Carotid endarterectomy on the course of the acute period of ischemic stroke and chronic cerebral ischemia

颈动脉内膜剥脱术在缺血性卒中急性期和慢性脑缺血中的应用

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Abstract

BACKGROUND: Carotid endarterectomy (CE) is currently the main surgical treatment and preventative measure for ischemic stroke (IS) in patients with atherosclerotic stenosis and carotid artery occlusion; however, there are no clear opinions regarding the effect of CE on the course of the acute period of IS and chronic cerebral ischemia (CCI). METHODS: The study included 186 patients aged 45-81 years. The study population comprised two observation groups: group I included 131 patients with internal carotid artery (ICA) stenosis of more than 60% with unstable atherosclerotic plaque who underwent CE, and group II included 55 patients with ICA stenosis 60% with stable atherosclerotic plaque who did not undergo surgical treatment. The SPSS 21 package was used for statistical analysis. RESULTS: The results of the NIHSS, Rankin, and Rivermead scales after 12 months indicated a significant positive dynamic of the neurological status in patients in the first group (2.33±0.30 in the first group and 0.89±0.12 in the comparison group, p < 0.05). In the acute period of IS, CE performed according to indications led to a decrease in neurological symptoms (80.9% of patients scored 0-3 points on the NIHSS scale), a decrease in the degree of disability, and an increase in mobility in patients. CONCLUSION: In patients who underwent the operation, disability was significantly lower 1 year after IS.

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