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Khirurgii

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Year 2015 Vol. 23 No 6

GENERAL & SPECIAL SURGERY

N. TORMA 1, I.I. KOPOLOVETS 2, V. SIHOTSKÝ 3, 4, M. KUBÍKOVÁ 3, 4,M. FRANKOVIČOVÁ 3, 4

SURGICAL TREATMENT OF ATHEROSCLEROTIC STENOSIS OF CAROTID ARTERIES IN COMBINATION WITH PATHOLOGICAL TORTUOSITY OF THE INTERNAL CAROTID ARTERY FOR ISCHEMIC STROKE PREVENTION

Vascular Center "IMEA ÑÑ", Kosice1,
The Slovak Republic
HSEE "Uzhgorod National University"2,
Ukraine
East Slovak Institute of Cardiovascular Diseases "VUSCH"3,
P.I. Safarik University, medical faculty, Kosice4,
The Slovak Republic

Objectives. To investigate the results of surgical treatment of patients with pathological tortuosity of the internal carotid artery.
Methods. The results of surgical treatment of patients (n=97) with pathological tortuosity (PT) of internal carotid artery (ICA) in combination with atherosclerotic stenosis have been presented. The results of treatment depending on the degree of deformation, atherosclerotic damage localization and clinical symptomatology have been analyzed. The patients were divided into 3 groups depending on etiopathogenetical factors, clinical manifestations and patients’ examination results. In those groups the patients didn’t differ in their age and sex characteristics.
Group I (n=18) – the patients with pathological tortuosity of internal carotid artery (PT ICA) without atherosclerotic stenosis of carotid arteries;
Group II (n=36) – the patients with pathological tortuosity of internal carotid artery and asymptomatic atherosclerotic stenosis;
Group III (n=43) – the patients with pathological tortuosity of internal carotid artery and symptomatic atherosclerotic stenosis.
Results. No reliable statistic difference was revealed in comparison with the surgical treatment results of CA atherosclerotic stenosis in combination with ICA pathological tortuosity in the groups represented in the investigation (≥0,05). The optimal method of treatment of ICA pathological tortuosity is considered to be a surgical reconstruction. Surgical tactics means resection of excessive ICA length with further reimplantation or transposition, and in case of atherosclerotic stenosis – performing eversion endarterectomy.
In group I the patients (n=11; 61,1%) showed specific symptoms of cerebral ischemic regression typical for PT ICA; in the group II (n=21; 58,3%); in group III (n=16; 37,2%).
Conclusion. Surgical correction in symptomatic patients is a successful method of treatment of cerebral insufficiency and ischemic stroke prevention. Early good and satisfactory results of surgical treatment of pathological tortuosity of the internal carotid artery accounted for 100% in group I; 97,2% – in group II and 95,3% – in group III.

Keywords: carotid arteries atherosclerosis, kinking, coiling, ischemic stroke, etiopathogenetical factors, cerebral insufficiency, surgical treatment
p. 631-636 of the original issue
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Address for correspondence:
88000, Uzhgorod, Ukraine,
ul. Universitetskaya d.10,
VGUZ "Uzhgorodskiy natsionalnyiy universitet",
tel.mob.: 38050558-82-11,
e-mail: i.kopolovets@gmail.com,
Kopolovets Ivan Ivanovich
Information about the authors:
Torma N. PhD, vascular surgeon, "IMEA ÑÑ".
Kopolovets I.I. PhD, a researcher of HSEE "Uzhgorod National University".
Sihotský V. PhD, P.I. Safarik University, medical faculty, Deputy Head of the Vascular Surgery Clinic for teaching.
Kubíková M. PhD, a head of the Vascular Surgery Department, P.I. Safarik University, medical faculty.
Frankovičová M. PhD, professor, a head of the Vascular Surgery Clinic, P.I. Safarik University, medical faculty.
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