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Kazantsev AN, Zharova AS, Shmatov DV, Zakeryaev AB, Lider RY, Kazantseva EG, Bagdavadze GS, Korotkikh AV, Lutsenko VA, Sultanov RV, Lebedev OV, Sirotkin AA, Snopova EV, Palagin PD. The results of thrombectomy from the arteries of the lower extremities in patients infected with SARS-CoV-2 Omicron variant with different severity of respiratory failure. Vascular 2024; 32:811-819. [PMID: 36867526 PMCID: PMC9988629 DOI: 10.1177/17085381231160933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
GOAL Analysis of the results of thrombectomy from the arteries of the lower extremities in patients with COVID-19 against the background of different severity of respiratory failure. MATERIALS AND METHODS This retrospective, cohort, comparative study for the period from 05/01/2022 to 20/07/2022 included 305 patients with acute thrombosis of the arteries of the lower extremities against the background of the course of COVID-19 (SARS-CoV-2 Omicron variant). Depending on the type of oxygen support, 3 groups of patients were formed: group 1 (n = 168) - oxygen insufflation through nasal cannulas; group 2 (n = 92) - non-invasive lung ventilation; and group 3 (n = 45) - artificial lung ventilation. RESULTS Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5.3%, n = 9; group 2: 72.8%, n = 67; group 3: 100%, n = 45; p < 0.0001), rethrombosis (group 1 : 18.4%, n = 31; group 2: 69.5%, n = 64; group 3: 91.1%, n = 41; p < 0.0001), and limb amputations (group 1: 9.5%, n = 16; group 2: 56.5%, n = 52; group 3: 91.1%, n = 41; p < 0.0001) was recorded in group 3 (ventilated) patients. CONCLUSION In patients infected with COVID-19 and on artificial lung ventilation, a more aggressive course of the disease is noted, expressed in an increase in laboratory parameters (C-reactive protein, ferritin, interleukin-6, and D-dimer) of the degree of pneumonia (CT-4 in overwhelming number) and localization of thrombosis of the arteries of the lower extremities, mainly in the tibial arteries.
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Affiliation(s)
- Anton N Kazantsev
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Alina S Zharova
- North-Western State Medical University named after I. I. Mechnikov, Saint Petersburg, Russian Federation
| | - Dmitriy V Shmatov
- Clinic of High Medical Technologies named after N. I. Pirogov St Petersburg State University, Saint Petersburg, Russian Federation
| | - Aslan B Zakeryaev
- Research Institute Regional Clinical Hospital No. 1 named. prof. S.V. Ochapovsky, Krasnodar, Russian Federation
| | - Roman Yu Lider
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Elizaveta G Kazantseva
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Goderzi S. Bagdavadze
- North-Western State Medical University named after I. I. Mechnikov, Saint Petersburg, Russian Federation
| | - Alexander V Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Victor A Lutsenko
- Kemerovo Regional Clinical Hospital named after S. V. Belyaeva, Kemerovo, Russian Federation
| | - Roman V Sultanov
- Kemerovo Regional Clinical Hospital named after S. V. Belyaeva, Kemerovo, Russian Federation
| | - Oleg V Lebedev
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Alexey A Sirotkin
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Elena V Snopova
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
| | - Petr D Palagin
- Kostroma Regional Clinical Hospital named after E. I. Korolev, Kostroma, Russian Federation
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Kazantsev AN, Korotkikh AV, Wang S, Gloria Nonye O, Artyukhov SV, Mukhtorov OS, Roshkovskaya LV, Zakharova KL, Unguryan VM, Shmatov DV, Urokov DA, Choriev AA, Zabolotniy VN, Lebedev OV, Zarkua NE, Kravchuk VN, Alekseyeva EO, Bagdavadze GS, Chernyavin MP, Leader RY, Solobuev AI, Vaiman EF, Kazantseva EG, Lutsenko VA, Sultanov RV, Matusevich VV, Zakeryaev AB, Sukhoruchkin PV. Carotid endarterectomy for symptomic and asymptomic stenosis: Report of 65388 cases (Russian register). Vascular 2024:17085381241259928. [PMID: 38848729 DOI: 10.1177/17085381241259928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
