Potentials for the pharmacological preconditioning in the surgical treatment of hemodynamically significant carotid stenosis


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The article is devoted to pharmacological preconditioning before carotid endarterectomy in patients with chronic cerebrovascular insufficiency. The study was based on the results of surgical treatment of 80 patients with hemodynamically significant unilateral and bilateral carotid stenosis. Half of these patients underwent surgery immediately, and others - after pharmacological preconditioning with drug Actovegin at a dose of 1200 mg/day for 1.5 months. It was shown that preoperative preparation before surgery increases cerebral perfusion as determined by single photon emission computed tomography, and significantly improves the results of surgical treatment. There was significant difference in cognitive function of patients of these groups 7 days and 6 months after surgery. Such an improvement in cognitive functions correlated with fewer asymptomatic cerebral ischemic foci in different brain regions. The positive role of pharmacological preconditioning with drug Actovegin in the surgical treatment of stenoses of precerebral arteries, contributing to a more complete recovery of cognitive functions, was noted.

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