Journal «Angiology and Vascular Surgery» • 

2018 • VOLUME 24 • №3

Carotid endarterectomy: three-year results of follow up within the framework of a single-centre register

Kazantsev A.N.1, Tarasov R.S.1, Burkov N.N.1, Shabaev A.R.2, Lider R.Yu.3, Mironov A.V.2

1) Scientific Research Institute for Complex Problems of Cardiovascular Diseases,
2) Kemerovo Cardiological Dispensary,
3) Kemerovo State Medical University, Kemerovo, Russia

The purpose of the study was to determine the incidence rate and structure of cardiovascular complications in patients presenting with lesions of the carotid arteries and multifocal atherosclerosis, having endured carotid endarterectomy (CEA), during a three-year period within the framework of a single-centre register.

The study included a total of 1,035 patients subjected to CEA over the period from 2011 to 2016. The duration of the long-term follow up averagely amounted to 42.4±18.6 months. The outcome measures assessed were as follows: death, myocardial infarction (MI), acute cerebral circulation impairment (transitory ischaemic attack) [ACCI (TIA)], clinically significant haemorrhage according to the BARC scale, unplanned repeat revascularization.

In the remote period of follow up, the mortality rate did not exceed 2.3%. Of the unfavourable outcomes, most frequently observed turned out to be ACCI (TIA), with less often observed being MI. Two times a year, all patients underwent duplex scanning of the carotid arteries, whose findings revealed haemodynamically significant restenosis in 3.28% of cases. The average period of formation of restenosis amounted to 14.0±3.1 months after the operation. Three patients underwent repeat CEA and a further 16 patients endured stenting of the internal carotid artery (with 2 patients having developed intraoperative TIA). In the remote period, no cases of secondary restenosis were revealed this group of patients. It was determined that restenosis more often developed in patients having sustained classical CEA without patch modelling (p=0.005). Also noted was statistically significant dynamics of an increasing degree of stenosis, whose average level required no active surgical policy.

KEY WORDS: carotid endarterectomy, remote results, progression of atherosclerosis, restenosis, register.

P. 108

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