Journal «Angiology and Vascular Surgery» • 

2015 • VOLUME 21 • №3

Ways to improve diagnosis and surgical treatment for pathology of brachiocephalic arteries

Fokin A.A.1, Manoilov A.E.1, Faizullin K.R.2

1) South Ural State Medical University of the RF Ministry of Public Health, Chelyabinsk, Russia
2) Health Promoting Centre – Sanatorium – Preventorium, Russian Federal Nuclear Centre – All-Russian Scientific Research Institute of Technical Physics named after Academician E.I. Zababakhin, city of Snezhinsk, Russia

Over 2010-2013 we anonymously interrogated a total of 397 therapeutists of municipal polyclinics of six regions of Russia (Chelyabinsk, Kurgan, Sverdlovsk, Orenburg, and Saratov Regions and the Republic of Bashkortostan), studying their awareness of the indications and objectives of ultrasound examination of brachiocephalic arteries (US BCA) in patients presenting with arterial hypertension (AH) and revealing the physicians’ attitude to carrying out surgical prevention of stroke in hypertensive patients.

As the indications for USS BCA 35 (8.82%) of physicians reported symptoms of local cerebrovascular lesions, mentioning: "complaints of unilateral weakness in the extremities" (n=18), "complaints of speech impairments disorders" (n=2), "complaints of loss of fields of vision" (n=4), "endured TIA" (n=11). A total of 261 (65.74%) respondents considered the grounds for US BCA to be as non-specific cerebrovascular symptoms (isolated dizziness, headache, disequilibrium, syncope).

242 (60.96%) physicians with the purpose of examining asymptomatic hypertensive patients mentioned the type and character of a vascular lesion: 16 (4.03%) – "determining the intima media thickness"; (22 (5.4%) – "an atherosclerotic plaque"; 100 (25.18%) – "arterial stenoses/occlusions". 155 (39.04%) interrogated physicians failed to determine the objectives of ultrasonic duplex scanning of major arteries of the head.

256 (64.65%) physicians answered that they do not recommend their hypertensive patients with AH to undergo surgical prevention of ischaemic stroke.

The obtained findings reflect poor awareness of physicians of the primary medical care (PMC) on diagnostic criteria for cerebrovascular diseases (CVDs). The revealed problems concerning follow up of CVDs would help decide upon publication and active distribution of All-Russian guidelines for primary care physicians (therapeutists, cardiologists, neurologists, functionalinsts) on selection patients for BCA USS and angiosurgical interventions. A draft of the informational letter "Indications for BCA ultrasound examination" is attached to the article.

KEY WORDS: arterial hypertension, cerebrovascular symptoms, ultrasonographic duplex scanning of brachiocephalic arteries, surgical prevention of stroke.

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