Journal «Angiology and Vascular Surgery» • 

2011 • VOLUME 17 • №4

Immediate outcomes of reconstructive operations for pathological deformity of the internal carotid artery

Pokrovsky A.V., Beloyartsev D.F., Adyrkhaev Z.A.
Department of Vascular Surgery State Federal Facility A.V. Vishnevsky Institute of Surgery under the RF Ministry of Public Health and Social Development, Moscow, Russia

Objective: to investigate the immediate outcomes of surgical treatment of patients presenting with pathological deformity of the internal carotid artery.

Methods: the study was based on retrospective analysis of the outcomes of surgical management of 142 patients with isolated pathological deformity of the internal carotid artery who underwent a total of 166 reconstructive procedures.

Results: resection with redressing of the internal carotid artery and reimplantation into the old bed was a method of choice of repairing the deformed artery (74%). More often it was possible to have performed it in kinking, C- and S-shape tortuosity of the internal carotid artery, whereas prosthetic repair was more often in coiling (P<0.05). A positive clinical effect of the operation was achieved in 97% of the patients. Neurological efficacy of the performed interventions depended upon the baseline degree of cerebrovascular insufficiency and the duration of clamping of carotid arteries (P<0.05). The incidence of the development of thrombosis of the reconstructed internal carotid artery (1.2%) did not depend on either the form of pathological deformity or the method of reconstruction thereof. Cerebral circulation impairments in two (1.2%) cases were transitory and in three (1.8%) resulted in ischaemic stroke, one of which having become the cause of the patient’s death. The index «stroke + lethality from stroke» amounted to 2.4%. Neurological complications had been caused by rheological impairments, instability of haemodynamics and inadequate redressing of the internal carotid artery.

Conclusion: Analysing the immediate outcomes confirmed that surgical treatment of pathological deformity of the internal carotid artery is an effective method aimed at preventing cerebral circulation impairments and removal of cerebrovascular insufficiency in patients with the disease concerned.

KEY WORDS: pathological deformity, pathological tortuosity, internal carotid artery, surgical management, outcomes.

P. 98

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