Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study
Aim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients w...
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«FIRMA «SILICEA» LLC
2022-01-01
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| author | Yu. V. Belov A. N. Kazantsev R. A. Vinogradov A. V. Korotkikh V. V. Matusevich S. V. Artyukhov E. Yu. Kachesov D. V. Shmatov A. B. Zakeryaev P. V. Sukhoruchkin A. A. Erofeev A. R. Shabaev M. O. Dzhanelidze B. M. Taits D. B. Taits G. Sh. Bagdavadze N. E. Zarkua A. S. Fedorov I. M. Radzhabov V. A. Lutsenko R. V. Sultanov F. R. Alizada A. D. Abdullaev A. V. Povtoreyko T. I. Kapran D. A. Popov R. Yu. Leader E. F. Vaiman A. I. Solobuev E. O. Meleshin E. R. Ginzburg V. P. Derbilova E. R. Vinogradova A. E. Gofman E. O. Alekseeva K. L. Zakharova L. V. Roshkovskaya Yu. P. Linets |
| author_facet | Yu. V. Belov A. N. Kazantsev R. A. Vinogradov A. V. Korotkikh V. V. Matusevich S. V. Artyukhov E. Yu. Kachesov D. V. Shmatov A. B. Zakeryaev P. V. Sukhoruchkin A. A. Erofeev A. R. Shabaev M. O. Dzhanelidze B. M. Taits D. B. Taits G. Sh. Bagdavadze N. E. Zarkua A. S. Fedorov I. M. Radzhabov V. A. Lutsenko R. V. Sultanov F. R. Alizada A. D. Abdullaev A. V. Povtoreyko T. I. Kapran D. A. Popov R. Yu. Leader E. F. Vaiman A. I. Solobuev E. O. Meleshin E. R. Ginzburg V. P. Derbilova E. R. Vinogradova A. E. Gofman E. O. Alekseeva K. L. Zakharova L. V. Roshkovskaya Yu. P. Linets |
| author_sort | Yu. V. Belov |
| collection | DOAJ |
| description | Aim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients who underwent CE. Depending on the technique of operation, the following groups were formed: group 1 (n=18362) — eversion CE; group 2 (n=6744) — conventional CE with patch angioplasty. The long-term follow-up period was 124,7±53,8 months.Results. In the hospital postoperative period, the groups were comparable in incidence of all complications: lethal outcome (group 1: 0,19%, n=36; group 2: 0,17%, n=12; p=0,89; odds ratio (OR) =1,1; 95% confidence interval (CI) =0,57- 2,11); myocardial infarction (MI) (group 1: 0,15%, n=28; group 2: 0,13%, n=9; p=0,87; OR=1,14; 95% CI=0,53-2,42); stroke (group 1: 0,33%, n=62; group 2: 0,4%, n=27; p=0,53; OR=0,84; 95% CI=0,53-1,32); bleeding with hematoma formation (group 1: 0,39%, n=73; group 2: 0,41%, n=28; p=0,93; OR=0,95; 95% CI=0,61-1,48); internal carotid artery (ICA) thrombosis (group 1: 0,05%, n=11; group 2: 0,07%, n=5, p=0,9; OR=0,8; 95% CI=0,28-2,32). In the long-term follow-up, the groups were comparable only in MI incidence: group 1: 0,56%, n=103; group 2: 0,66%, n=45; p=0,37; OR=0,84; 95% CI=0,59-1,19. All other complications were more frequent after conventional CE with patch angioplasty: all-cause death (group 1: 2,7%, n=492; group 2: 9,1%, n=616; p<0,0001; OR=0,27; 95% CI=0,24-0,3); lethal ischemic stroke (group 1: 1,0%, n=180; group 2: 5,5%, n=371; p<0,0001; OR=0,17; 95% CI=0,14-0,21); non-lethal ischemic stroke (group 1: 0,62%, n=114; group 2: 7,0%, n=472; p<0,0001; OR=0,08; 95% CI=0,06-0,1); ICA restenosis >60%, requiring re-revascularization (group 1: 1,6%, n=296; group 2: 12,6%, n=851; p<0,0001; OR=0,11; 95% CI=0,09-0,12). Thus, the composite endpoint (lethal ischemic stroke + non-lethal ischemic stroke + MI) after conventional CE with patch angioplasty was more than 6 times higher than this parameter of eversion CE: group 1: 2,2%, n=397; group 2: 13,2%, n=888; p<0,0001; OR=0,14; 95% CI=0,12-1,16.Conclusion. Conventional CE with patch angioplasty is not prefer for cerebral revascularization in the presence of hemodynamically significant ICA stenosis due to the high prevalence of deaths, stroke, and ICA restenosis in the long-term follow-up. |