AIM Analysis of in-hospital and long-term results of carotid endarterectomy in patients with asymptomatic and symptomatic stenoses. MATERIALS AND METHODS The sample was formed by completely including all cases of carotid endarterectomy (n = 65,388) performed during the period from May 1, 2015 to November 1, 2023. Depending on the symptomatic/asymptomatic nature of the stenosis, all patients were divided into two groups: group 1 - n = 39,172 (75.2%) - patients with asymptomatic stenosis; Group 2 - n = 26216 (24.8%) - patients with symptomatic stenosis. The postoperative follow-up period was 53.5 ± 31.4 months. RESULTS In the hospital postoperative period, the groups were comparable in the incidence of death (group 1: n = 164 (0.41%); group 2: n = 124 (0.47%); p = .3), transient ischemic attack (group 1: n = 116 (0.29%); group 2: n = 88 (0.33%); p = .37), myocardial infarction (group 1: n = 32 (0.08%); group 2: n = 19 (0.07%); p = .68), thrombosis of the internal carotid artery (group 1: n = 8 (0.02%); group 2: n = 2 (0.007%); p = 0, 19), bleeding (group 1: n = 58 (0.14%); group 2: n = 33 (0.12%); p = .45). In group 2, ischemic stroke developed statistically more often (group 1: n = 328 (0.83%); group 2: n = 286 (1.09%); p = .001), which led to a higher value of the combined endpoint (group 1: n = 640 (1.63%); group 2: n = 517 (1.97%); p = .001). In the long-term postoperative period, the groups were comparable in cases of death (group 1: n = 65 (0.16%); group 2: n = 41 (0.15%); p = .76) and death from cardiovascular causes (group 1: n = 59 (0.15%); group 2: n = 33 (0.12%); p = .4). A greater number of ischemic strokes were detected in patients of group 2 (group 1: n = 213 (0.54%); group 2: n = 187 (0.71%); p = .006). In group 1, hemodynamically significant restenosis (≥70%) of the internal carotid artery was more often diagnosed (group 1: n = 974 (2.49%); group 2: n = 351 (1.34%); p < .0001) and myocardial infarction (group 1: n = 66 (0.16%); group 2: n = 34 (0.13%); p < .0001). When analyzing stroke-free survival, analysis of Kaplan-Meier curves showed that a statistically larger number of strokes were diagnosed in group 2 (p < .0001). CONCLUSION Due to the fact that the patients were initially not comparable for a number of indicators, to achieve balance, we applied propensity score matching analysis. Thus, group 1 consisted of 24,381 patients, and group 2 consisted of 17,219 patients. In the hospital postoperative period, statistically significant differences were obtained only in the combined end point, which was greater in group 2 (group 1: n = 465 (1.9%); group 2: n = 382 (2.2%); p = .02). In the long-term follow-up period, after applying propensity score matching, no statistically significant differences were obtained between groups.
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Affiliation(s)
- Anton N Kazantsev
- Kostroma Regional Clinic, Kostroma, Russian Federation
- Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky, Moscow, Russian Federation
- Kostroma Oncology Dispensary, Kostroma, Russian Federation
| | - Alexander V Korotkikh
- Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation
| | - Showen Wang
- First Moscow State Medical University. THEM. Sechenov, Moscow, Russian Federation
| | | | - Sergey V Artyukhov
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | | | - Lyudmila V Roshkovskaya
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | - Kristina L Zakharova
- State Budgetary Healthcare Institution "City Alexander Hospital", St. Petersburg, Russian Federation
| | | | - Dmitry V Shmatov
- St. Petersburg State University, St. Petersburg, Russian Federation
| | | | | | | | | | - Nona E Zarkua
- Northwestern State Medical University Named After Mechnikov, St. Petersburg, Russian Federation
| | - Vyacheslav N Kravchuk
- Northwestern State Medical University Named After Mechnikov, St. Petersburg, Russian Federation
| | - Elena O Alekseyeva
- Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russian Federation
| | | | - Maxim P Chernyavin
- Clinical Hospital of the Administration of the President of the Russian Federation, Moscow, Russian Federation
| | - Roman Yu Leader
- Kemerovo State Medical University, Kemerovo, Russian Federation
| | | | | | | | - Viktor A Lutsenko
- Kemerovo Regional Clinical Hospital Named After S.V. Belyaev, Kemerovo, Russian Federation
| | - Roman V Sultanov
- Kemerovo Regional Clinical Hospital Named After S.V. Belyaev, Kemerovo, Russian Federation
| | - Vyacheslav V Matusevich
- Scientific Research Institute - Ochapovsky Regional Clinic Hospital №1, Krasnodar, Russian Federation
| | - Aslan B Zakeryaev
- Scientific Research Institute - Ochapovsky Regional Clinic Hospital №1, Krasnodar, Russian Federation
| | - Pavel V Sukhoruchkin
- Scientific Research Institute - Ochapovsky Regional Clinic Hospital №1, Krasnodar, Russian Federation
