfunction increases significantly in the early postoperative period and is restored to baseline values during the year of follow-up.
Conclusion. An intraoperative risk factor for carotid endarterectomy that does not significantly reduce the risk of developing acute neurological syndromes and reduces the rate of reduction of cognitive impairment is the use of a temporary intraluminal shunt.
Keywords: atherosclerotic plaque, internal carotid artery stenosis, carotid endarterectomy, risk factor, cognitive dysfunction, temporary intraluminal shunting.
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