Open AccessDifferentiated approach to surgical treatment of atherosclerotic lesions of supra-aortic arteries
Author(s) -
Іvan Kopolovets,
Péter Berek,
Vladimír Sihotský,
M Kubíková,
N Torma,
Peter Śtefanič,
M Frankovičová
Publication year - 2016
Publication title -
galician medical journal
Language(s) - English
Resource type - Journals
ISSN - 2414-1518
DOI - 10.21802/gmj.2016.3.3
Subject(s) - medicine , aortic arch , aorta , coronary arteries , carotid arteries , trunk , surgery , artery , common carotid artery , myocardial infarction , cardiology , radiology , ecology , biology
Atherosclerotic lesions of the supra-aortic arteries are mainly localized in the carotid artery bifurcations – 57%, the subclavian artery – 18%, the vertebral arteries – 14%, the brachiocephalic trunk and the common carotid artery – 11%.Objective. Theobjective of the research was to systematize the principles of surgical treatment of patients with atherosclerotic lesions of the supra-aortic arteries taking into consideration their polymorbidity and the multicentricity of atherosclerosis.Materials and methods. The results of surgical reconstruction of the supra-aortic arteries in 468 patients were analyzed.All the patients were divided into two groups.Group I included 276 (59%) patients with previous surgical or endovascular intervention on any vascular territory for treatment of atherosclerotic lesions being admitted to the hospital for elective surgery on the extracranial arteries.Group II included 192 (41%) patients without previous surgical and invasive treatments of arterial pathology being hospitalized for surgery on the supra-aortic arteries.Results. In Group I, according to the objective and clinical methods of examination, the patients’ condition was more critical due to somatic and intraoperative risk. When analyzing the results of postoperative complications there was no statistically significant difference between both groups (p<0.05).The overall rate for serious complications (acute cerebrovascular disease and myocardial infarction) in both groups was 3.4%; the mortality rate was 1.1%.Conclusions. 1. Approximately 87% of surgical reconstructions of the aortic arch branches are aimed at the prevention of acute cerebrovascular disease. 2. Surgical treatment of atherosclerotic lesions of the supra-aortic arteries allows us to achieve good postoperative results (the overall rate for serious complications – 3.4%, the mortality rate –1.1%).