RISK FACTORS FOR PRE AND POSTOPERATIVE COMPLICATIONS OF INTRA-EXTRACRANIAL ATHEROSCLEROTIC ARTERIAL LESIONS
Background. Arterial hypertension, high cholesterol, blood sugar, smoking and old age are risk factors for atherosclerotic ischemic stroke and transient ischemic attack. Other risk factors that are also considered as causes of atherosclerotic ischemic stroke require confirmation: obesity, lack of physical activity, psychosocial factors, dietary patterns. The surgical standard for the treatment of atherosclerotic diseases of intra-extracranial vessels is endovascular stenting and carotid endarterectomy. The aim of this study was to identify the main risk factors for pre- and postoperative complications and to determine the criteria for the correct selection of patients for surgical treatment with intra- and extracranial atherosclerotic arterial disease.
Methods. A retrospective analysis of 725 case histories of treated cases with atherosclerotic lesions of extra- and intracranial arteries, operated on the basis of the clinic of JSC "Central Clinical Hospital" in Almaty in the Department of Neurosurgery for the period from 2016 to 2021, was carried out. The main group included 212 cases with intracranial atherosclerotic plaques, the control group included 513 cases with extracranial plaques.
Results. The predictors of the development of complications (stroke) in atherosclerosis before surgery were determined: the presence of coronary artery disease increased the chance of developing stroke by 4.882 (95% CI: 3.313–7.194), smoking by 2.659 times (95% CI: 2.151–3.288), diabetes mellitus by 1.2 times (95% CI: 0.868-1.648), hypercholesterolemia - 1.248 times (95% CI: 1.099 - 1.416), hypertensive crisis - 1.04 times (95% CI: 1.000-1.085). Extracranial vascular lesions had an inverse relationship with the development of complications. The presence of diabetes in 3.870 increased the chance of developing a complication after surgery (stent thrombosis) (95% CI: 0.959 -15.614).
Conclusion. In the presence of risk factors: smoking, diabetes mellitus, hypercholesterolemia, hypertensive crisis and age over 60 years, closer monitoring is necessary for the implementation of preventive measures and treatment, especially for intracranial arterial disease. Before a planned operation, stabilization of blood sugar levels and strict adherence to the recommendations of an endocrinologist regarding therapy during the treatment of atherosclerosis are especially necessary.
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Sarshayev M.A., Berdikhojayev M.S., Turdalieva B.S., Tanbaeva G.Z., Makhanbetkhan Sh.Sh., Zhumabekov A.K., Lupezhova A.D., Baimuratova M.A., Mussabekov M.G., Suleimankulov N.A., Suieumbetov D.Sh., Laktionova M.V. Risk factors for pre and postoperative complications of intra-extracranial atherosclerotic arterial lesions // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 4, pp. 67-76. doi 10.34689/SH.2023.25.4.008Related publications:
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