Changes in Geometry and Hemodynamics After Carotid Endarterectomy
V. P. Derbilova,
R. A. Vinogradov,
Yu. N. Zakharov,
V. G. Borisov,
E. E. Kheteeva,
E. R. Vinogradova,
O. M. Meshcheryakova,
V. A. Gagin,
E. I. Zyablova,
A. G. Baryshev https://doi.org/10.35401/2541-9897-2024-9-4-60-67
Abstract
Background: Many studies on cerebral atherosclerosis and its treatment have been conducted over the past 60 years. Several modifications of open surgical treatment (carotid endarterectomy) have been proposed. There are several techniques of carotid endarterectomy; however, there is no consensus on advantages of any of these techniques.
Objective: To analyze the anatomy and geometry of the common carotid artery bifurcation in patients with hemodynamically significant stenoses of the internal carotid artery.
Materials and methods: To study geometric parameters, we used computed tomography data of patients operated on at the Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation). The patients underwent the following procedures: classical, eversion, or glomus-sparing carotid endarterectomy. We built geometric models using specialized software and studied hemodynamics at the common carotid artery bifurcation in the early postoperative period (1 day after surgery) and 1 year after surgery.
Results and conclusion: Zones at risk for atherosclerotic plaque formation are mainly in the common carotid artery. This phenomenon is explained by the surgery technique, namely, by the fact that the cut line of the atherosclerotic plaque is located in this region. Models built on the basis of computed tomographic angiograms 1 year after surgery demonstrate a decrease in the area of zones at risk. This might be due to the arterial wall smoothing and neointima formation.
Keywords
atherosclerosis,
anatomy of the common carotid artery bifurcation,
geometry of the common carotid artery bifurcation,
hemodynamics,
carotid endarterectomy,
restenosis
Supporting agencies: The study was supported by the Kuban Science Foundation under scientific and innovation project No. НИП-20.1/22.11.
About the Authors
V. P. Derbilova
Kuban State Medical University; Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Viktoriya P. Derbilova - Postgraduate Student, Surgery Department No. 1, Faculty of Continuing Professional Development and Retraining, Kuban State Medical University; Cardiovascular Surgeon, Vascular Surgery Unit No. 2, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
R. A. Vinogradov
Kuban State Medical University; Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Roman A. Vinogradov - Dr. Sci. (Med.), Head of the Vascular Surgery Unit No. 1, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Professor at the Surgery Department No. 1, Faculty of Continuing Professional Development and Retraining, Kuban State Medical University.
Krasnodar
Yu. N. Zakharov
Federal Research Center for Information and Computational Technologies
Russian Federation
Russian Federation
Yury N. Zakharov - Dr. Sci. (Phys.-Math.), Laboratory Head, Federal Research Center for Information and Computational Technologies.
Novosibirsk
V. G. Borisov
Kemerovo State University; Federal Research Center for Information and Computational Technologies
Russian Federation
Russian Federation
Vladimir G. Borisov - Cand. Sci. (Phys.-Math.), Associate Professor, Associate Professor at the Department of Fundamental Mathematics, Kemerovo State University; Senior Researcher, Federal Research Center for Information and Computational Technologies.
Kemerovo; Novosibirsk
E. E. Kheteeva
Kuban State Medical University; Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Elina E. Kheteeva - Department Assistant, Surgery Department No. 1, Faculty of Continuing Professional Development and Retraining, Kuban State Medical University; Cardiovascular Surgeon, Vascular Surgery Unit No. 1, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
E. R. Vinogradova
Kuban State Medical University
Russian Federation
Russian Federation
Elvira R. Vinogradova - 6th Year Student, Faculty of Medicine, Kuban State Medical University.
Krasnodar
O. M. Meshcheryakova
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Olga M. Meshcheryakova - Ultrasonographer, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
V. A. Gagin
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Vladimir A. Gagin - Radiologist, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
E. I. Zyablova
Kuban State Medical University; Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Elena I. Zyablova - Dr. Sci. (Med.), Associate Professor, Head of the Diagnostic Radiology Department No. 2, Kuban State Medical University; Head of the Radiology Unit, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
A. G. Baryshev
Kuban State Medical University; Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Aleksandr G. Baryshev - Dr. Sci. (Med.), Associate Professor, Head of the Surgery Department No. 1, Faculty of Continuing Professional Development and Retraining, Kuban State Medical University; Deputy Chief Physician for Surgical Care, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
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Review
For citations:
Derbilova V.P., Vinogradov R.A., Zakharov Yu.N., Borisov V.G., Kheteeva E.E., Vinogradova E.R., Meshcheryakova O.M., Gagin V.A., Zyablova E.I., Baryshev A.G. Changes in Geometry and Hemodynamics After Carotid Endarterectomy. Innovative Medicine of Kuban. 2024;(4):60-67. (In Russ.) https://doi.org/10.35401/2541-9897-2024-9-4-60-67
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