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[Early reconstruction of brachiocephalic arteries as a prevention of recurrent ischemic stroke]. / Ranniaia rekonstruktsiia brakhitsefal'nykh arterii kak profilaktika povtornogo ishemicheskogo insul'ta.
Khripun, A I; Salikov, A V; Pryamikov, A D; Mironkov, A B; Asratyan, S A; Abashin, M V; Mikhailenko, V P.
Afiliación
  • Khripun AI; Chair of surgery and endoscopy of the Department of advanced medical training of the N.I. Pirogov's Russian National Research Medical University, Moscow, Russia.
  • Salikov AV; V.M. Buyanov's City Clinical Hospital, Moscow, Russia.
  • Pryamikov AD; Chair of surgery and endoscopy of the Department of advanced medical training of the N.I. Pirogov's Russian National Research Medical University, Moscow, Russia; V.M. Buyanov's City Clinical Hospital, Moscow, Russia.
  • Mironkov AB; Chair of surgery and endoscopy of the Department of advanced medical training of the N.I. Pirogov's Russian National Research Medical University, Moscow, Russia; V.M. Buyanov's City Clinical Hospital, Moscow, Russia.
  • Asratyan SA; V.M. Buyanov's City Clinical Hospital, Moscow, Russia.
  • Abashin MV; V.M. Buyanov's City Clinical Hospital, Moscow, Russia.
  • Mikhailenko VP; V.M. Buyanov's City Clinical Hospital, Moscow, Russia.
Khirurgiia (Mosk) ; (7): 18-23, 2017.
Article en Ru | MEDLINE | ID: mdl-28745701
AIM: To assess an efficacy and safety of brachiocephalic arteries reconstruction at the acute stage of stroke. MATERIAL AND METHODS: Early reconstruction of brachiocephalic arteries was made in 7 patients (mean age 67±9 years). Mean terms of brachiocephalic arteries reconstruction after stroke were 4.6 days (range 2-7 days). Pre- and postoperative neurological state was assessed by NIHSS score (mean preoperative score was 3.9±2.7 in these 7 patients, range 0-7). All patients had ipsilateral cerebral ischemic lesions with stenosis/occlusion of brachiocephalic artery. Their mean dimension was 10 mm (range 4-32 mm). Internal carotid artery stenting was made in 2 patients, carotid endarterectomy - in 4 patients, stenting of the 1st segment of left subclavian artery - in 1 patient. RESULTS: There were no deaths and recurrent postoperative ischemic strokes. Complications developed in 2 patients: postoperative hematoma and intraoperative transient ischemic attack during ICA stenting in 5 days after stroke. There was a positive course of neurological state after brachiocephalic arteries reconstruction: mean score of neurological deficit decreased by almost 2 times (from 3.9±2.7 to 2±1.7). CONCLUSION: Early surgical prevention (within 7 days after stroke) may be effective and safe in certain patients with ischemic stroke (neurological deficit by Rankin score ≤3 and NIHSS ≤7, ischemic focus dimension less than 4 cm). Brachiocephalic arteries reconstruction early after stroke improves neurological state postoperatively by reducing motor and sensitive disorders. However, at present time there are no clear indications for early revascularization depending on either neurological deficit severity and ischemic focus dimension. So, our data should be confirmed by large trials.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Isquemia Encefálica / Tronco Braquiocefálico / Accidente Cerebrovascular / Procedimientos Endovasculares Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia / Europa Idioma: Ru Revista: Khirurgiia (Mosk) Año: 2017 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Rusia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Isquemia Encefálica / Tronco Braquiocefálico / Accidente Cerebrovascular / Procedimientos Endovasculares Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia / Europa Idioma: Ru Revista: Khirurgiia (Mosk) Año: 2017 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Rusia