POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Objective. To estimate the efficacy of surgical treatment of internal carotid artery (ICA) thrombosis in patients suffered from acute ischemic stroke (AIS).Material and methods. Author operated 25 patients suffered from AIS and ICA thrombosis from 01 Feb, 2014 till 31 Aug, 2016 in Neurosurgical Depa...

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Main Authors: V. A. Lukyanchikov, E. V. Udodov, N. A. Polunina, A. S. Tokarev, V. A. Dalibaldyan, O. Y. Nakhabin, E. V. Grigoryeva, Y. I. Shatokhina, N. Y. Kudryashova, G. K. Guseynova, E. A. Khodykin, V. G. Dashyan, V. L. Lemenyov, V. V. Krylov
Format: Article
Language:Russian
Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2017-06-01
Series:Неотложная медицинская помощь
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Online Access:https://www.jnmp.ru/jour/article/view/358
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author V. A. Lukyanchikov
E. V. Udodov
N. A. Polunina
A. S. Tokarev
V. A. Dalibaldyan
O. Y. Nakhabin
E. V. Grigoryeva
Y. I. Shatokhina
N. Y. Kudryashova
G. K. Guseynova
E. A. Khodykin
V. G. Dashyan
V. L. Lemenyov
V. V. Krylov
author_facet V. A. Lukyanchikov
E. V. Udodov
N. A. Polunina
A. S. Tokarev
V. A. Dalibaldyan
O. Y. Nakhabin
E. V. Grigoryeva
Y. I. Shatokhina
N. Y. Kudryashova
G. K. Guseynova
E. A. Khodykin
V. G. Dashyan
V. L. Lemenyov
V. V. Krylov
author_sort V. A. Lukyanchikov
collection DOAJ
description Objective. To estimate the efficacy of surgical treatment of internal carotid artery (ICA) thrombosis in patients suffered from acute ischemic stroke (AIS).Material and methods. Author operated 25 patients suffered from AIS and ICA thrombosis from 01 Feb, 2014 till 31 Aug, 2016 in Neurosurgical Department of N.V. Sklifosovsky Research Institute for Emergency Medicine. Among them, 15 patients had total thrombosis of ICA and were operated on, 10 patients had partial mural thrombosis or floating thrombus (6 patients were operated on). There were 7 thrombectomies with the removal of intima, 13 superficial temporal artery (STA)-middle cerebral artery (MCA) bypasses, 1 ICA stent installation.Results. The excellent outcomes were seen in 7 (33.4%) patients, good outcomes — in 11 (52.3%) and satisfactory outcomes were observed in 3 (14.3%) patients. The improvement of functional deficit in the early post-operative period was 4.85 scores according to NIHSS, 1.2 scores according to Rankin scale and 2.3 scores according to Rivermead mobility index. The regress of neurological deficit was more significant among patients with severe focal disturbances; better outcomes were among patients operated on within first 3 days from an onset of the disease. There was no significant improvement among non-operated patients at the moment of discharge from hospital. Thrombectomy with the removal of intima performed in 2 (40%) patients with partial mural thrombosis was complicated by repeated thrombosis of ICA. The improvement of cerebral blood supply was verified in 16 (76.2%) operated patients according to the data of cerebral perfusion examination.Conclusions. The early surgical treatment is indicated for patients with acute total thrombosis of ICA. It is possible to perform STA-MCA bypass in case of inability to perform endovascular thrombextraction or open thrombectomy with the removal of intima. The conservative treatment is indicated for patients with partial mural thrombosis while urgent operation is necessary among patient with floating thrombus to decrease the risk of cerebral embolism.
