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Published on: September 13, 2020
[Roentgenosurgical treatment lesions of the brachiocephalic arteries]
1Regional Clinical Hospital, Vladimir, Russia. vasilisa@aport.ru
Insights
Cerebrovascular diseases, often caused by aortic arch lesions, can lead to stroke. Roentgenosurgical interventions on brachiocephalic arteries effectively reduced neurological symptoms and hospital stays in patients.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Cardiology
Background:
- Cerebrovascular diseases are a leading cause of mortality and disability.
- Stenotic and occlusive processes in aortic arch branches are responsible for half of all ischemic brain lesions.
- Surgical treatment for cerebrovascular insufficiency is established, but challenges remain in endovascular techniques.
Purpose of the Study:
- To evaluate the outcomes of roentgenosurgical treatment for hemodynamically significant brachiocephalic artery (BCA) lesions.
- To assess the efficacy of endovascular interventions in patients with BCA disease.
Main Methods:
- Retrospective analysis of 19 patients (26-61 years old) undergoing roentgenosurgical interventions on the BCA.
- Inclusion of various endovascular procedures for BCA treatment.
Main Results:
- Significant regression of neurological symptoms observed in the patient group.
- Marked improvement in the quality of life reported post-intervention.
- Considerable reduction in hospital stay duration for patients treated with roentgenosurgical methods.
Conclusions:
- Roentgenosurgical interventions offer a viable treatment option for BCA lesions.
- Advantages include continuous patient contact and minimized brain hypovolemia.
- Careful patient selection and technical expertise are crucial to mitigate intraoperative risks.
Abstract:
Being the main cause of the lethality and permanent loss of work fitness, cerebrovascular diseases are assumed to be one of the most pressing problems of neurology and vascular surgery. It is to be noted that precisely stenotic and occlusive processes occurring in aortic arch branches induce ischemic lesions of the brain in half the cases. The multicenter cooperative randomized studies (MASCET, BCST, 'Veterans Affairs Cooperative Studies Program', VACT and ACAS) finalized the problem of the necessity of surgical treatment of patients with symptomatic and asymptomatic cerebrovascular insufficiency. However, despite the speedy progress in the cardiovascular surgery trend under consideration, a number of the fairly important problems remain unsolved. One of the important problems lies in the use of balloon angioplasty, stenting and thrombolysis of the precerebral arteries. The purpose of the study was to evaluate the results of roentrgenosurgical treatment of patients with hemodynamically significant lesion of the brachiocephalic arteries (BCA). Analysis was made of the treatment results in 19 patients aged 26 to 61 years. There were 13 (68.4%) men and 6 (31.6%) women. All the patients were provided different roentgenosurgical interventions on the BCA. Analysis of the results of roentgenosurgical interventions allowed to 7 establish that in the given patient group, the neurologic syinptomatology regressed, to an appreciable measure, with an improvement in the quality of life. It is noteworthy that roentgenosurgical interventions considerably shortened the patients' stay at hospital. The advantages of the technology are as follows: a possibility of the contact with the patient for the whole period of the procedure, minimization of the time of brain hypovolemia due to instrumental examinations. However, the risk of intraoperative complications requires a careful selection of the patients and impeccable technical performance.
