[Surgical treatment of internal carotid artery kinking following fibromuscular dysplasia].

Autor:	Gavrilenko AV; Petrovsky Russian Research Center of Surgery, Moscow, Russia.; Sechenov First Moscow State Medical University, Moscow, Russia., Paltseva EM; Petrovsky Russian Research Center of Surgery, Moscow, Russia., Oskolkova SA; Sechenov First Moscow State Medical University, Moscow, Russia., Abramyan AV; Petrovsky Russian Research Center of Surgery, Moscow, Russia.; Sechenov First Moscow State Medical University, Moscow, Russia., Kochetkov VA; Petrovsky Russian Research Center of Surgery, Moscow, Russia., Timofeeva IE; Petrovsky Russian Research Center of Surgery, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2020 (12), pp. 70-75.
DOI:	10.17116/hirurgia202012170
Abstrakt:	Objective: To evaluate the results of surgical treatment of internal carotid artery kinking following fibromuscular dysplasia. Material and Methods: There were 32 patients who underwent surgical treatment of internal carotid artery kinking following fibromuscular dysplasia. Structural changes of carotid artery wall were analyzed using immunohistochemical survey. Considering destructive changes revealed, we divided all patients into 2 groups in order to assess long-term postoperative outcomes: 1 - ICA resection followed by anastomosis in end-to-end fashion; 2 - ICA replacement. Postoperative analysis included incidence of stroke, thrombosis and deformities of anastomosis zone, regression of cerebrovascular insufficiency. Results: The main « phenotype» of arterial wall in patients with ICA kinking following fibromuscular dysplasia is a large number of smooth muscle cells releasing matrix matelloproteinases-2 and -9 and low level of their tissue inhibitor type 1. Postoperative deformities are more common within a year after surgery. Maximum incidence is observed after 12 months. Both ICA resection and replacement are followed by similar incidence of deformity later. No severe deformities were diagnosed. Resection of ICA kinking on the background of fibromuscular dysplasia is followed by comparable results with ICA replacement regarding the incidence stroke, thrombosis and regression of cerebrovascular insufficiency. Conclusion: Despite degradation of extracellular matrix, destruction of elastic fibers and their fragmentation, no significant deformities are observed in long-term postoperative period in patients with ICA kinking and fibromuscular dysplasia.
Databáze:	MEDLINE
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