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Arguments in favor of practical application of sinus-sparing modification of eversion carotid endarterectomy

Abstract

Currently, a patient with significant stenosis of the carotid bifurcation can be offered both open and endovascular reconstruction. Potential complications after an open operation on carotid arteries include myocardial infarction, ischemic or hemorrhagic stroke of the brain, transient disorders of cerebral circulation, postoperative hematomas with compression of cranial nerves or respiratory organs. One of the starting points in the development of these complications is a significant increase in arterial pressure in the early postoperative period. One of the techniques of performing an open operation aimed at preventing postoperative hypertension is sinus-sparing eversion carotid endarterectomy. A peculiarity of this procedure consists in changing the geometry of arteriotomy followed by cutting off the internal carotid artery. Thus, the sinocarotid zone remains intact.

The use of such a modification makes it possible to achieve more manageable parameters of arterial hemodynamics, thereby preventing the development of persistent postoperative arterial hypertension and, accordingly, the complications described above.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Fokin A.A., Treiger G.A.; data collection and handling – Fokin A.A., Treiger G.A.; statistical processing – Treiger G.A.; draft manuscript preparation – Treiger G.A.; manuscript revision – Fokin A.A., Treiger G.A.

For citation: Fokin A.A., Treiger G.A. Arguments in favor of practical application of sinus-sparing modification of eversion carotid endarterectomy. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2024; 30 (2): 49–55. DOI: https://doi.org/10.33029/1027-6661-2024-30-2-49-55

Keywords: carotid endarterectomy; sinus-sparing modification; carotid sinus nerves; arterial hypertension; rhythmocardiography

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Akchurin Renat Suleymanovich

Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Deputy General Director for Surgery, Head of the Department of Cardiovascular Surgery, National Medical Research Center for Cardiology named after Academician E.I. Chazov, President of the Russian Society of Angiologists and Vascular Surgeons

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.