Carotid stenosis is a common complication of atherosclerosis, occurring in 0.25–7.5% of the population. Since 50’s of XX c. surgical treatment of carotid stenosis has become the “gold standard”.
The aim of the study was to compare complication rates after carotid endarterectomy with and without intraoperative use of antihypoxants.
Materials and methods. A retrospective analysis of 172 medical records (2008–2013) was performed. The intraoperative neuroprotection was used in the first group (29 patients). Remaining 143 patients (group II) were treated according to a conventional scheme.
Inclusion criteria: > 60% carotid stenosis with prior transient ischemic attacks or amaurosis fugas; discirculatory encephalopathy; prior ischemic stroke; high-risk atherosclerotic plaques; > 70% carotid stenosis despite stable atherosclerotic plaque without clinical signs of chronic cerebrovascular insufficiency.
Exclusion criteria: restenosis after carotid endarterectomy or carotid stenting; post-radiation stenosis; vertebrobasilar stenosis; extra-intracranial microanastomoses on the affected side, severe arrhythmias, respiratory failure, heart failure NYHA III–IV, high perioperative risk.
The first group of patients received a bolus injection of 20 ml creatine phosphate 2% (neoton “Alfa Wassermann”) during endarterectomy, followed by a continuous infusion (1 ml/min). For this purpose a 7F catheter was introduced antegradely.
The results were processed with the methods of contingence table and variance analyses using the Statistica 6.15 software (StatSoftInc.,USA).
Results. The complications after carotid endarterectomy occurred in 97.9% of cases with the reperfusion syndrome being the most frequent (33.6%). The intraoperative use of neoton infusion reduced the risk of complications 7.1 times (19.7%).