EFFICTIVENESS AND SAFETY OF «OPEN» CAROTID REVASCULARIZATION IN THE ACUTE PERIOD OF ISCHEMIC STROKE

Abstract

The article presents the experience of the Department of Vascular Surgery of the Emergency Clinical Hospital in Ufa in secondary prevention of recurrence of acute cerebrovascular accident (ACVA) in patients in the acute period of ischemic stroke. According to the «Perioperative management of patients with concomitant pathology of the central nervous system» clinical guidelines of the Federation of Anesthesiologists and Resuscitators, it is not recommended to perform planned surgical interventions earlier than 9 months after acute cerebrovascular accident. However, in the «National Clinical Guidelines for the Management of Patients with Brachycephalic Artery Disease», the interventions on the carotid arteries are recommended within 14 days after an ACVA of an ischemic type.

Material and methods. For the period of 2021-2022 in the Department of Vascular Surgery of the Emergency Clinical Hospital in Ufa, 443 patients with carotid artery stenosis were treated. Of this number, 350 patients underwent "open" interventions. All patients who underwent "open" interventions were divided into 2 groups: group 1 - 152 patients in the acute period of ischemic stroke, transferred from the "stroke" departments on the 10th–12th day and operated no later than 14 days after an ACVA; group 2 - the remaining patients.

Conclusion. The analysis of postoperative complications showed the effectiveness and safety of "open" surgical interventions in patients within the first 14 days after the ACVA. The complication rate and mortality do not exceed those in patients outside the acute period of stroke.