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Kazantsev AN, Lider RY, Korotkikh AV, Kazantseva EG, Bagdavadze GS, Kravchuk VN, Shmatov DV, Lebedev OV, Lutsenko VA, Zakeryaev AB, Artyukhov S, Palagin PD, Sirotkin AA, Sultanov RV, Taits D, Taits B, Snopova EV, Zharova AS, Zarkua N, Zakharova K, Belov Y. Effects of different types of carotid endarterectomy on the course of resistant arterial hypertension. Vascular 2024; 32:458-466. [PMID: 36409961 DOI: 10.1177/17085381221140620] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Analysis of the dynamics of systolic blood pressure (SBP) and the results of various types of carotid endarterectomy (СЕЕ) (classical with plasty of the reconstruction zone with a patch, eversion, formation of a new bifurcation, autoarterial reconstruction, glomus-saving techniques) in patients with resistant arterial hypertension (RAH). MATERIALS AND METHODS The actual cohort, comparative, retrospective, open research for the period from January 2013 to December 2021 includes 1577 patients with significant hemodynamic stenosis of the internal carotid artery Depending on revascularization strategy five groups were formed: Group 1: 18.3% (n = 289) - classical Carotid endarterectomy with plasty of the reconstruction zone with a patch (from diepoxy-treated xenopericardium or synthetic); Group 2: 29.9% (n = 472) - eversional CEE with cut-off of carotid gloomus (CG); Group 3: 6.9% (n = 109) - the formation of a new bifurcation; Group 4: 7.4% (n = 117) - autoarterial reconstruction; Group 5: 37.4% (n = 590) - glomus-saving CEE (1 technique - according to A.N. Kazantsev; two technicians - according to R.A. Vinogradov; three technicians - according to K.A.Antsupov). According to the 24-h blood pressure monitor in the preoperative period, the following degrees of AH were identified: 1° - 5.7% (n = 89); 2° - 64.2% (n = 1013); and 3° - 30.1% (n = 475). RESULTS In the postoperative period, no significant differences were obtained in the frequency of deaths, myocardial infarction, stroke, hemorrhagic transformation. However, according to the frequency of the combined endpoint (death + myocardial infarction + ischemic stroke + hemorrhagic transformation), the lowest rates were observed in the group of classical carotid endarterectomy with plasty of the reconstruction zone with a patch and glomus-sparing CEE (group 1: 1.03% (n = 3); group 2: 3.6% (n = 17); group 3: 3.67% (n = 4); group 4: 2.56% (n = 3); group 5: 0.5% (n = 3); p = 0.10). This is due to the absence of cases of labile AH and hypertensive crises among patients of groups 1 and 5, which was ensured by the preservation of carotid glomus (CG). As a result, the number of patients with 2 and 3 degrees of hypertension in these groups decreased statistically significantly. The vast majority of patients after these operations achieved a stable target SBP. In groups 2, 3, and 4, there was a statistically significant increase in the number of patients with 2 and 3 degrees of AH, which is associated with excision of the CG. CONCLUSION Classical CEE and glomus-sparing CEE techniques make it possible to achieve a stable target SBP level in patients with RAH as a result of CG preservation. Removal or traumatization of the latter during eversional CEE, the formation of a new bifurcation, autoarterial reconstruction is accompanied by the development of labile hypertension, an increase in the degree of hypertension and a high risk of hemorrhagic transformation in the brain. Thus, the most effective and safe types of CEE in the presence of RAH are classical CEE with plasty of the reconstruction zone with a patch and glomus-sparing CEE, accompanied by the lowest incidence of adverse cardiovascular events caused by postoperative hypertensive crisis and hyperperfusion syndrome.
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Affiliation(s)
- Anton N Kazantsev
- Kostroma Regional Clinical Hospital Named after E. I. Korolev, Kostroma, Russia
| | - Roman Yu Lider
- Ministry of Health of the Russian Federation, Kemerovo State Medical University, Kemerovo, Russia
| | - Alexander V Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russia
| | - Elizaveta G Kazantseva
- Ministry of Health of the Russian Federation, Kemerovo State Medical University, Kemerovo, Russia
| | - Goderzi Sh Bagdavadze
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Vyacheslav N Kravchuk
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Dmitriy V Shmatov
- Clinic of High Medical Technologies Named after N. I. Pirogov, St Petersburg State University, Saint Petersburg, Russia
| | - Oleg V Lebedev
- Kostroma Regional Clinical Hospital Named after E. I. Korolev, Kostroma, Russia
| | - Victor A Lutsenko
- Kemerovo Regional Clinical Hospital Named after S. V. Belyaeva, Kemerovo, Russia
| | - Aslan B Zakeryaev
- Research Institute Regional Clinical Hospital No. 1 Named Prof. S. V. Ochapovsky, Krasnodar, Russia
| | - Sergey Artyukhov
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Petr D Palagin
- Kostroma Regional Clinical Hospital Named after E. I. Korolev, Kostroma, Russia
| | - Alexey A Sirotkin
- Kostroma Regional Clinical Hospital Named after E. I. Korolev, Kostroma, Russia
| | - Roman V Sultanov
- Kemerovo Regional Clinical Hospital Named after S. V. Belyaeva, Kemerovo, Russia
| | - Denis Taits
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Boris Taits
