Successful throb endarterectomy in a patient with occlusion of the internal carotid artery

Strokes account for 15–25 % of confirmed cases internal carotid artery (ICA) occlusion. The frequency of ICA occlusion in asymptomatic patients is unknown. The strategy of treatment patients with symptomatic ICA occlusion has not been determined. A clinical observation is presented with the stage of...

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Main Authors: V. V. Akhmetov, K. V. Mozharovskiy, M. S. Gapizov, R. V. Shilov, Yu. V. Chernikova, I. P. Dudanov
Format: Article
Language:Russian
Published: QUASAR, LLC 2022-12-01
Series:Исследования и практика в медицине
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Online Access:https://www.rpmj.ru/rpmj/article/view/837
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author V. V. Akhmetov
K. V. Mozharovskiy
M. S. Gapizov
R. V. Shilov
Yu. V. Chernikova
I. P. Dudanov
author_facet V. V. Akhmetov
K. V. Mozharovskiy
M. S. Gapizov
R. V. Shilov
Yu. V. Chernikova
I. P. Dudanov
author_sort V. V. Akhmetov
collection DOAJ
description Strokes account for 15–25 % of confirmed cases internal carotid artery (ICA) occlusion. The frequency of ICA occlusion in asymptomatic patients is unknown. The strategy of treatment patients with symptomatic ICA occlusion has not been determined. A clinical observation is presented with the stage of surgical treatment of a 67‑year-old patient with a developed stroke in the basin of the left middle cerebral artery. The examination according to MSCT angiography revealed occlusion of the left ICA. To assess the brain perfusion, a single-photon emission computed tomography (SPECT) with 99mTc was performed. Throb endarterectomy of the left internal carotid artery was performed, with a control ultrasound examination on the 6th day after the operation and after 6 months the blood flow through the internal carotid artery was preserved. Control SPECT with 99mTc was performed, in comparison with the previous study, a significant improvement perfusion on both hemispheres is determined. Improvements in the neurological status were noted in the form of a complete regression of neurological symptoms. On the sixth day after surgical treatment, the patient was discharged in a satisfactory condition. During the hospital stay, the patient was “examined” using a questionnaire for assessing the quality of life – The Short Form‑36 (SF‑36) and MoCA (Montreal Cognitive Impairment Assessment Scale). The survey was conducted on the 15th day of inpatient treatment, before surgery, and on the 6th day after surgery. After 6 months, the patient was re-interviewed. The results obtained indicate a correlation between the improvement of brain perfusion and cognitive impairment, as well as a positive effect of revascularization of the internal carotid artery on the patient’s quality of life. The presented results indicate not only the possibility, but also the high efficiency of surgical treatment of occlusive lesions of the internal carotid artery. Surgical treatment in the early stages after occlusion against the background of the collapse of atherosclerotic plaque and thrombosis of the lumen is a determining factor in the successful restoration of blood flow, improvement of brain perfusion.
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series Исследования и практика в медицине
spelling doaj-art-7acd366ee88b401ab0289d2ed94ec2732025-08-20T03:00:55ZrusQUASAR, LLCИсследования и практика в медицине2410-18932022-12-019410611310.17709/2410-1893-2022-9-4-10473Successful throb endarterectomy in a patient with occlusion of the internal carotid arteryV. V. Akhmetov0K. V. Mozharovskiy1M. S. Gapizov2R. V. Shilov3Yu. V. Chernikova4I. P. Dudanov5Petrozavodsk State University; City Clinical Hospital named after A. K. EramishantsevPetrozavodsk State University; City Clinical Hospital named after A. K. EramishantsevPetrozavodsk State University; City Clinical Hospital named after A. K. EramishantsevPetrozavodsk State University; City Clinical Hospital named after A. K. EramishantsevPetrozavodsk State UniversityPetrozavodsk State UniversityStrokes account for 15–25 % of confirmed cases internal carotid artery (ICA) occlusion. The frequency of ICA occlusion in asymptomatic patients is unknown. The strategy of treatment patients with symptomatic ICA occlusion has not been determined. A clinical observation is presented with the stage of surgical treatment of a 67‑year-old patient with a developed stroke in the basin of the left middle cerebral artery. The examination according to MSCT angiography revealed occlusion of the left ICA. To assess the brain perfusion, a single-photon emission computed tomography (SPECT) with 99mTc was performed. Throb endarterectomy of the left internal carotid artery was performed, with a control ultrasound examination on the 6th day after the operation and after 6 months the blood flow through the internal carotid artery was preserved. Control SPECT with 99mTc was performed, in comparison with the previous study, a significant improvement perfusion on both hemispheres is determined. Improvements in the neurological status were noted in the form of a complete regression of neurological symptoms. On the sixth day after surgical treatment, the patient was discharged in a satisfactory condition. During the hospital stay, the patient was “examined” using a questionnaire for assessing the quality of life – The Short Form‑36 (SF‑36) and MoCA (Montreal Cognitive Impairment Assessment Scale). The survey was conducted on the 15th day of inpatient treatment, before surgery, and on the 6th day after surgery. After 6 months, the patient was re-interviewed. The results obtained indicate a correlation between the improvement of brain perfusion and cognitive impairment, as well as a positive effect of revascularization of the internal carotid artery on the patient’s quality of life. The presented results indicate not only the possibility, but also the high efficiency of surgical treatment of occlusive lesions of the internal carotid artery. Surgical treatment in the early stages after occlusion against the background of the collapse of atherosclerotic plaque and thrombosis of the lumen is a determining factor in the successful restoration of blood flow, improvement of brain perfusion.https://www.rpmj.ru/rpmj/article/view/837strokeinternal carotid artery occlusionthrob endarterectomy
spellingShingle V. V. Akhmetov
K. V. Mozharovskiy
M. S. Gapizov
R. V. Shilov
Yu. V. Chernikova
I. P. Dudanov
Successful throb endarterectomy in a patient with occlusion of the internal carotid artery
Исследования и практика в медицине
stroke
internal carotid artery occlusion
throb endarterectomy
title Successful throb endarterectomy in a patient with occlusion of the internal carotid artery
title_full Successful throb endarterectomy in a patient with occlusion of the internal carotid artery
title_fullStr Successful throb endarterectomy in a patient with occlusion of the internal carotid artery
title_full_unstemmed Successful throb endarterectomy in a patient with occlusion of the internal carotid artery
title_short Successful throb endarterectomy in a patient with occlusion of the internal carotid artery
title_sort successful throb endarterectomy in a patient with occlusion of the internal carotid artery
topic stroke
internal carotid artery occlusion
throb endarterectomy
url https://www.rpmj.ru/rpmj/article/view/837
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AT kvmozharovskiy successfulthrobendarterectomyinapatientwithocclusionoftheinternalcarotidartery
AT msgapizov successfulthrobendarterectomyinapatientwithocclusionoftheinternalcarotidartery
AT rvshilov successfulthrobendarterectomyinapatientwithocclusionoftheinternalcarotidartery
AT yuvchernikova successfulthrobendarterectomyinapatientwithocclusionoftheinternalcarotidartery
AT ipdudanov successfulthrobendarterectomyinapatientwithocclusionoftheinternalcarotidartery