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| issn | 1560-4071 2618-7620 |
| language | Russian |
| publishDate | 2022-01-01 |
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| series | Российский кардиологический журнал |
| spelling | doaj-art-cd548835450f44ac9d33d13a9d08d2f52025-08-04T13:00:26Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202022-01-01261210.15829/1560-4071-2021-47423416Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter studyYu. V. Belov0A. N. Kazantsev1R. A. Vinogradov2A. V. Korotkikh3V. V. Matusevich4S. V. Artyukhov5E. Yu. Kachesov6D. V. Shmatov7A. B. Zakeryaev8P. V. Sukhoruchkin9A. A. Erofeev10A. R. Shabaev11M. O. Dzhanelidze12B. M. Taits13D. B. Taits14G. Sh. Bagdavadze15N. E. Zarkua16A. S. Fedorov17I. M. Radzhabov18V. A. Lutsenko19R. V. Sultanov20F. R. Alizada21A. D. Abdullaev22A. V. Povtoreyko23T. I. Kapran24D. A. Popov25R. Yu. Leader26E. F. Vaiman27A. I. Solobuev28E. O. Meleshin29E. R. Ginzburg30V. P. Derbilova31E. R. Vinogradova32A. E. Gofman33E. O. Alekseeva34K. L. Zakharova35L. V. Roshkovskaya36Yu. P. Linets37B. V. Petrovsky Russian Research Center of SurgeryAlexandrovskaya City HospitalResearch Institute — S. V. Ochapovsky Regional Clinical Hospital № 1Heart Surgery Clinic of the Amur State Medical AcademyResearch Institute — S. V. Ochapovsky Regional Clinical Hospital № 1Alexandrovskaya City HospitalAlexandrovskaya City HospitalSt. Petersburg State University N.I. Pirogov Clinic of High Medical TechnologiesResearch Institute — S. V. Ochapovsky Regional Clinical Hospital № 1Research Institute — S. V. Ochapovsky Regional Clinical Hospital № 1City Multidisciplinary Hospital № 2Kemerovo Regional Clinical Cardiology DispensaryWestern Regional Center for Modern Medical TechnologiesI.I. Mechnikov North-Western State Medical UniversitySt. Petersburg State Pediatric Medical UniversityI.I. Mechnikov North-Western State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityN.N. Burdenko Main Military Clinical HospitalS.V. Belyaev Kemerovo Regional Clinical HospitalS.V. Belyaev Kemerovo Regional Clinical HospitalS.V. Belyaev Kemerovo Regional Clinical HospitalPskov Regional Infectious Diseases HospitalPskov Regional Infectious Diseases HospitalResearch Institute — S. V. Ochapovsky Regional Clinical Hospital № 1Research Institute — S. V. Ochapovsky Regional Clinical Hospital № 1Kemerovo State Medical UniversityKemerovo State Medical UniversityKemerovo State Medical UniversityM.A. Podgorbunsky Kuzbass Clinical Hospital of Emergency CareM.A. Podgorbunsky Kuzbass Clinical Hospital of Emergency CareKuban State Medical UniversityKuban State Medical UniversitySiberian State Medical UniversityYaroslav-the-Wise Novgorod State UniversityAlexandrovskaya City HospitalAlexandrovskaya City HospitalAlexandrovskaya City HospitalAim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients who underwent CE. Depending on the technique of operation, the following groups were formed: group 1 (n=18362) — eversion CE; group 2 (n=6744) — conventional CE with patch angioplasty. The long-term follow-up period was 124,7±53,8 months.Results. In the hospital postoperative period, the groups were comparable in incidence of all complications: lethal outcome (group 1: 0,19%, n=36; group 2: 0,17%, n=12; p=0,89; odds ratio (OR) =1,1; 95% confidence interval (CI) =0,57- 2,11); myocardial