[Results of carotid endarterectomy in the acutest period of ischemic stroke].

Autor:	Zharova AS; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Abramov OO; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Golets KO; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Gaganova TS; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Ryl'skiy RM; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Kokaya RV; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Buksayev DS; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Solotenkova KN; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Golokhvastov SV; Kemerovo State Medical University, Kemerovo, Russia., Klimova AI; Mechnikov North-Western State Medical University, St. Petersburg, Russia., Puchnina LI; Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2022; Vol. 122 (12. Vyp. 2), pp. 55-59.
DOI:	10.17116/jnevro202212212255
Abstrakt:	Objective: Analysis of the results of carotid endarterectomy (CEE) in the acute period of ischemic stroke (IS). Material and Methods: This retrospective study included 128 patients (mean age 65.2±4.7 years, 84 (65.6%) men) who underwent CEE in the acute period. Inclusion criteria were: an ischemic focus in the brain with a diameter of no more than 2.5 cm according to MRI; mild neurological deficit (from 3 to 8 points on NIHSS); ≤3 points on the modified Rankin Scale (mRS); stenosis of ICA over 60%. Exclusion criteria were: severe neurological deficit; presence of decompensated comorbid dependence; contraindications to CEE. Results: In the hospital postoperative period, 3.9% of patients were diagnosed with hemorrhagic transformation of the ischemic focus in the brain with progression of neurological deficit and level of consciousness to coma II. In 3.1% cases, a lethal outcome developed on 4-7 days after the operation. In 2.3% patients after CEE, the progression of neurological deficit was noted with the development of new ischemic foci according to postoperative neuroimaging. The probable cause of this event was a distal embolism that developed during the installation of a temporary shunt. Myocardial infarction was diagnosed in 3.9% of patients. The combined end point (death + myocardial infarction + ischemic stroke + hemorrhagic transformation) was 10.1%. Conclusion: CEE in the most acute period of ischemic stroke is accompanied by a high risk of hemorrhagic transformation, myocardial infarction, and death, which characterizes this revascularization option as unsafe.
Databáze:	MEDLINE
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