RESUMEN
The study was aimed at examining efficacy of preoperative preparation (pharmacological preconditioning) for carotid endarterectomy in patients with chronic cerebrovascular insufficiency. For this purpose, we analysed the outcomes of surgical treatment in a total of 80 patients presenting with haemodynamically significant unilateral and bilateral lesions of carotid arteries. Of these, 40 patients were operated on immediately and a further 40 patients underwent surgery after pharmacological preconditioning with Actovegin taken at a daily dose of 1,200 mg for 1.5 months. It was demonstrated that preoperative preparation prior to surgery increases cerebral perfusion which is determined by means of single-photon emission computed tomography, thus substantially improving the outcomes of surgical treatment. Statistically significant differences in cognitive function of these groups of patients were revealed 7 days and 6 months after the operation. Improvement of cognitive functions was associated with fewer symptom-free postoperative cerebral ischaemic foci in various regions of the brain. A conclusion was made on a positive role of pharmacological preconditioning with Actovegin in surgical management of cerebrovascular insufficiency, first of all in relation to more complete restoration of cognitive functions.
Asunto(s)
Isquemia Encefálica , Estenosis Carotídea , Trastornos del Conocimiento , Endarterectomía Carotidea , Hemo/análogos & derivados , Complicaciones Posoperatorias/prevención & control , Anciano , Antioxidantes/administración & dosificación , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/etiología , Isquemia Encefálica/prevención & control , Estenosis Carotídea/complicaciones , Estenosis Carotídea/cirugía , Circulación Cerebrovascular/efectos de los fármacos , Trastornos Cerebrovasculares/diagnóstico , Trastornos Cerebrovasculares/etiología , Trastornos Cerebrovasculares/prevención & control , Quimioterapia Adyuvante/métodos , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/prevención & control , Endarterectomía Carotidea/efectos adversos , Endarterectomía Carotidea/métodos , Femenino , Hemo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Tomografía Computarizada de Emisión de Fotón Único , Resultado del TratamientoRESUMEN
The review analyses the role of serotonin in the development of pathological processes in angiological patients, showing its negative role in aggravating chronic and acute ischaemia of various organs (brain, myocardium, extremities) both at the expense of vasoconstriction and due to an increase in blood platelet aggregation of blood platelets and erythrocytes, followed by analysis of clinical efficacy of naftidrofuryl) - serotonin 5-HT2 receptor antagonist. Results of numerous randomized trials confirmed its efficacy and safety in treatment of angiological patients, being superior to other vasotropic drugs (cilostazol, pentoxyphyllin, nicotinic acid).
