An emergency angiosurgery in the group of patients with acute ischemic stroke
https://doi.org/10.25016/2541-7487-2015-0-4-7-18
Abstract
Despite research carried out in the last few years, there is still no consensus on the need, feasibility and safety of endarterectomy in atherosclerotic lesions of the carotid bifurcation within 12–14 days after ischemic stroke. In the available literature there is no data on the possibility of this operation in patients with neurological deficit (Rankin scale score 4). The analysis of 110 carotid endarterectomies performed during the period from 2 to 14 days after the onset of ipsilateral cerebrovascular accident (CVA) has demonstrated the safety of the procedure (1 patient (0.9%) with postoperative CVA) and its effectiveness in preventing recurrent ischemic events. Despite the lack of advice about the possibility of performing carotid endarterectomy after CVA in patients with grade IV neurological deficit by the modified Rankin scale, we have proved the effectiveness and feasibility of this operation in this group of patients. No transformations of ischemic lesion into bleeding were observed. One patient developed a fatal CVA. During 12-month follow-up neurologic symptoms regressed in 16 (66.7%) out of 24 operated patients with grade IV neurological deficit by the Rankin scale.
About the Authors
A. V. Shatravka
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
PhD Med. Sci., Associate Prof., Department of Hospital Surgery No 2, Pavlov First Saint Petersburg State Medical University (Russia, 197022, Saint-Petersburg, Lva Tolstogo Str., 6/8)
G. Y. Sokurenko
The Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia
Russian Federation
Russian Federation
Dr. Med. Sci. Prof., Head Physician of Clinic No 2, the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia (Russia, 194044, Saint-Petersburg, Academica Lebedeva Str., 4/2)
S. A. Suvorov
Saint-Petersburg City Hospital N 26
Russian Federation
Russian Federation
Cardio-vascular surgeon, Department of Cardiac Surgery, Saint Petersburg City Hospital No 26 (Russia, 196247, Saint-Petersburg, Kostushko Str., 2)
M. R. Rizakhanova
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
PhD Student, Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov (Russia, 191015, Saint-Petersburg, Kirochnaya Str., 41)
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Review
For citations:
Shatravka A.V., Sokurenko G.Y., Suvorov S.A., Rizakhanova M.R. An emergency angiosurgery in the group of patients with acute ischemic stroke. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2015;(4):48-52. (In Russ.) https://doi.org/10.25016/2541-7487-2015-0-4-7-18
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