COMPARATIVE CHARACTERISTIC OF ANESTHESIOLOGICAL SUPPORT AND TYPES OF SURGICAL INTERVENTION IN PATIENTS WITH ATHEROSCLEROTIC LESIONS OF BRAHIOCEPHAL ARTERIES

Introduction. Atherosclerotic lesions of the branches of the aortic arch in 60% of cases is the cause of the development of ischemic stroke. As a radical means of preventing neurological disorders, carotid endarterectomy is used, since there is currently no effective drug treatment.

Material and methods. This article presents a comparative characteristic of anesthesiological support and types of surgical intervention in 710 patients with atherosclerotic lesions of brachiocephalic arteries in the period from January 2010 to December 2017 in Department of Vascular Surgery at the Clinic of the Bashkir State Medical University. To perform this comparative characteristic, the patients were divided into 2 groups, depending on the time interval. Group 1 — patients operated from 2010 to 2013 (291 patients). Group 2 — patients operated from 2014 to 2017 (491 patients). In Group 1, operations were predominantly performed under regional anesthesia and classical carotid endarterectomy predominated over an eversion. In Group 2, operations were performed under general anesthesia, and here the overthe-top carotid endarterectomy predominated over the classical one. Patients were comparable in age, sex and risk of anesthesia and surgical intervention according to the ASA classification. The overall incidence of ischemic postoperative complications was 4.22%.

Results. According to our data, the application of the eversion method of carotid endarterectomy under general anesthesia reduces the relative risk of neurological complications by 1.648 times (as in the 2nd group the technique of eversion carotid endarterectomy under general anesthesia was used). The use of general anesthesia with carotid endarterectomy allows to provide adequate gas exchange, manageability by hemodynamic parameters, absence of emotional reactions from the patient.

Conclusion. Thus, at the present moment, our experience in treating patients with atherosclerotic lesions of the brachiocephalic arteries is approaching the optimal one, allowing us to achieve good results of carotid endarterectomy. 

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