Relationship of pharmacotherapy and the incidence of embolic complications of carotid reconstructive surgery
| Autor: | O. S. Osipova, S. V. Bugurov, Sh. B. Saaya, A. V. Cheban, A. A. Gostev, A. A. Rabtsun, P. V. Ignatenko, A. A. Karpenko |
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| Jazyk: | ruština |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Кардиоваскулярная терапия и профилактика, Vol 21, Iss 2 (2022) |
| Druh dokumentu: | article |
| ISSN: | 1728-8800 2619-0125 |
| DOI: | 10.15829/1728-8800-2022-3085 |
| Popis: | Aim. To evaluate the relationship between lipid-lowering and antiplatelet therapy and the incidence of cerebral microembolism and related complications in open and endovascular revascularization of the carotid arteries (CA).Material and methods. This single-center study involved patients with internal CA stenosis. The patients were divided into 2 groups depending on the surgery type performed: carotid endarterectomy (CEA) — 163 patients; CA stenting (CAS) — 71 patients. All patients underwent intraoperative transcranial Doppler monitoring to register cerebral embolism during CAS and CE.Results. In CAS, microembolism episodes were observed in 66,2% vs 22,1% of patients in the CEA group (p=0,04), the largest number of which was recorded during catheterization of the internal CA and embolic filter installation (p=0,000). There were no significant differences between the groups in terms of the stroke incidence. In 8 patients in the CAS group and 1 patient in the CEA group, a transient ischemic attack was observed within 30 days after surgery (p=4x10-4 ). Intraoperative embolism was a predictor of a neurological event in the early postoperative period (odds ratio (OR), 33,08; 95% confidence interval (CI): 3,49-56,37 (p6 months before surgery reduces the likelihood of embolism by 4 times (OR 0,25; 95% CI: 0,11-0,58 (p=0,001), while lipid-lowering and antiplatelet therapy combination — by 12,5 times (OR, 0,08; 95% CI: 0,01-0,40 (p=0,001)).Conclusion. Preoperative antiplatelet and statin therapy reduces the likelihood of embolism during the CA revascularization procedure. |
| Databáze: | Directory of Open Access Journals |
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