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Elena V Snopova
- Kostroma Regional Clinical Hospital Named after E. I. Korolev, Kostroma, Russia
| | - Alina S Zharova
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Nona Zarkua
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Kristina Zakharova
- North-Western State Medical University Named after I. I. Mechnikov, Saint Petersburg, Russia
| | - Yuriy Belov
- Russian Scientific Center of Surgery Named after Academician B. V. Petrovsky, Moscow, Russia
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Li J, Pan Y, Wang M, Meng X, Lin J, Li Z, Li H, Wang Y, Zhao X, Liu L, Wang Y. High-Sensitivity C-reactive Protein and Intracranial Arterial Stenosis Predicted Recurrent Stroke and Dependence or Death in Minor Stroke or Transient Ischemic Attack. J Atheroscler Thromb 2024; 31:249-258. [PMID: 37704441 PMCID: PMC10918048 DOI: 10.5551/jat.64229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/18/2023] [Indexed: 09/15/2023] Open
Abstract
AIMS Inflammation is associated with vascular events. We aimed to investigate the relationship between high-sensitivity C-reactive protein (hsCRP) levels with and without intracranial arterial stenosis (ICAS) and the prognosis of patients with minor stroke or transient ischemic attack. METHODS We used data from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events trial (derivation cohort) and the Third China National Stroke Registry (validation cohort). Patients were divided into four groups according to the dichotomy of hsCRP level and ICAS status. The primary outcome was new ischemic stroke within 90 days, and the secondary outcome was dependence or death (Modified Rankin Scale score of 3-6) at 90 days. The associations between hsCRP level with and without ICAS and risk of outcomes were analyzed using multivariate Cox regression and logistic regression models. RESULTS In the derivation cohort, compared with patients with nonelevated hsCRP levels and no ICAS, those with both elevated hsCRP levels and ICAS had increased risk of recurrent stroke (adjusted hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.28-5.34; p=0.008) and dependence or death (adjusted odds ratio [OR], 7.58; 95% CI, 1.30-44.13; p=0.02). Consistent relationships of elevated hsCRP levels and presence of ICAS with recurrent stroke (adjusted HR, 1.67; 95% CI, 1.13-2.45; p=0.009) and dependence or death (adjusted OR, 1.87; 95% CI, 1.23-2.84; p=0.003) were observed in the validation cohort. CONCLUSION Concomitant presence of increased hsCRP levels and ICAS was associated with increased risk of stroke recurrence and dependence or death in patients with minor ischemic stroke or transient ischemic attack.
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Affiliation(s)
- Jiejie Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Mengxing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jinxi Lin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Advanced Innovation Center for Human Brain Protection, Capital Medical University and Clinical Center for Precision Medicine in Stroke, Capital Medical University, Beijing, China
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5
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Kazantsev AN, Abdullaev IA, Danilchuk LB, Shramko VA, Korotkikh AV, Chernykh KP, Bagdavadze G, Zharova AS, Kharchilava EU, Lider R, Kazantseva Y, Zakeryayev AB, Shmatov DV, Kravchuk VN, Zakharova KL, Artyukhov SV, Bhand HK, Chernyavtsev IA, Erofeev AA, Khorkova SM, Kulikov KA, Lutsenko VA, Matusevich VV, Morozov D, Peshekhonov KS, Sultanov RV, Zarkua NE, Khasanova DD, Serova NY, Shaikhutdinova RA, Gavrilova OO, Alekseeva EO, Kleschenogov AS, Sukhoruchkin PV, Taits DB, Taits BM, Palagin PD, Lebedev OV, Alekseev MV, Belov Y. CAROTIDSCORE.RU-The first Russian computer program for risk stratification of postoperative complications of carotid endarterectomy. Vascular 2024; 32:132-142. [PMID: 36056591 DOI: 10.1177/17085381221124709] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
GOAL Presentation of the first Russian computer program (www.carotidscore.ru) for risk stratification of postoperative complications of carotid endarterectomy (CEE). MATERIAL AND METHODS The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE. RESULTS In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%-myocardial infarction, 0.35%-stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in "%" and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework (https://www.qt.io), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient's personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person. CONCLUSION CarotidSCORE (www.carotidscore.ru) is able to determine the likelihood of postoperative complications in patients undergoing CEE.
