[Comparing the risks for the development of perioperative complications in carotid endarterectomy and carotid angioplasty]. / Sravnenie riskov razvitiia perioperatsionnykh oslozhnenii pri karotidnoi éndarteréktomii i karotidnoi angioplastike.

The article is a literature review presenting a comparative analysis of 30-day risks of mortality and complications after carotid endarterectomy and carotid angioplasty with stenting. The risks studied were as follows: myocardial infarction, stroke, transitory ischaemic attacks, bradycardia, hypotension, postoperative haematomas, and damages to the craniocerebral nerves. The authors analysed a series of recently published foreign studies and meta-analyses dedicated to the problem concerned. The obtained findings revealed that carotid endarterectomy turned out to be associated with a higher perioperative risk for the development of myocardial infarction, postoperative haematomas and damages to the craniocerebral nerves, whereas carotid angioplasty with stenting appeared to be associated with an increased risk for the development of stroke, bradycardia and hypotension within the first 30 postoperative days. As far as mortality is concerned, it proved to be relatively similar for both methods of revascularization. The use of systems of protection of the brain from embolism during stenting of carotid arteries decreases the perioperative risks, however, it seems difficult to unequivocally affirm which of the methods of cerebral protection demonstrates better results.

[Remote results of open surgical and endovascular treatment of internal carotid artery stenoses]. / Otdalennye rezul'taty otkrytogo khirurgicheskogo m éndovaskuliarnogo lecheniia stenozov vnutrennikh sonnykh arterii.

The article is a review containing a comparative analysis of the remote results in patients presenting with carotid artery atherosclerosis and treated by means of either stenting or carotid endarterectomy. More than ten international randomized studies have up to now been conducted. Some of them prove the advantage of using either carotid endarterectomy or stenting of carotid arteries, others show equivalence of both methods of treatment. Carotid endarterectomy is currently a preferred operation for carotid artery stenoses, with lower incidence of the development of postoperative strokes and restenoses in the remote period. But stenting is an alternative technique in patients with high operative risk. Therefore, the question of choosing an appropriate type of the intervention should be decided upon for each patient individually. A more definite conclusion to be made on advantages of carotid endarterectomy over endovascular angioplasty, or vice versa, requires further studying therapeutic outcomes during a longer follow-up period.