Some comments on the 2017 European Guidelines on treatment of atherosclerotic lesions of brachiocephalic arteries

2019 ◽  
Vol 25 (1) ◽  
pp. 109 ◽  
Author(s):  
D. F. Beloiartsev
Keyword(s):  
European Guidelines ◽  
Atherosclerotic Lesions ◽  
Brachiocephalic Arteries

scholarly journals Early and late outcomes of combined and staged surgeries in patients with concomitant atherosclerotic lesions of the coronary and brachiocephalic arteries

2022 ◽  
Vol 36 (4) ◽  
pp. 107-119
Author(s):  
A. V. Marchenko ◽  
A. S. Vronskiy ◽  
P. A. Myalyuk ◽  
R. N. Chebykin ◽  
V. N. Minasyan ◽  
...  
Keyword(s):  
Cardiovascular Surgery ◽  
Artery Bypass ◽  
Late Results ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
Atherosclerotic Lesions ◽  
Cerebrovascular Events ◽  
Brachiocephalic Arteries ◽  
Federal Center

Objective. To study the early and late outcomes of surgical treatment of patients with concomitant atherosclerotic lesions of coronary and brachiocephalic arteries while choosing a treatment strategy based on the developed diff erentiated approach algorithm.Material and Methods. The study comprised 243 patients with combined atherosclerotic lesions of the coronary and carotid arteries examined during the period from 01.07.2014 to 01.01.2021. Patients underwent revascularization surgeries based on the algorithm for choosing the volume and stages of surgical intervention, which was previously developed in the Federal Center for Cardiovascular Surgery named after S.G. Sukhanov. A single-stage combined surgery of coronary artery bypass grafting (CABG) and carotid endarterectomy (CEE) was performed in 104 patients (42.8%); 139 patients (57.2%) received staged revascularization including 102 patients (73.4%) who received CABG as the fi rst step and 37 patients (26.6%) who received CEE as the fi rst step of surgery. The endpoints for both early and late results were death from all causes, stroke, transient ischemic attack (TIA), acute myocardial infarction (AMI), and combined endpoint that included all of the above. Average follow-up time was 41.1 ± 21.8 months.Results. No fatal outcomes were in any group during the early postoperative period. At the hospital stage, there were 5 cases (2.1%) of stroke, 1 case (0.4%) of TIA, and 3 cases (1.2%) of acute MI. Long-term results were evaluated in 225 patients (92.3%). The overall survival rate was 93.8%. There were 5 cases (2.4%) of MI, 11 cases (4.9%) of stroke, and 1 case (1.0%) of TIA. No signifi cant diff erences were observed in immediate and long-term endpoints between the groups of staged and combined interventions as compared to immediate (AMI: p = 0.680; TIA: p = 0.500; acute cerebrovascular events: p = 0.567; combined: p = 0.940) and long-term results (deaths: 0.860; AMI: p = 0.906; TIA: p = 0.528; acute cerebrovascular events: p = 0.378; combined: p = 0.669).Conclusion. Based on successful experience with treating the concomitant atherosclerotic lesions of the coronary and brachiocephalic arteries, the proposed algorithm allowed to perform safe procedures in both arterial basins and to achieve satisfactory results in in-hospital and long-term periods in the Federal Center for Cardiovascular Surgery named after S.G. Sukhanov (Perm).

scholarly journals Atherosclerotic lesions of brachiocephalic arteries and issues of surgical correction of symptomatic and asymptomatic carotid stenosis

2018 ◽  
Vol 177 (5) ◽  
pp. 17-20
Author(s):  
N. I. Glushkov ◽  
M. A. Ivanov ◽  
A. S. Artemova ◽  
A. Yu. Apresyan ◽  
A. D. Gorovaya ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Metabolic Disorders ◽  
Carotid Arteries ◽  
Atherosclerotic Lesion ◽  
Control Group ◽  
Asymptomatic Carotid ◽  
Symptomatic Carotid ◽  
Atherosclerotic Lesions ◽  
Symptomatic Carotid Stenosis ◽  
Brachiocephalic Arteries

The objective of the study was to evaluate the results of carotid endarterectomy in patients with symptomatic and asymptomatic course of hemodynamically significant stenosis of carotid arteries.Material and methods. The work was based on observations of 88 patients: the main group included 28 patients with asymptomatic lesion, the control group – 60 patients with symptomatic critical carotid stenosis.Results. There was a predominance of contralateral carotid stenosis, changes in vertebral arteries in the control group. Features of atherosclerotic lesion of carotid arteries associated with the severity of metabolic disorders, perioperative fluctuations of hemodynamics, time of clamping of carotid arteries.Conclusion. Aggressive course of symptomatic carotid stenosis requires correction of metabolic disorders in the perioperative and in the distant periods, as well as monitoring of hemodynamic abnormalities.

