Carotid Endarterectomy in the Acute Period of Ischemic Stroke After Thrombolytic Therapy
https://doi.org/10.23934/2223-9022-2024-13-3-445-450
Abstract
AIM OF STUDY. To study the outcomes, complications and risk factors of CEA surgery in patients after thrombolytic therapy.
MATERIAL AND METHODS. The results of treatment of patients after carotid endarterectomy in the acute period of ischemic acute cerebrovascular accident after thrombolytic therapy were assessed. The group of patients operated on with thrombolytic therapy included 43 patients (29 women and 14 men). The average age of the operated patients was 64±8.9 years. In 24 patients, the stroke was localized in the blood supply of the left middle cerebral artery, in 19 — in the right. A group of patients (n=50) with similar clinical characteristics was selected as a comparison group.
RESULTS. Adverse events occurred in only two patients (4.6%) in the thrombolytic therapy group. One complication required active surgical tactics, the formation of a significant hematoma in the area of surgical intervention. No adverse events were noted in the control group. There were no lethal outcomes in both groups. There were no significant differences in long-term survival rates between groups (p>0.05).
DISCUSSION. Numerous researchers have come to the conclusion that by observing clear criteria for selecting patients for surgical treatment, it is possible to minimize complications associated with the use of thrombolytic drugs in the preoperative period. Our study confirms these conclusions. Patients with previously performed thrombolytic therapy for stroke are in a group of special attention and require close monitoring in the short and long term.
CONCLUSION. Carotid endarterectomy in the acute period of stroke during thrombolytic therapy is not associated with an increased risk of postoperative complications and does not compromise long-term treatment results. Further large studies are needed to clarify the results obtained.
About the Authors
D. А. Nekrasov
B.V. Petrovsky Russian Scientific Center of Surgery
Russian Federation
Russian Federation
Dmitriy А. Nekrasov, Cardiovascular Surgeon, Head of the Day Hospital of Surgical Profile of the Scientific and Clinical Center 2
Abrikosov Str. 2, Moscow, 117593
D. Ya. Ziyarova
B.V. Petrovsky Russian Scientific Center of Surgery
Russian Federation
Russian Federation
Diana Ya. Ziyarova, Post-graduate Student
Abrikosov Str. 2, Moscow, 117593
A. V. Gavrilenko
B.V. Petrovsky Russian Scientific Center of Surgery; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Alexander V. Gavrilenko, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Head of the Department of Vascular Surgery, B.V. Petrovsky Russian Scientific Center of Surgery, Professor of the Department of Cardiovascular Surgery No. 1
Abrikosov Str. 2, Moscow, 117593;
Moskvorechye Str. 16, Moscow, 115409
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Review
For citations:
Nekrasov D.А., Ziyarova D.Ya., Gavrilenko A.V. Carotid Endarterectomy in the Acute Period of Ischemic Stroke After Thrombolytic Therapy. Russian Sklifosovsky Journal "Emergency Medical Care". 2024;13(3):445-450. (In Russ.) https://doi.org/10.23934/2223-9022-2024-13-3-445-450
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