infarction (MI) (group 1: 0,15%, n=28; group 2: 0,13%, n=9; p=0,87; OR=1,14; 95% CI=0,53-2,42); stroke (group 1: 0,33%, n=62; group 2: 0,4%, n=27; p=0,53; OR=0,84; 95% CI=0,53-1,32); bleeding with hematoma formation (group 1: 0,39%, n=73; group 2: 0,41%, n=28; p=0,93; OR=0,95; 95% CI=0,61-1,48); internal carotid artery (ICA) thrombosis (group 1: 0,05%, n=11; group 2: 0,07%, n=5, p=0,9; OR=0,8; 95% CI=0,28-2,32). In the long-term follow-up, the groups were comparable only in MI incidence: group 1: 0,56%, n=103; group 2: 0,66%, n=45; p=0,37; OR=0,84; 95% CI=0,59-1,19. All other complications were more frequent after conventional CE with patch angioplasty: all-cause death (group 1: 2,7%, n=492; group 2: 9,1%, n=616; p<0,0001; OR=0,27; 95% CI=0,24-0,3); lethal ischemic stroke (group 1: 1,0%, n=180; group 2: 5,5%, n=371; p<0,0001; OR=0,17; 95% CI=0,14-0,21); non-lethal ischemic stroke (group 1: 0,62%, n=114; group 2: 7,0%, n=472; p<0,0001; OR=0,08; 95% CI=0,06-0,1); ICA restenosis >60%, requiring re-revascularization (group 1: 1,6%, n=296; group 2: 12,6%, n=851; p<0,0001; OR=0,11; 95% CI=0,09-0,12). Thus, the composite endpoint (lethal ischemic stroke + non-lethal ischemic stroke + MI) after conventional CE with patch angioplasty was more than 6 times higher than this parameter of eversion CE: group 1: 2,2%, n=397; group 2: 13,2%, n=888; p<0,0001; OR=0,14; 95% CI=0,12-1,16.Conclusion. Conventional CE with patch angioplasty is not prefer for cerebral revascularization in the presence of hemodynamically significant ICA stenosis due to the high prevalence of deaths, stroke, and ICA restenosis in the long-term follow-up.https://russjcardiol.elpub.ru/jour/article/view/4742carotid endarterectomyconventional carotid endarterectomyeversion carotid endarterectomycomparisonpatchrestenosiscomputer modelingneointimal hyperplasiaresidual stenosis |
| spellingShingle | Yu. V. Belov A. N. Kazantsev R. A. Vinogradov A. V. Korotkikh V. V. Matusevich S. V. Artyukhov E. Yu. Kachesov D. V. Shmatov A. B. Zakeryaev P. V. Sukhoruchkin A. A. Erofeev A. R. Shabaev M. O. Dzhanelidze B. M. Taits D. B. Taits G. Sh. Bagdavadze N. E. Zarkua A. S. Fedorov I. M. Radzhabov V. A. Lutsenko R. V. Sultanov F. R. Alizada A. D. Abdullaev A. V. Povtoreyko T. I. Kapran D. A. Popov R. Yu. Leader E. F. Vaiman A. I. Solobuev E. O. Meleshin E. R. Ginzburg V. P. Derbilova E. R. Vinogradova A. E. Gofman E. O. Alekseeva K. L. Zakharova L. V. Roshkovskaya Yu. P. Linets Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study Российский кардиологический журнал carotid endarterectomy conventional carotid endarterectomy eversion carotid endarterectomy comparison patch restenosis computer modeling neointimal hyperplasia residual stenosis |
| title | Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study |
| title_full | Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study |
| title_fullStr | Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study |
| title_full_unstemmed | Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study |
| title_short | Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study |
| title_sort | ten year long term outcomes of conventional and eversion carotid endarterectomy multicenter study |
| topic | carotid endarterectomy conventional carotid endarterectomy eversion carotid endarterectomy comparison patch restenosis computer modeling neointimal hyperplasia residual stenosis |
| url | https://russjcardiol.elpub.ru/jour/article/view/4742 |
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