[Early reconstruction of brachiocephalic arteries as a prevention of recurrent ischemic stroke]. / Ranniaia rekonstruktsiia brakhitsefal'nykh arterii kak profilaktika povtornogo ishemicheskogo insul'ta.
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.
Palabras clave
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