NEUROLOGICAL STATUS AND QUALITY OF LIFE IN PATIENTS WITH DEGREE IV CHRONIC CEREBRAL ISCHAEMIA AFTER ENDURED CAROTID ENDARTERECTOMY

Gavrilenko A.V., Kouklin A.V. Kravchenko A.A.
Department of Vascular Surgery В.V. Petrovsky Russian Research Centre of Surgery under the Russian Academy of Medical Sciences,
Moscow, Russia

The study was aimed at evaluating the dynamics of the neurological status and quality of life (QOL) in patients after endured carotid endarterectomy (CEA) with previously sustained ischaemic stroke (IS). Materials and methods: At the Department of Vascular Surgery of the В.V. Petrovsky Russian Research Centre of Surgery under the Russian Academy of Medical Sciences, from 2001 to 2009 we treated a total of ninety-six patients after endured IS. CEA was performed in fifty-one patients (Group I), and the control group patients underwent conservative treatment (Group II). QOL was assessed by means of the Medical Outcomes Study Short Form – 36 (SF-36) questionnaire and the Bartel scale (predominantly in order to determine life activity). Initially, patients from the both groups had had equally low baseline QOL scores. After one year we carried out a repeat survey using the same SF-36, Bartel scale, and examination by the neurologist. Relapses of cerebral circulatory impairments were registered in two (3.9%) Group I patients and in three (6.6%) Group II subjects (p>0.05). Total mortality rate in Group I amounted to 1 (1.9%) case and in Group II – 2 (4.4%) lethal cases (p>0.05). According to the findings of the SF-36 questionnaire, restoration of the lost functions was observed in eleven (22%) Group I patients and in five (11.6%) Group II patients. Partial restoration was seen in seventeen (34%) Group I patients and in twelve (27.9%) Group II subjects. The neurological status was noted to have preserved in twenty- three (46%) Group I patients and in twenty-six (60.5%) Group II patients (p>0.05). Both in Group I and Group II patients, positive dynamics of the neurological status was observed among those being in the early restoration period (p<0.05).

Conclusion: CEA performed in the early restoration period in patients with endured IS appeared to promote improved neurological status, extending physical activity, improving QOL, and is thus an efficient means of preventing relapses of cerebrovascular circulatory impairments.

KEY WORDS: carotid endarterectomy, stroke, quality of life.

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