Effektivnost' khirurgicheskogo lecheniia okkliuziruiushchikh porazheniǐ sonnykh arteriǐ.

The authors from the A. N. Bakulev Institute of Cardiovascular Surgery analyze the results of surgical management of 154 males aged 40-60 years who suffered from carotid artery occlusions. The patients were divided into three groups of patients: (1) 28 patients with asymptomatic occlusions; (2) 36 with transient ischemic episodes (TIE), and (3) 90 with ischemic stroke. A set of techniques was used, which involved Doppler ultrasonography with spectral analysis of a Doppler ultrasonographic signal, study of regional brain blood flow from brain tissue 133Xe clearance by using the functional hypercapnic test, computed tomography and angiography. A total of 165 operations were performed. The outcomes of surgical management in the early postoperative period were studied in all patients. The long-term outcomes were analyzed in 130 patients who had been followed up for average 2.3 years. In the immediate postoperative period, the uncomplicated course was in 96.4% from Group 1, in 96.3% from Group 2, and in 94.4% from Group 3. Deaths occurred in 1.3%. In the late period, all patients from Group 1 had no signs of cerebrovascular insufficiency, an improvement was observed in 88.9 and 80.0% in Groups 2 and 3, respectively. No deaths occurred in all the groups in the late postoperative period. The paper discusses how the efficiency of surgical management is related to the cerebral hemodynamics and morphological changes in brain tissues in carotid artery occlusions.