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Affiliation(s)
- A N Kazantsev
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Russian Federation
| | - I A Abdullaev
- St. Petersburg State Pediatric Medical University, Russian Federation
| | - L B Danilchuk
- First St. Petersburg State Medical University Named After Academician I. P. Pavlov, Russian Federation
| | - V A Shramko
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - A V Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | | | - Gsh Bagdavadze
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - A S Zharova
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - E U Kharchilava
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - Ryu Lider
- Kemerovo State Medical University, Russian Federation
| | | | - A B Zakeryayev
- Regional Clinical Hospital No. 1 Named. Prof. S.V. Ochapovsky, Russian Federation
| | - D V Shmatov
- Clinic of High Medical Technologies. N.I. Pirogov St. Petersburg State University, Russian Federation
| | - V N Kravchuk
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | | | | | - H K Bhand
- Kemerovo State Medical University, Russian Federation
| | - I A Chernyavtsev
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - A A Erofeev
- City Multidisciplinary Hospital No. 2, Russian Federation
| | - S M Khorkova
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - K A Kulikov
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - V A Lutsenko
- Kemerovo Regional Clinical Hospital Named After S.V. Belyaeva, Russian Federation
| | - V V Matusevich
- Regional Clinical Hospital No. 1 Named. Prof. S.V. Ochapovsky, Russian Federation
| | - Dyu Morozov
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | | | - R V Sultanov
- Kemerovo Regional Clinical Hospital Named After S.V. Belyaeva, Russian Federation
| | - N E Zarkua
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - D D Khasanova
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - N Y Serova
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | | | - O O Gavrilova
- Yaroslav-the-Wise Novgorod State University, Russian Federation
| | - E O Alekseeva
- Yaroslav-the-Wise Novgorod State University, Russian Federation
| | | | - P V Sukhoruchkin
- Regional Clinical Hospital No. 1 Named. Prof. S.V. Ochapovsky, Russian Federation
| | - D B Taits
- St. Petersburg State Pediatric Medical University, Russian Federation
| | - B M Taits
- North-Western State Medical University. I.I. Mechnikov, Russian Federation
| | - P D Palagin
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Russian Federation
| | - O V Lebedev
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Russian Federation
| | - M V Alekseev
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Russian Federation
| | - YuV Belov
- Federal State Budgetary Scientific Institution "Russian Scientific Center of Surgery Named B.V. Petrovsky", Moscow, Russian Federation
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Nikolaevich KA, Vladimirovich KA, Mikhailovich UV, Vladimirovich BY. Acute thrombosis of the lower limb arteries on the background of the XBB.1.5 ("Kraken") subvariant of omicron SARS-COV-2 - medical or surgical treatment? Indian J Thorac Cardiovasc Surg 2023; 39:601-607. [PMID: 37885941 PMCID: PMC10597904 DOI: 10.1007/s12055-023-01551-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 10/28/2023] Open
Abstract
Aim Comparative analysis of the results of open thrombectomy and conservative therapy in patients with acute thrombosis of the lower limb arteries against the background of the XBB.1.5 ("Kraken") subvariant of Omicron Severe acute respiratory syndrome-related coronavirus-2 (Sars-cov-2). Material and methods The present prospective, open, multicenter comparative study for the period 04/01/2022 to 12/01/2023 included 167 patients with acute thrombosis of the lower limb arteries against the background of the XBB.1.5 ("Kraken") subvariant of the XBB.1.5 ("Kraken") subvariant of Omicron Sars-cov-2.Depending on the treatment strategy, two groups were formed: group 1 - open thrombectomy (n = 136) and drug treatment with an anticoagulant (unfractionated heparin in a therapeutic dosage) and an antiplatelet (acetylsalicylic acid 125 mg once a day); group 2 - only drug therapy (n = 31). This group consisted of patients who refused surgical revascularization and were on a prophylactic dose of unfractionated heparin (5000 U 3 times a day subcutaneously). On the development of acute arterial thrombosis, 80 U/kg (maximum 5000 U) of unfractionated heparin was injected intravenously in a bolus, followed by transfer to intravenous infusion using an infusion pump with an initial rate of 18 U/kg per hour under control of activated partial thromboplastin time. Analgesic and antiplatelet therapy was also prescribed (acetylsalicylic acid 125 mg once a day). Results No significant intergroup differences either in mortality rates (group 1: n = 58, 38.2%; group 2: n = 7, 22.6%; p = 0.09) or limb amputation (group 1: n = 63, 46.3%; group 2: n = 9, 29.0%; p = 0.07) were found. However, there was a trend towards a decrease in the incidence of these events in the drug treatment group. After open thrombectomy, rethrombosis developed in 50.7% (n = 69) cases; and thrombosis after rethrombectomy followed by amputation in 46.3% (n = 63). There were no hemorrhagic complications in both groups. Myocardial infarction and ischemic strokes were not recorded. Conclusion Anticoagulant therapy demonstrates several advantages over aggressive surgical management. However, probably due to the small size of the studied sample, significant differences were not obtained. Further study of this issue is required with the identification of the optimal reperfusion method in this complex cohort of patients.
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Affiliation(s)
- Kazantsev Anton Nikolaevich
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
- Kostroma Oncological Dispensary, Kostroma, Russian Federation
| | - Korotkikh Alexander Vladimirovich
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | | | - Belov Yuri Vladimirovich
- First Moscow State Medical University Named After Sechenov, Moscow, Russian Federation
- Federal State Budgetary Scientific Institution “Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky”, Moscow, Russian Federation
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7
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Kazantsev AN, Korotkikh AV, Chernyavin MP, Domke AP, Medvedev VM, Lider RY, Mukhtorov OS, Palagin PD, Sirotkin AA, Lebedev OV, Kazantsva EG. Vertebral triangle of doctor A.N. Kazantsev - double vertebral artery in V3 segment. Radiol Case Rep 2023; 18:2370-2375. [PMID: 37179809 PMCID: PMC10172637 DOI: 10.1016/j.radcr.2023.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
We have described a variant of the structure of the vertebral artery. In the V3 segment, the vertebral artery bifurcated and then joined again. This building looks like a triangle. Such anatomy has not been previously described in the world literature. By the right of the first description, this anatomical formation was called the «vertebral triangle of Dr A.N. Kazantsev». This discovery was made during stenting of the V4 segment of the left vertebral artery in the most acute period of stroke.