Features of interleukin-33 production in atherosclerotic lesions of brachiocephalic arteries

2020 ◽  
Vol 315 ◽  
pp. e124-e125
Author(s):  
Y. Saranchina ◽  
S. Dutova ◽  
O. Kilina ◽  
T. Kulakova ◽  
N. Hanarin
Keyword(s):  
Interleukin 33 ◽  
Atherosclerotic Lesions ◽  
Brachiocephalic Arteries

Cerebral hemodynamics and cognitive function in patients with atherosclerotic lesions of brachiocephalic arteries

2019 ◽  
Vol 405 ◽  
pp. 71
Author(s):  
A. Mushba ◽  
O. Vinogradov ◽  
A. Kuznetsov ◽  
M. Vachromeeva ◽  
E. Kankia-Denisenko ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cerebral Hemodynamics ◽  
Atherosclerotic Lesions ◽  
Brachiocephalic Arteries

scholarly journals Intimal Lipid Accretion and Elevated Serum Cholesterol in Marek's Disease Virus-inoculated Chickens

1996 ◽  
Vol 33 (6) ◽  
pp. 704-708 ◽  
Author(s):  
M. Kariuki Njenga ◽  
C. A. Dangler
Keyword(s):  
Disease Virus ◽  
Serum Cholesterol ◽  
Marek's Disease Virus ◽  
Marek's Disease ◽  
Model Description ◽  
Marek’S Disease Virus ◽  
Marek’S Disease ◽  
Atherosclerotic Lesions ◽  
Cholesterol Supplementation ◽  
Brachiocephalic Arteries

In our previous studies of the early pathogenesis of the Marek's disease virus (MDV)-associated model of atherosclerosis, the brachiocephalic arteries and ascending aortas of MDV-inoculated chickens failed to develop lipid accretion and intimal/medial proliferation consistent with atherosclerotic lesions, as described in the original reports of this model. The role of cholesterol supplementation in the formation of MDV-associated atherosclerotic lesions was reexamined. At 3 days of age, 40 chicks were inoculated with the CU-2 strain of MDV. Another 40 chicks were sham inoculated. At 15 weeks postinfection, half of the sham- and MDV-inoculated birds received 2% cholesterol supplementation in the diet for the rest of the experimental period. At 30 weeks postinfection, the aortas and brachiocephalic arteries were evaluated. Several observations were different from the original description of the model. None of the chickens among the four experimental groups developed atherosclerotic lesions, regardless of MDV inoculation or cholesterol supplementation. However, intimal thickening and marked oil red O-positive foam cell accumulation were observed in all 11 MDV-inoculated, cholesterol-supplemented chickens. None of the nine MDV-inoculated, unsupplemented chickens manifested arterial lipid accumulation, despite the presence of an intimal cellular infiltrate. Also in contrast to the original model description, both cholesterol-supplemented and unsupplemented MDV-inoculated chickens manifested significant increases in serum cholesterol in comparison with the respective sham-inoculated groups.

COMPARATIVE CHARACTERISTIC OF ANESTHESIOLOGICAL SUPPORT AND TYPES OF SURGICAL INTERVENTION IN PATIENTS WITH ATHEROSCLEROTIC LESIONS OF BRAHIOCEPHAL ARTERIES

2018 ◽  
Vol 8 (1) ◽  
pp. 57-63
Author(s):  
A. F. Nurimanshin ◽  
M. Sh. Kashaev ◽  
F. F. Farkhutdinov ◽  
I. R. Karimov
Keyword(s):  
General Anesthesia ◽  
Carotid Endarterectomy ◽  
Surgical Intervention ◽  
Comparative Characteristic ◽  
Time Interval ◽  
Present Moment ◽  
Atherosclerotic Lesions ◽  
Group 2 ◽  
Brachiocephalic Arteries ◽  
Group 1

