ASSESSMENT OF RISK FACTORS IN THE SURGICAL TREATMENT OF PATIENTS WITH OCCLUSION INTERNAL CAROTID ARTERY

Complications after endarterectomy of the external carotid artery and to evaluate risk factors. Material and Methods. Our study was based on the observation and examination of 117 patients with occlusion of the internal carotid artery undergoing endarterectomy of the external carotid artery in the vascular surgery department of the Lviv Regional Hospital over the period since May 2002 till October 2013. Early (30 days) complications of the procedure and risk factors were assessed and analyzed. Results and Discussion. The number of periprocedural ischemic events in the first 30 days after endarterectomy was 4 (3.4%) cases (2 cases of intraoperative and 2 cases of postoperative stroke). In one (0.9%) patient in the early postoperative period thrombosis of the external carotid artery without any neurological symptoms was diagnosed. Other complications such as lesions of the cranial nerves (VII, IX, Õ, Õ??) and hyperperfusion syndrome were detected in 11 (9.4%) and 10 (8.5 %) patients respectively. Postoperative hematoma that would have been clinically significant and affected the patient's condition was diagnosed in 2 (1.7%) patients. Among risk factors for perioperative ischemic events in patients with occlusion of the ICA (internal carotid artery) in this study the following were found: the history of contralateral ICA stenosis of more than 70 % (ð=0.05, OR 25.77; 95 %, CI 1.34-493.3); the use of intraluminal shunt (ð=0.008; OR 36.6; 95 %, C? 3.78 -355.2); incapacitating stroke (3-5 points for Rankin's scale) in anamnesis (ð=0.04; OR 10.6; 95 %, C? 1.05-105.2). Conclusions. Endarterectomy of the external carotid artery is a sufficiently safe surgical intervention with low incidence of perioperative complications. Among the factors that have a statistically significant impact on the development of periprocedural strokes are contralateral ICA stenosis of more than 70%, the use of an intraluminal shunt and history of incapacitating (3-5 points for Rankin scale) ipsilateral stroke. These factors must be considered when planning patients for surgery. Keywords: occlusion of the internal carotid artery, endarterectomy of the external carotid artery, hyperperfusion syndrome