[Indications for repairing the internal carotid artery after carotid endarterectomy].
From 1983 to 1989, a total of 182 patients with atherosclerotic stenosis of the internal carotid artery (ICA) were examined and operated on. They underwent 198 carotid endarterectomies (EAE). In the long-term postoperative period, Doppler sonography and spectral analysis of an ultra Doppler signal were used to study 143 patients. Depending on the type of endarterectomy, 2 groups of patients were identified (1) 61 who had after EAE a plastic bifurcation operation with transition to the ostium of the ICA by means of a flap from a fragment of a synthetic prosthesis, autovein or xeno-pericardium; (2) 82 underwent EAE without dilatation of ICA. The analysis of the results of the studies revealed that after carotid EAE, the incidence of restenoses was 18.2%, that of thromboses was 8.4%, the incidence of atherosclerotic restenoses depended on the method to close the arteriotomic ostium: when the dilating flap was used, it was 1.5%, in isolated carotid EAE without its use, it was 11.03%. The incidence of myointimal restenoses in patients undergone plasty or no plasty of ICA was virtually equal. In atherosclerotic restenosis, 18.2% developed a negative dynamics of cerebrovascular insufficiency, whereas in thromboses 25% did, myointimal restenoses ran without clinical signs. The low incidence of atherosclerotic restenosis in plasty of carotid bifurcation made it the method of choice. Taking into account the nature of myointimal hyperplasia and the absence of clinical signs it should be noted that repeated reconstruction in this restenosis is not indicated, while in atherosclerotic restenosis, reconstruction is indicated in the presence of clinical manifestations.
Spiridonov
A A
AA
Kuperberg
E B
EB
Abramov
I S
IS
Iarustovskiĭ
M B
MB
D017130:Angioplasty; D001161:Arteriosclerosis / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies
O pokazaniiakh k primeneniiu plastiki vnutrenneĭ sonnoĭ arterii posle karotidnoĭ éndarteréktomii.