title: [Short- and long-term results of various methods of reconstruction of carotid artery bifurcation].
abstract: OBJECTIVE
  comparative assessment of immediate and remote outcomes of various methods of reconstruction of the zone of bifurcation of the common carotid artery in stenotic lesions.
  
  
  METHODS
  the authors carried out retrospective and prospective analysis of a total of 457 reconstructive operations on the bifurcation of the common carotid artery in 432 patients presenting with haemodynamically significant stenoses. Depending on the type of reconstruction of the carotid artery bifurcation, the patients were subdivided into four groups: group I - eversion carotid endarterectomy (CEA) - 157 (34.4%) operations, group II - CEA with xenopericardial patch plasty - 211 (46.2%) operations, group III- CEA with polytetrafluoroethylene (PTFE) patch plasty - 61 (13.3%) operations, group IV - CEA with original autoarterial remodelling of the bifurcation of the common carotid artery - 28 (6.1%) operations. We evaluated both immediate and remote (from 6 month to 4 years) results of surgical treatment.
  
  
  RESULTS
  clinical efficacy of carotid endarterectomy in prevention of ischaemic stroke in the remote period after surgery amounted to 97.8%. Strokes developed in 2.2% of cases. It was shown that after using a xenopericardium patch the incidence rate of the development of restenosis proved statistically significantly lower than after using a PTFE patch. It was confirmed that CAE with autoarterial remodelling of the common carotid artery bifurcation or eversion CEA are accompanied by a significantly lower incidence rate of restenosis development in remote terms of follow up as compared to the methods of CAE with xenopericardial or PTFE patches (p<0.01). It was determined that coronary revascularization carried out by indications as the first stage statistically significantly decreases the incidence rate of acute myocardial infarction both in the immediate and remote terms of follow up after CEA.
authors.affiliation: Centre of Vascular and Hybrid Surgery, Novosibirsk Scientific Research Institute for Circulatory Pathology named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia.
authors.forename: V B
authors.initials: VB
authors.lastname: Starodubtsev
authors.forename: A A
authors.initials: AA
authors.lastname: Karpenko
authors.forename: P V
authors.initials: PV
authors.lastname: Ignatenko
authors.forename: I N
authors.initials: IN
authors.lastname: Kim
authors.forename: D G
authors.initials: DG
authors.lastname: Zoloev
authors.forename: V N
authors.initials: VN
authors.lastname: Gorbatykh
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods; D001672:Biocompatible Materials / Q000627:therapeutic use; D017536:Carotid Artery, Common / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D057186:Comparative Effectiveness Research; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012800:Siberia; D036542:Tomography, Spiral Computed; D014183:Transplantation, Heterologous / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D065506:Vascular Closure Devices
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene