scholarly journals Hybrid technologies in surgical treatment of patients with concomitant atherosclerotic lesions of carotid and coronary arteries

2015 ◽  
Vol 17 (1) ◽  
pp. 45 ◽  
Author(s):  
A. M. Chernyavskiy ◽  
M. A. Chernyavskiy ◽  
T. Ye. Vinogradova ◽  
A. G. Yedemskiy
Keyword(s):  
Surgical Treatment ◽  
Coronary Arteries ◽  
Carotid Arteries ◽  
Rapid Development ◽  
Peripheral Arteries ◽  
Endovascular Techniques ◽  
Hybrid Procedures ◽  
Atherosclerotic Lesions ◽  
Hybrid Technologies ◽  
Revascularization Surgery

Cardiovascular diseases, which have their origins in atherosclerosis, are the "leaders" in morbidity and mortality among the population in many countries. Given the increase of elderly people in the population, it is important to choose the best strategy for surgical treatment of patients with combined atherosclerotic lesions of several arteries (coronary arteries, carotid arteries, peripheral arteries of the lower extremities, atherosclerosis visceral branches of the abdominal aorta). Currently, there is yet no common approach to the timing and sequence of revascularization surgery in this group of patients. The rapid development of endovascular techniques enables us to carry out the so-called hybrid procedures in patients with atherosclerotic lesions of several arteries. In this article we analyze different strategies that are used to manage patients with both coronary and carotid arteries atherosclerotic lesions.

Immunohistochemical Detection of Apolipoprotein A-I and B-100 in Canine Atherosclerotic Lesions

2003 ◽  
Vol 40 (3) ◽  
pp. 328-331 ◽  
Author(s):  
T. Sako ◽  
E. Uchida ◽  
Y. Kagawa ◽  
K. Hirayama ◽  
T. Nakade ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Endothelial Cells ◽  
Coronary Arteries ◽  
Peripheral Arteries ◽  
Immunohistochemical Detection ◽  
Atherosclerotic Lesions ◽  
Apolipoprotein A ◽  
Subendothelial Space ◽  
Immunohistochemical Techniques ◽  
Tunica Intima

We attempt to determine and compare the localization of apolipoproteins (apo) apoA-I and B-100 in atherosclerotic lesions of canine aortas, coronary arteries, and the peripheral arteries, using immunohistochemical techniques. Histopathologically, atherosclerotic lesions were characterized by deposition of lipids and infiltration of lipid-laden foamy cells in the tunica intima and tunica media, sometimes forming fibrofatty plaques containing abundant sudanophilic and mineralized material. Canine apoA (CapoA)-I and canine apoB (CapoB)-100 immunopositive signals were simultaneously observed in mild and severe atherosclerotic lesions of the aorta, coronary arteries, splenic arteries, and renal arteries in the double-immunolabeled sections. Both CapoAI and CapoB-100 positive signals were seen in the cytoplasm of endothelial cells, smooth muscle cells, and macrophages. The subendothelial space and extracellular matrix in the tunica intima and media were also positive. Neither CapoA-I nor CapoB-100 positive signals were seen in normal arteries. These findings closely resemble those of the localization of apoA-I and apoB-100 in human atherosclerotic lesions.

scholarly journals INDICATIONS TO SURGICAL TREATMENT OF ATHEROSCLEROTIC IMPACT OF THE CAROTID ARTERIES

2020 ◽  
pp. 76-80
Author(s):  
I. S. Puliayeva
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Recurrent Stroke ◽  
Comprehensive Treatment ◽  
Hemorrhagic Complication ◽  
Atherosclerotic Lesions ◽  
Asymptomatic Patients ◽  
Ica Stenosis

Summary. Goal. To analyze the indications for surgical treatment of symptomatic and asymptomatic stenosis of the internal carotid artery. Materials and methods. The well-known tactics of performing carotid endarterectomy in symptomatic and asymptomatic patients still need to be divided into groups with symptomatic and asymptomatic ICA stenosis, depending on the clinical course of the disease and the risk of developing stroke. Of the 140 patients enrolled in the study, 60 patients formed patients with symptomatic ICA lesions, namely: a) 50 patients with symptomatic ICA stenosis; b) 10 patients with visual impairment and ICA stenosis. Of 80 asymptomatic patients with verified atherosclerotic lesions of the carotid arteries without manifestations of acute ischemic cerebral circulation during the last 6 months, of which. Discussion and results. Patients with symptomatic ICA lesions are the most at-risk group for the development of recurrent stroke, they require comprehensive treatment depending on the size of the lesion and the risk of hemorrhagic complication. Conclusions. Patients with multifocal atherosclerosis should be screened for carotid artery screening to reduce the risk of ischemic stroke in the postoperative period. Patients with ischemic stroke should perform an MRI to confirm the focus of the first stage, followed by ultrasound examination of the carotid arteries. In the case of carotid lesions, patients undergo carotid CT scans to establish indications for surgical treatment.

scholarly journals Surgical Treatment of Patients with Bilateral Atherosclerotic Lesions of Carotid Arteries

2015 ◽  
Vol 5 (1) ◽  
pp. 20-23
Author(s):  
Shavkat Karimov ◽  
◽  
Ravshan Sunnatov ◽  
Rustam Muminov ◽  
Akmal Irnazarov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Carotid Arteries ◽  
Atherosclerotic Lesions

scholarly journals Results of a six-year prospective study of surgical treatment of patients with combined atherosclerosisof coronary and brachiocephalic arteries based on differentiated approach

2021 ◽  
Vol 38 (5) ◽  
pp. 35-48
Author(s):  
A. V. Marchenko ◽  
Alexey S. Vronskiy ◽  
P. A. Myalyuk ◽  
A. A. Oborin ◽  
V. N. Minasyan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Surgical Treatment ◽  
Coronary Arteries ◽  
Carotid Arteries ◽  
Perioperative Stroke ◽  
Differential Approach ◽  
One Stage ◽  
Significant Difference ◽  
Combined Lesions ◽  
Combined Interventions

Objective. To present the results of surgical treatment of patients with multifocal atherosclerosis based on a differential approach of surgical strategy. Materials and methods. During the period of 20142021 in the S.G. Sukhanov Federal Center for Cardiovascular Surgery, Perm, we operated 243 patients with combined atherosclerosis of coronary and carotid arteries; 104 (42.8 %) patients underwent a one-stage coronary and carotid artery surgeries, and 139 (57.2 %) patients underwent a staged correction of pathology. Critical lesion of the coronary arteries was revealed in 16 (6.6 %) patients, single-vessel critical lesion in 24 (9.9 %), two-vessel and three-vessel critical lesion was detected in 87 (35.8 %) and 79 (32.5 %) patients, respectively. 145 (59.7 %) patients had a critical lesion of the carotid arteries, and 16 (6.58 %) had a bilateral critical lesion. We have developed an algorithm for choosing treatment tactics in patients with concomitant atherosclerotic lesions of the coronary and carotid arteries. Depending on our differential approach, we selected 104 (42.8 %) patients who underwent a one-stage surgery, and 139 (42.8 %) patients who were subjected to a staged treatment. Results. A total hospital mortality was 0 %. In the staged group, 1 case of transitory ischemic attack (TIA) (0.7 %) was recorded, in the group of combined interventions there was no TIA. In the group of combined interventions, there were 3 (2.9 %) cases of the perioperative stroke and 1 (0.9 %) case of myocardial infarction. In the group that underwent staged interventions, there were 2 (1.4 %) cases of perioperative stroke and 2 (1.4 %) cases of myocardial infarction. Both groups had similar combined results (death, acute MI, stroke) 5 (3.6 %) for the staged group and 4 (3.8 %) for the combined one. There was no significant difference in any of the endpoints. Conclusions. The proposed approach to the choice of techniques for treatment of combined lesions of the carotid and coronary arteries based on the differential approach is safe and permits to adequately eliminate the lesions.

scholarly journals Features of atherosclerotic lesions of the coronary and peripheral arteries among patients with various forms of ischemic heart disease

2019 ◽  
Vol 19 (2) ◽  
pp. 73-80
Author(s):  
Alexander R. Prudnikov
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Coronary Arteries ◽  
Ultrasound Examination ◽  
Study Groups ◽  
Atherosclerotic Plaques ◽  
Syntax Score ◽  
Peripheral Arteries ◽  
Average Force ◽  
Atherosclerotic Lesions