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Affiliation(s)
- Anton N. Kazantsev
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
- Corresponding author.
| | - Alexander V. Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Maxim P. Chernyavin
- Clinical Hospital №1 of the Presidential Administration of the Russian Federation, Moscow, Russian Federation
| | - Alexey P. Domke
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Vasily M. Medvedev
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | - Roman Yu. Lider
- Kemerovo State Medical University, Kemerovo, Russian Federation
| | - Otabek Sh. Mukhtorov
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
| | - Petr D. Palagin
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
| | - Alexey A. Sirotkin
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
| | - Oleg V. Lebedev
- Kostroma Regional Clinical Hospital named after E.I. Korolev, Kostroma, Russian Federation
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8
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Kazantsev A, Korotkikh A, Lider R, Lebedev O, Sirotkin A, Palagin P, Mukhtorov O, Shmatov D, Artyukhov S, Ageev I, Rogova A, Kalichkin I, Beglaryan J, Snigur A, Belov Y. Results of carotid endarterectomy with the use of temporary shunts with reduced retrograde pressure in the internal carotid artery - analysis of the multicenter Russian register. Indian J Thorac Cardiovasc Surg 2023; 39:244-250. [PMID: 37124591 PMCID: PMC10140191 DOI: 10.1007/s12055-023-01487-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/25/2023] Open
Abstract
Aim The aim of the study was to assess the role of a temporary carotid shunt in patients undergoing carotid endarterectomy. Materials and methods This was a retrospective, multicentric (n = 159) study carried out between January 2005 and October 2020. The study included 3114 patients undergoing carotid endarterectomy who had a reduced retrograde internal carotid artery pressure (<60% of systolic blood pressure). A temporary carotid shunt was used in 1328 patients and 1786 patients underwent carotid endarterectomy without a shunt. Results The in-hospital outcomes were comparable in terms of the incidence of deaths, myocardial infarctions, and stroke between the two groups. However, asymptomatic strokes (confirmed on computed tomography) occurred more frequently in the group where the temporary shunt was used (34 (2.5%) vs. 10 (0.55%), p < 0.0001). The composite endpoints of adverse events were also higher in the group where a temporary shunt was used (44 (3.3%) vs. 28 (1.5%), p = 0.002). The risk of symptomatic stroke (both fatal and non-fatal) was higher in the group where a temporary shunt was not used, though this was statistically not significant. Logistic regression analysis identified diabetes mellitus and stenosis (81-90%) of the contralateral internal carotid artery to be important predictors for stroke. Conclusion Temporary carotid shunts during carotid endarterectomy were associated with increased rates of asymptomatic stroke. There were no statistically significant differences in the incidence of non-fatal or fatal stroke, myocardial infarction, and mortality.
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Affiliation(s)
- Anton Kazantsev
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Kostroma, Russian Federation
| | - Alexander Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russia
| | - Roman Lider
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Oleg Lebedev
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Kostroma, Russian Federation
| | - Alexey Sirotkin
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Kostroma, Russian Federation
| | - Petr Palagin
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Kostroma, Russian Federation
| | - Otabek Mukhtorov
- Kostroma Regional Clinical Hospital Named After E.I. Korolev, Kostroma, Russian Federation
| | - Dmitriy Shmatov
- Clinic of High Medical Technologies Named After N.I. Pirogov St. Petersburg State University, Saint Petersburg, Russian Federation
| | - Sergey Artyukhov
- North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation
| | - Ivan Ageev
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Alexandra Rogova
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Ivan Kalichkin
- Kemerovo State Medical University of the Ministry of Health of the Russian Federation, Kemerovo, Russian Federation
| | - Jasmine Beglaryan
- North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation
| | - Alla Snigur
- North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation
| | - Yuri Belov
- Russian Scientific Center of Surgery named after Academician B.V. Petrovsky, Moscow, Russian Federation
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9
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Matsuzaka Y, Yashiro R. Extracellular Vesicle-Based SARS-CoV-2 Vaccine. Vaccines (Basel) 2023; 11:vaccines11030539. [PMID: 36992123 DOI: 10.3390/vaccines11030539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
Messenger ribonucleic acid (RNA) vaccines are mainly used as SARS-CoV-2 vaccines. Despite several issues concerning storage, stability, effective period, and side effects, viral vector vaccines are widely used for the prevention and treatment of various diseases. Recently, viral vector-encapsulated extracellular vesicles (EVs) have been suggested as useful tools, owing to their safety and ability to escape from neutral antibodies. Herein, we summarize the possible cellular mechanisms underlying EV-based SARS-CoV-2 vaccines.
