Federal State Budgetary Scientific Institution "Russian Scientific Center of Surgery named B.V. Petrovsky", Moscow, Russian Federation.
City Alexandrovskaya Hospital, Saint Petersburg, Russian Federation.
Curr Probl Cardiol. 2022 Sep;47(9):101272. doi: 10.1016/j.cpcardiol.2022.101272. Epub 2022 May 27.
This review of the literature discusses the solution of unresolved issues related to carotid endarterectomy in Russia: (1) A program has been created for choosing the tactics of revascularization of patients with simultaneous atherosclerotic lesions of the coronary and carotid arteries; (2) Using the methods of computer modeling, studying the genetics and morphology of restenosis, it was found that the classic carotid endarterectomy with plasty of the reconstruction zone with a patch is an unsafe type of revascularization; (3) An eversion carotid endarterectomy with transposition of the internal carotid artery over the hypoglossal nerve has been developed, which makes it possible to prevent damage to the latter during repeated carotid endarterectomy for restenosis; (4) It has been established that carotid endarterectomy is associated with a high risk of complications in patients over 75 years of age; (5) It has been proven that emergency carotid endarterectomy in the first hours after the development of a stroke is not safe because. combined with the maximum number of all non-favorable cardiovascular events; (6) 3 new types of carotid endarterectomy with carotid glomus preservation have been developed.
（1）创建了一个程序，用于选择同时患有冠状动脉和颈动脉粥样硬化病变的患者的血管重建策略；（2）使用计算机建模方法，研究再狭窄的遗传学和形态学，发现经典的颈动脉内膜切除术，用补片成形修复区，是一种不安全的血管重建类型；（3）开发了一种外翻颈动脉内膜切除术，将颈内动脉穿过舌下神经转位，这使得在重复颈动脉内膜切除术后再狭窄时防止后者受损成为可能；（4）已经确定颈动脉内膜切除术与 75 岁以上患者的并发症风险较高有关；（5）已经证明，中风发生后最初几小时内进行紧急颈动脉内膜切除术是不安全的，因为。与所有非有利心血管事件的最大数量相结合；（6）开发了 3 种新的保颈动脉窦的颈动脉内膜切除术。