The aim of the article. To determine the features of atherosclerotic lesions of the coronary and peripheral arteries in patients with various forms of coronary heart disease. Material and methods. Male patients with verified IHD diagnoses: stable angina pectoris of 2 FC and patients with myocardial infarction of different localization and severity were investigated. All of the examined patients were underwent ultrasound examination of peripheral arteries with assessment of vessel wall, intima-media complex and description of atherosclerotic plaques if they were presented in vessels. Results. The predominance of non-concentric atherosclerotic plaques of type 3 according to the classification of Gray-Weal and Geroulakos in peripheral arteries is noted. It was found that atherosclerotic plaques in the carotid arteries, combined with the thickening of the intima-media complex were more common in the group of patients with myocardial infarction. The amount of Syntax score I points, reflecting the severity of atherosclerotic lesions of the coronary arteries, did not differ significantly in the studied groups. The presence of direct correlation relationships of average force (p < 0,05) between the parameters of peripheral artery atherosclerosis severity and Syntax score I points, as well as the number of affected coronary arteries in the study groups was noted. Conclusion. The results indicate a close relationship between carotid and coronary atherosclerosis, which determines the importance of using ultrasound examination of peripheral arteries (in particular, brachiocephalic) to assess the risk of recurrent acute coronary events.

scholarly journals Carotid webs produce greater hemodynamic disturbances than atherosclerotic disease: a DSA time–density curve study

2021 ◽  
pp. neurintsurg-2021-017588
Author(s):  
Charlie C Park ◽  
Retta El Sayed ◽  
Benjamin B Risk ◽  
Diogo C Haussen ◽  
Raul G Nogueira ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Carotid Artery ◽  
Carotid Arteries ◽  
Region Of Interest ◽  
Hemodynamic Parameters ◽  
Density Curve ◽  
Atherosclerotic Lesions ◽  
Clinically Significant ◽  
Flow Stasis ◽  
Time Density

BackgroundCarotid webs (CaWs) are associated with ischemic strokes in younger patients without degrees of stenosis that are traditionally considered clinically significant.ObjectiveTo compare the hemodynamic parameters in the internal carotid artery (ICA) bulbar segment in patients with CaW with those in patients with atherosclerotic lesions using time–density curve (TDC) analysis of digital subtraction angiography (DSA) images.MethodsWe retrospectively assessed DSA images of 47 carotid arteries in 41 adult patients who underwent ICA catheter angiography for evaluation after ischemic stroke. Hemodynamic parameters, including full width at half maximum (FWHM) and area under the time–density curve (AUC) as proxies for increased flow stasis, were calculated using TDC analyses of a region of interest (ROI) in the ICA bulb immediately rostral to the web/atherosclerotic plaque, relative to a standardized ROI in the ipsilateral distal common carotid artery (eg, relative FWHM (rFWHM)). Hemodynamic parameters were compared using non-parametric Kruskal-Wallis tests. Logistic regression was used to predict CaW versus mild/moderate atherosclerosis for each hemodynamic parameter, adjusting for degree of stenosis.ResultsMean age of patients was 56.0±13 years, with 22 (53.7%) women. 17 CaWs, 22 atherosclerotic plaques (15 mild/moderate and 7 severe), and eight normal carotid arteries were assessed. Significant between-group differences were present in the relative total AUC (p<0.001), relative AUC at wash out (p=0.031), and relative FWHM (p=0.001). Logistic regression to predict CaW versus mild/moderate atherosclerosis showed that rAUC total had the highest predictive value (pAUC=0.96, 95% CI 0.90 to 1.00), followed by rFWHM (0.87, 95% CI 0.74 to 1.00), and rAUC WO (0.74, 95% CI (0.57 to 0.91).ConclusionCaW results in larger local hemodynamic disruption, characterized by flow stasis, than mild/moderate carotid atherosclerotic lesions, suggesting that CaWs may produce larger regions of thrombogenic flow stasis.

Sign in / Sign up

Export Citation Format

Share Document