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spelling doaj-art-9bba59bd280a4dd48ff5945ddb5019672025-08-20T03:35:06ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172017-06-016211011710.23934/2223-9022-2017-6-2-110-117348POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKEV. A. Lukyanchikov0E. V. Udodov1N. A. Polunina2A. S. Tokarev3V. A. Dalibaldyan4O. Y. Nakhabin5E. V. Grigoryeva6Y. I. Shatokhina7N. Y. Kudryashova8G. K. Guseynova9E. A. Khodykin10V. G. Dashyan11V. L. Lemenyov12V. V. Krylov13N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department; Moscow State University of Medicine and Dentistry n.a. A.I. YevdokimovN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department; Moscow State University of Medicine and Dentistry n.a. A.I. YevdokimovN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department; Moscow State University of Medicine and Dentistry n.a. A.I. YevdokimovN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentMoscow State University of Medicine and Dentistry n.a. A.I. YevdokimovN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department; Moscow State University of Medicine and Dentistry n.a. A.I. YevdokimovN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department; Moscow State University of Medicine and Dentistry n.a. A.I. YevdokimovN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department; Moscow State University of Medicine and Dentistry n.a. A.I. YevdokimovObjective. To estimate the efficacy of surgical treatment of internal carotid artery (ICA) thrombosis in patients suffered from acute ischemic stroke (AIS).Material and methods. Author operated 25 patients suffered from AIS and ICA thrombosis from 01 Feb, 2014 till 31 Aug, 2016 in Neurosurgical Department of N.V. Sklifosovsky Research Institute for Emergency Medicine. Among them, 15 patients had total thrombosis of ICA and were operated on, 10 patients had partial mural thrombosis or floating thrombus (6 patients were operated on). There were 7 thrombectomies with the removal of intima, 13 superficial temporal artery (STA)-middle cerebral artery (MCA) bypasses, 1 ICA stent installation.Results. The excellent outcomes were seen in 7 (33.4%) patients, good outcomes — in 11 (52.3%) and satisfactory outcomes were observed in 3 (14.3%) patients. The improvement of functional deficit in the early post-operative period was 4.85 scores according to NIHSS, 1.2 scores according to Rankin scale and 2.3 scores according to Rivermead mobility index. The regress of neurological deficit was more significant among patients with severe focal disturbances; better outcomes were among patients operated on within first 3 days from an onset of the disease. There was no significant improvement among non-operated patients at the moment of discharge from hospital. Thrombectomy with the removal of intima performed in 2 (40%) patients with partial mural thrombosis was complicated by repeated thrombosis of ICA. The improvement of cerebral blood supply was verified in 16 (76.2%) operated patients according to the data of cerebral perfusion examination.Conclusions. The early surgical treatment is indicated for patients with acute total thrombosis of ICA. It is possible to perform STA-MCA bypass in case of inability to perform endovascular thrombextraction or open thrombectomy with the removal of intima. The conservative treatment is indicated for patients with partial mural thrombosis while urgent operation is necessary among patient with floating thrombus to decrease the risk of cerebral embolism.https://www.jnmp.ru/jour/article/view/358ischemic strokethrombosis of internal carotid arterythrombectomy and intima removalsta-mca bypassstent of internal carotid artery
spellingShingle V. A. Lukyanchikov
E. V. Udodov
N. A. Polunina
A. S. Tokarev
V. A. Dalibaldyan
O. Y. Nakhabin
E. V. Grigoryeva
Y. I. Shatokhina
N. Y. Kudryashova
G. K. Guseynova
E. A. Khodykin
V. G. Dashyan
V. L. Lemenyov
V. V. Krylov
POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE
Неотложная медицинская помощь
ischemic stroke
thrombosis of internal carotid artery
thrombectomy and intima removal
sta-mca bypass
stent of internal carotid artery
title POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE
title_full POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE
title_fullStr POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE
title_full_unstemmed POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE
title_short POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE
title_sort possibilities of surgical correction of internal carotid artery thrombosis in patients with acute ischemic stroke
topic ischemic stroke
thrombosis of internal carotid artery
thrombectomy and intima removal
sta-mca bypass
stent of internal carotid artery
url https://www.jnmp.ru/jour/article/view/358
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