Evaluation of the efficiency of endarterectomy from the external carotid artery in patients with internal carotid artery occlusion

Abstract

Objective. To assess the effect of external carotid artery (ECA) endarterectomy on regional cerebral blood flow, cognitive function, and quality of life in patients with ICA occlusion.Materials and Methods. From 2019 to 2020 year, 14 operations were performed on patients with ICA occlusion and hemodynamically significant ECA lesion. 14 patients, 12 men (85.7 %) and 2 women (14.3 %) underwent resection of the ICA, endarterectomy of the common carotid artery (CCA), and ECA. All patients had a history of stroke of 7±5.7 months. Neurological deficit according to the Rankin scale was 2 points in 11 patients (78.6 %) and 3 points in 3 patients (21.4 %). The mean age was 62.8±11.6 years. The preoperative period included ultrasound duplex scanning and computed tomography with the contrast of the brachiocephalic arteries. Single-photon emission computed tomography was used to assess cerebral blood flow before and after surgery. Cognitive status and quality of life were assessed by questionnaire survey.Results. In the early postoperative period, there were no registered strokes. A decrease in hypoperfusion foci and an increase of cerebral blood flow by an average of 10,33 ± 6,70 ml/min/100 g were observed in 13 patients (92,8 %). The Montreal Cognitive Deficit Scale score was 3,92±3,6. Improvement of quality of life according to the Short Form-36 questionnaire was 9.27±14.75.Conclusion. Endarterectomy of the external carotid artery at the internal carotid artery occlusion leads to a significant increase of regional cerebral blood flow in symptomatic patients, which in turn correlates with the regression of neurological deficit and improvement of quality of life. Continued work in this area will be a detailed analysis of the results of the treatment of patients with occlusion of the internal carotid artery for the period from 2018 to 2022 year.