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Affiliation(s)
- Yasunari Matsuzaka
- Division of Molecular and Medical Genetics, The Institute of Medical Science, Center for Gene and Cell Therapy, University of Tokyo, Minato-ku, Tokyo 108-8639, Japan
- Administrative Section of Radiation Protection, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan
| | - Ryu Yashiro
- Administrative Section of Radiation Protection, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan
- Department of Infectious Diseases, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
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10
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Kazantsev AN, Korotkikh AV, Unguryan VM, Belov YV. Update in Carotid Disease. Curr Probl Cardiol 2023; 48:101676. [PMID: 36828045 DOI: 10.1016/j.cpcardiol.2023.101676] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
This review of the literature analyzes publications over the past five years on various problems associated with carotid endarterectomy: 1. Is the eversion or classical technique of surgery with plastic repair of the reconstruction area with a patch more effective? 2. Carotid endarterectomy or carotid angioplasty with stenting is more optimal? 3. When should brain revascularization be performed after the development of ischemic stroke? 4. Should a temporary shunt be used to protect the brain during carotid endarterectomy? 5. How to prevent and treat different types of intraoperative ischemic strokes? 6. What tactics of treatment of patients with combined lesions of the carotid and coronary arteries is more effective? 7. What are the causes and methods of elimination of restenosis of the internal carotid artery known? 8. Is carotid endarterectomy safe in old age?
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Affiliation(s)
- Anton Nikolaevich Kazantsev
- Kostroma Regional Clinical Hospital named after Korolev E.I., Kostroma, Russian Federation; Kostroma oncological dispensary, Kostroma, Russian Federation.
| | - Alexander Vladimirovich Korotkikh
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | | | - Yuriy Vladimirovich Belov
- First Moscow State Medical University named after Sechenov, Moscow, Russian Federation; Federal State Budgetary Scientific Institution Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russian Federation
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11
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Kazantsev AN, Korotkikh AV, Lider RY, Lebedev OV, Sirotkin AA, Palagin PD, Mukhtorov OS, Shmatov DV, Sergey A, Kazantseva EG, Bagdavadze GS, Wang S, Roshkovskaya LV, Khetagurov MA, Unguryan VM, Chernyavin MP, Nonye OG, Belov YV. An alternative anatomical classification for carotid bifurcation and impact on outcome of carotid endarterectomy: a multicenter study. THE CARDIOTHORACIC SURGEON 2023. [DOI: 10.1186/s43057-023-00097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract
Background
The present multicenter retrospective study included 7148 patients who underwent carotid endarterectomy (CEA) between 2010 and 2021. Based on the results of angiography (AG)/multislice computed tomography (MSCT) angiography, 3 types of carotid bifurcation were identified depending on the projection of the carotid sinus to the cervical vertebrae: type I (high)—from the upper edge of the body of the II cervical vertebra to the lower edge of intervertebral disc located between III and IV cervical vertebrae; type II (medium)—from the upper edge of the body of the IV cervical vertebra to the lower edge of the body of the V cervical vertebra; and type III (low)—from the upper edge of the intervertebral disc located between the V and VI cervical vertebrae to the lower edge of the body of the VII cervical vertebra.
Purpose of the study
To develop a new classification of the types (high, medium, low) of carotid bifurcations (based on the level of cervical vertebrae) with analysis of the results of CEA depending on the type.
Results
The largest number of ischemic strokes (n = 15; 1.1%; p = 0.0001) was found in type I (high) bifurcation of the carotid artery. The majority of bleedings of type 3b and higher according to the BARC scale with the formation of acute hematomas in the intervention area (n = 14; 1.2%; p = 0.0029) were recorded in type III carotid bifurcation (low).
Conclusions
Type II (medium) carotid bifurcation may be the most preferred for CEA.
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12
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Computer Modeling of Carotid Endarterectomy With the Different Shape Patches and Prediction of the Atherosclerotic Plaque Formation Zones. Curr Probl Cardiol 2023; 48:101505. [PMID: 36402216 DOI: 10.1016/j.cpcardiol.2022.101505] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
The article describes a method for constructing geometric models of the carotid bifurcation and computer simulation of endarterectomy surgery with the patches of various configurations. The purpose of this work is to identify the areas of the greatest risk of restenosis in the constructed models and to conduct a comparative analysis of risk factors when using the patches of different widths and shapes. The method is demonstrated on a reconstructed model of a healthy vessel. Its building is based on a preoperative computed tomography study of a particular patient's affected vessel. The flow in the vessel is simulated by computational fluid dynamics using data from the patient's ultrasound Doppler velocimetry. Risk factors are assessed through the hemodynamic indices on the vessel wall associated with Wall Shear Stress. The distribution of risk zones in the healthy vessel, presumably leading to its observed lesion (plaque), is analyzed. Comparative evaluation of 10 various patches implantation results is carried out and the optimal variant is determined. The proposed method can be used to predict the hemodynamic results of surgery using patches of various sizes and shapes.