Introduction. Atherosclerotic lesions of the branches of the aortic arch in 60% of cases is the cause of the development of ischemic stroke. As a radical means of preventing neurological disorders, carotid endarterectomy is used, since there is currently no effective drug treatment.Material and methods. This article presents a comparative characteristic of anesthesiological support and types of surgical intervention in 710 patients with atherosclerotic lesions of brachiocephalic arteries in the period from January 2010 to December 2017 in Department of Vascular Surgery at the Clinic of the Bashkir State Medical University. To perform this comparative characteristic, the patients were divided into 2 groups, depending on the time interval. Group 1 — patients operated from 2010 to 2013 (291 patients). Group 2 — patients operated from 2014 to 2017 (491 patients). In Group 1, operations were predominantly performed under regional anesthesia and classical carotid endarterectomy predominated over an eversion. In Group 2, operations were performed under general anesthesia, and here the overthe-top carotid endarterectomy predominated over the classical one. Patients were comparable in age, sex and risk of anesthesia and surgical intervention according to the ASA classification. The overall incidence of ischemic postoperative complications was 4.22%.Results. According to our data, the application of the eversion method of carotid endarterectomy under general anesthesia reduces the relative risk of neurological complications by 1.648 times (as in the 2nd group the technique of eversion carotid endarterectomy under general anesthesia was used). The use of general anesthesia with carotid endarterectomy allows to provide adequate gas exchange, manageability by hemodynamic parameters, absence of emotional reactions from the patient.Conclusion. Thus, at the present moment, our experience in treating patients with atherosclerotic lesions of the brachiocephalic arteries is approaching the optimal one, allowing us to achieve good results of carotid endarterectomy. 

Cerebral hemodynamics and cognitive function in patients with atherosclerotic lesions of brachiocephalic arteries

2017 ◽  
Vol 381 ◽  
pp. 763
Author(s):  
A. Mushba ◽  
A. Tsvetkova ◽  
O. Vinogradov ◽  
E. Kankia-Denisenko ◽  
M. Vachromeeva ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cerebral Hemodynamics ◽  
Atherosclerotic Lesions ◽  
Brachiocephalic Arteries

Brachiocephalic atherosclerosis in patients with posterior circulation ischemic stroke

2020 ◽  
Vol 19 (5) ◽  
pp. 2399
Author(s):  
A. Yu. Vishnyakova ◽  
A. B. Berdalin ◽  
D. A. Golovin ◽  
S. Ed. Lelyuk ◽  
V. G. Lelyuk
Keyword(s):  
Ischemic Stroke ◽  
Duplex Ultrasound ◽  
Posterior Circulation ◽  
Control Group ◽  
Acoustic Characteristics ◽  
Atherosclerotic Lesions ◽  
Asymptomatic Individuals ◽  
The Right ◽  
Ica Stenosis ◽  
Brachiocephalic Arteries

Aim. To study echographic and acoustic characteristics of atherosclerotic plaques (ASP) in brachiocephalic arteries (BCA) in patients with acute posterior circulation ischemic stroke (PCIS).Material and methods. In this study we included data of duplex ultrasound from 235 patients (men, 129; women, 106; age, 59±12 and 63±10 years, respectively) with PCIS. Pathogenesis of PCIS was established only in 23 cases: in 17 (74%) — atherothrombosis, in 3 (13%) — cardioembolism, in 3 (13%) — lacunar stroke. Atrial fibrillation was established in 18,5% of patients. A total of 903 asymptomatic individuals were included in the control group, comparable with studied patients by sex and age.Results. The prevalence of ASP in vertebral arteries (VA) was equal in both groups. Also, no significant differences in the degree of VA stenosis were observed. Atherosclerotic lesions of common (CCA) and internal carotid arteries (ICA) on both sides were more often observed in control group, but the degree of their stenosis was higher in PSIS group (р<0,003). In ischemic stroke, stenosis of the right ICA was 47±17%, left ICA — 46±18%, while in asymptomatic individuals, right ICA stenosis was 40±14%, left ICA — 39±15%. In patients with PCIS, ASPs were significantly more often regarded as concentric (22,0% vs 10,4% in PCIS and asymptomatic individuals, respectively), prolonged (24,2% vs 7,5%), homogeneous (41,0% vs 21,1%), as well as were more likely to have an uneven contour (27,7% vs 2,8%).Conclusion. In patients with acute PCIS, the peculiarities of BCA atherosclerosis were recorded, distinguishing it from that in the asymptomatic population.

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