Glomus-Saving Autografting of the Internal Carotid Artery in the Peracute Period of Ischemic Stroke with Underlying COVID-19
- Authors: Altymukhamedova L.D.1, Rotanova A.I.1, Katykhina V..1, Chesnokova A.A.1, Korotkikh A.V.2, Zharova A.S.1, Pivovarov A.A.3, Buksayev D.S.1, Kazantsev A.N.4
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Affiliations:
- North-Western State Medical University named after I. I. Mechnikov
- Clinic of Cardiac Surgery of Amur State Medical Academy
- Kemerovo State Medical University
- Alexander City Hospital
- Issue: Vol 30, No 2 (2022)
- Pages: 233-242
- Section: Original study
- URL: https://journals.eco-vector.com/pavlovj/article/view/76125
- DOI: https://doi.org/10.17816/PAVLOVJ76125
- ID: 76125
Cite item
Abstract
INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 is associated with the development of arterial thromboses of different locations. This pathology is common in patients with multifocal atherosclerosis. The overwhelming majority of published reports are devoted to the surgical treatment of patients with thrombosis of lower limb arteries. Thus far, no studies of revascularization in the case of extended atherosclerotic lesion and thrombosis of the internal carotid artery (ICA) in patients with COVID-19, have been published.
AIM: To analyze the immediate results of glomus-saving autografting of the ICA with its extended atherosclerotic lesion and thrombosis in the peracute period of ischemic stroke in patients with COVID-19.
MATERIALS AND METHODS: The retrospective study (inclusion period 01.01.2017–01.03.2020) involved 49 patients with hemodynamically significant extended atherosclerotic lesion of the ICA in the peracute period of acute cerebrovascular accident (ACVA). From April 1, 2020, to May 15, 2021, 26 patients with hemodynamically significant extended atherosclerotic lesion and floating thrombus in the ICA and a positive result of polymerase chain reaction to SARS-CoV-2 were included. In all cases, brain revascularization was performed in the peracute period of ACVA in the volume of glomus-saving autografting of the ICA.
RESULTS: No adverse cardiovascular events were noted throughout the postoperative follow-up period in both groups. In the examination of the reconstruction zone using color duplex ultrasonography, no data for restenosis/thrombosis were recorded. On day 7 after surgery, in both cohorts of patients, significant regression of neurological deficit on the National Institute of Health Stroke Scale was noted: in the first group, the values during admission and day 7 after revascularization were10.5 ± 3.5 and 6.5 ± 1.5, respectively (р = 0.001); in the second group, the values were 12.5 ± 2.5 and 5.5 ± 1.5, respectively (р = 0.001). In both groups, no cases of unstable difficult-to-control arterial hypertension were noted, and no changes were introduced to the antihypertensive therapy.
CONCLUSIONS: Emergency autografting of the ICA with its extended atherosclerotic lesion and thrombosis in the peracute period of ACVA is an effective and safe method of brain revascularization in patients with COVID-19.
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About the authors
Leyli D. Altymukhamedova
North-Western State Medical University named after I. I. Mechnikov
Email: lilialtlolo@gmail.com
ORCID iD: 0000-0002-7660-2871
Russian Federation, Saint Petersburg
Anna I. Rotanova
North-Western State Medical University named after I. I. Mechnikov
Email: rotanova-anna@rambler.ru
ORCID iD: 0000-0002-1926-663X
Russian Federation, Saint Petersburg
Valentina V. Katykhina
North-Western State Medical University named after I. I. Mechnikov
Email: vkatyhina16@mail.ru
ORCID iD: 0000-0002-3839-5226
SPIN-code: 5134-2132
Russian Federation, Saint Petersburg
Anna A. Chesnokova
North-Western State Medical University named after I. I. Mechnikov
Email: a.chesnockova22@yandex.ru
ORCID iD: 0000-0003-1732-0978
SPIN-code: 1034-0906
Russian Federation, Saint Petersburg
Aleksandr V. Korotkikh
Clinic of Cardiac Surgery of Amur State Medical Academy
Email: ssemioo@rambler.ru
ORCID iD: 0000-0002-9709-1097
SPIN-code: 6080-1442
Russian Federation, Blagoveshchensk
Alina S. Zharova
North-Western State Medical University named after I. I. Mechnikov
Email: zharova.alina2018@yandex.ru
ORCID iD: 0000-0001-9474-4972
Russian Federation, Saint Petersburg
Aleksandr A. Pivovarov
Kemerovo State Medical University
Email: a.a.pivovarov@bk.ru
ORCID iD: 0000-0001-9461-4908
Russian Federation, Kemerovo
Dmitriy S. Buksayev
North-Western State Medical University named after I. I. Mechnikov
Email: buksaev00@mail.ru
ORCID iD: 0000-0003-4251-7238
Russian Federation, Saint Petersburg
Anton N. Kazantsev
Alexander City Hospital
Author for correspondence.
Email: dr.antonio.kazantsev@mail.ru
ORCID iD: 0000-0002-1115-609X
SPIN-code: 8396-1845
Russian Federation, Saint Petersburg
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