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13
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Golets KO, Gaganova TS, Kokaya RV, Golokhvastov SV, Zarkua NE, Zharova AS, Korotkikh AV, Kazantsev AN. [Long-term results conventional and eversion carotid endarterectomy]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:70-76. [PMID: 37682098 DOI: 10.17116/jnevro202312308270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To analyze immediate and long-term results of conventional and eversion carotid endarterectomy (CEA) within a multicenter registry. MATERIAL AND METHODS This retrospective, multi-center, comparative study included 375 patients who underwent CEA between February 1, 2018 and February 1, 2022. Depending on the type of operation, the sample was stratified into the eversion CEA (group 1, n=218) and conventional CEA with plasty of the reconstruction area with a diepoxy-treated xenopericardium patch (group 2, n=157). The long-term follow-up period was 26.5±18.3 months. Information about the condition of patients and the development of complications was obtained by telephone questioning and calling patients to the clinic for a follow-up examination. RESULTS No myocardial infarction was diagnosed in the hospital postoperative period. There were no statistically significant differences in the frequency of acute cerebrovascular accident. The only cause of death after conventional CEA was hemorrhagic stroke. According to the section study, the cause of death was edema with dislocation of the brain stem. The remaining strokes in both groups (1 case each) were of the ischemic type. The probable cause was a distal embolism following the use of a temporary shunt. During conservative treatment, the neurological deficit completely regressed on days 21 and 26, respectively. In the late postoperative period, significant differences were obtained in the incidence of stroke (group 1: n=2; 0.91%; group 2: n=6; 3.8%; p=0.05; OR - 0.23; 95% CI=0.04-1.17) and restenosis of the internal carotid artery (ICA) more than 60% (group 1: n=0; group 2: n=11; 7.0%; p<0.0001; OR - 0.03, 95% CI=0.001-0.49). CONCLUSION The eversion CEA technique demonstrated a lower risk of developing hemodynamically significant restenosis of the internal carotid artery in the long-term follow-up period. To obtain convincing evidence of the effectiveness of eversion or conventional CEA, additional randomized multicenter trials with the inclusion of results in clinical guidelines are required.
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Affiliation(s)
- K O Golets
- North-Western State Medical University I.I. Mechnikov, St. Petersburg, Russia
| | - T S Gaganova
- North-Western State Medical University I.I. Mechnikov, St. Petersburg, Russia
| | - R V Kokaya
- North-Western State Medical University I.I. Mechnikov, St. Petersburg, Russia
| | | | - N E Zarkua
- North-Western State Medical University I.I. Mechnikov, St. Petersburg, Russia
| | - A S Zharova
- North-Western State Medical University I.I. Mechnikov, St. Petersburg, Russia
| | | | - A N Kazantsev
- Korolev Regional Clinical Hospital, Kostroma, Russia
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14
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Kazantsev AN, Korotkikh AV, Lider RY, Lebedev OV, Sirotkin AA, Palagin PD, Mukhtorov O, Shmatov DV, Sergey A. Mathematical model for the choice of tactics of revascularization in case of combined lesions of the carotid and coronary arteries. Curr Probl Cardiol 2022; 48:101436. [DOI: 10.1016/j.cpcardiol.2022.101436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/03/2022]
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15
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Wang Y, Liang X, Wang S, Wang Y, Qin L, Chen D, Jiang Y, Zhang H. Analysis of the Risk Factors for Elevated D-Dimer Level After Breast Cancer Surgery: A Multicenter Study Based on Nursing Follow-Up Data. Front Oncol 2022; 12:772726. [PMID: 35928882 PMCID: PMC9343692 DOI: 10.3389/fonc.2022.772726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 06/21/2022] [Indexed: 11/30/2022] Open
Abstract
D-dimer level is often used to assess the severity of trauma as well as the risk of thrombosis. This study investigated the risk factors for high postoperative D-dimer level. This study included a total of 2706 patients undergoing breast cancer surgery to examine the associations between various clinicopathological factors and variation in D-dimer levels. After adjusting for other factors, T stage, neoadjuvant chemotherapy, blood loss, surgery type, diabetes, and elevated leukocyte and neutrophil counts were found to be significant risk factors for D-dimer variation. This study identified several factors associated with elevated D-dimer levels and consequent thrombosis after breast cancer surgery, which may aid in the development of more precise preventive measures and interventions as well as serve as a reference for future research.
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Affiliation(s)
- Yanqiu Wang
- Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Xi Liang
- Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Xi Liang, ; Shujun Wang, ; Yuying Wang, ; Ling Qin, ; Hao Zhang,
| | - Shujun Wang
- Department of Obstetrics and Gynecology, Second Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Xi Liang, ; Shujun Wang, ; Yuying Wang, ; Ling Qin, ; Hao Zhang,
| | - Yuying Wang
- Department of Breast Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
- *Correspondence: Xi Liang, ; Shujun Wang, ; Yuying Wang, ; Ling Qin, ; Hao Zhang,
| | - Ling Qin
- Department of Operation Room, Second Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Xi Liang, ; Shujun Wang, ; Yuying Wang, ; Ling Qin, ; Hao Zhang,
| | - Danni Chen
- Department of Neurology, Boao Yiling Life Care Center, Boao, China
| | - Yanlin Jiang
- Department of Breast Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Hao Zhang
- Department of Breast Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
- *Correspondence: Xi Liang, ; Shujun Wang, ; Yuying Wang, ; Ling Qin, ; Hao Zhang,
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