[The follow up of patients with extracranial pathology of the carotid arteries and ischemic disorders of cerebral circulation].
According to the populational studies, about 50% of ischemic disorders of cerebral circulation, both persistent and transient, are induced by thrombotic or embolic complications of atherosclerotic plaques which produce an adverse effect on the large and small caliber arteries; about 20-25% is associated with lesion of the small diameter intracranial vessels, about 20% with embolism from the heart, and the remaining disorders fall within other rare causes. The prevalence of atherosclerotic lesions of the vessels feeding the brain, the severity of their clinical manifestations, insufficient efficacy of conservative therapy and the high risk of surgical treatment remain as before a matter of great medical and social concern. In connection with an appreciable progress of vascular surgery carotid endarterectoray (GEAE) as one of the radical approaches to correction of the pathology of the carotid artery segment is widespread at the large centers of vascular surgery of different countries. However, in spite of the fact that CEAE is an advanced and radical technique of preventive operation, it produces only a local effect on vascular diseases whereas the other, no less important pathogenetic mechanisms leading to disorders of cerebral circulation remain unchanged and demand drug correction to avoid repeated disorders of cerebral circulation. Analysis of the long-tern results evidences a stable and lasting effect of CEAE. The postoperative clinical manifestations can be used as the main criterion for the efficacy of CEAE, especially as compared to the purely conservative therepy. The results of the long-term follow up (over the period as long as 15 years) of a large group of operated patients demonstrate that the majority of them did not show the emergence of the new focal neurologic symptomatology in the ipsilateral hemisphere and only a small percentage of cases developed stroke. The major western statistics provide the analogous results.
Dzhibladze
D N
DN
Research Institute of Neurology, Russian Academy of Medical Sciences, Moscow, Russia.
Amintaeva
A G
AG
Lagoda
O V
OV
Ionova
V G
VG
D001921:Brain / Q000098:blood supply* / Q000601:surgery*; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D048909:Diabetes Complications; D016894:Endarterectomy, Carotid / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging; D018616:Ultrasonography, Doppler, Duplex