Kazantsev A N, Chernykh K P, Artyukhov S V, Bagdavadze G Sh, Dzhanelidze M O, Lider R Yu, Abdullaev A D, Zarkua N E, Kalinin E Yu, Chikin A E, Zaitseva T E, Linets Yu P
City Alexandrovskaya Hospital, St. Petersburg, Russia.
Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(10):25-31. doi: 10.17116/jnevro202112110125.
Analysis of the results of emergency carotid endarterectomy (CEE) in internal carotid artery (ICA) thrombosis in the acute period of acute cerebrovascular accident (ACVI) in patients with COVID-19.
During the COVID-19 pandemic (April 1, 2020 - May 1, 2021), 43 patients with ICA thrombosis and a positive polymerase chain reaction (PCR) result for SARS-CoV-2 were included in this prospective study. In all cases, CEE was performed in the acutest period of ACVA. These patients were included in group 1. The comparison group was represented by 89 patients who underwent CEE in the acute period of stroke, in the period before the COVID-19 pandemic (April 1, 2019 - March 1.2020).
In the hospital postoperative period, the groups were comparable in terms of the incidence of deaths (group 1: 2.3%, =1; group 2: 1.1%, =1; =0.81; OR=2.09; 95% CI=0.12-34.3) myocardial infarction (group 1: 2.3%, =1; group 2: 0%; =0.7; OR=6.3; 95% CI=0.25-158.5), CVA (group 1: 2.3%, =1; group 2: 2.2%, =2; =0.55; OR=1.03; 95% CI=0.09-11.,7). ICA thrombosis and hemorrhagic transformations were not recorded. However, in view of severe coagulopathy with ongoing anticoagulant/antiplatelet therapy, patients with COVID-19 more often developed bleeding in the operation area (group 1: 11.6%, =5; group 2: 1.1%, =1; =0.02; OR=11.5; 95% CI=1.3-102.5).
Emergency CEE in the acute period of stroke is an effective and safe method of cerebral revascularization in case of ICA thrombosis in conditions of COVID-19.
分析新型冠状病毒肺炎（COVID-19）患者急性脑血管意外（ACVI）急性期颈内动脉（ICA）血栓形成行急诊颈动脉内膜切除术（CEE）的结果。
在COVID-19大流行期间（2020年4月1日至2021年5月1日），本前瞻性研究纳入了43例ICA血栓形成且严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）结果呈阳性的患者。所有病例均在ACVA最急性期行CEE。这些患者被纳入第1组。对照组为89例在COVID-19大流行之前（2019年4月1日至2020年3月1日）卒中急性期行CEE的患者。
在术后住院期间，两组在死亡率（第1组：2.3%，n = 1；第2组：1.1%，n = 1；p = 0.81；OR = 2.09；95%CI = 0.12 - 34.3）、心肌梗死（第1组：2.3%，n = 1；第2组：0%，n = 0；p = 0.7；OR = 6.3；95%CI = 0.25 - 158.5）、脑血管意外（CVA）（第1组：2.3%，n = 1；第2组：2.2%，n = 2；p = 0.55；OR = 1.03；95%CI = 0.09 - 11.7）方面具有可比性。未记录到ICA血栓形成和出血性转化。然而，鉴于持续抗凝/抗血小板治疗导致的严重凝血病，COVID-19患者手术区域出血更为常见（第1组：11.6%，n = 5；第2组：1.1%，n = 1；p = 0.02；OR = 11.5；95%CI = 1.3 - 102.5）。
卒中急性期急诊CEE是COVID-19情况下ICA血栓形成时一种有效且安全的脑血运重建方法。
