Skip to main content
Erschienen in:

14.06.2023 | Brief Research Report

Prospective multicenter online testing of the carotid endarterectomy risk stratification calculator carotidscore.ru

verfasst von: Anton Nikolaevich Kazantsev, Alexander Korotkikh, Merab Dzhanelidze, Elguja Kharchilava, Nonna Zarkua, Elena Alekseeva, Valeria Staroverova, Victoria Koplik, Roman Leader, Aslan Zakeryaev, Goderzi Bagdavadze, Kristina Zakharova, Igor Semyin, Anton Kostenkov, Konstantin Chernykh, Dmitry Shmatov, Oleg Lebedev, Sergey Artyukhov, Otabek Mukhtorov, Shuowen Wang, Roman Komarov, Lyudmila Roshkovskaya, Mikhail Khetagurov, Vladimir Unguryan, Maxim Chernyavin, Petr Palagin, Alexey Sirotkin, Yuri Belov

Erschienen in: Indian Journal of Thoracic and Cardiovascular Surgery | Ausgabe 6/2023

Einloggen, um Zugang zu erhalten

Abstract

Aim

To evaluate the incidence of complications, including fatal outcomes, ischemic strokes, and transient ischemic attacks, associated with carotid endarterectomy (CEA) in patients categorized as low-, medium-, and high-risk based on their CarotidSCORE (carotidscore.ru).

Material and Methods

This prospective, multicenter study was conducted from January 1, 2022, to December 20, 2022, and enrolled 5,496 patients with stenosis of the internal carotid artery (ICA), who were categorized into four groups according to their risk level. Group 1 (n=1,759) included patients at low risk; Group 2 (n=2,483) included those at medium risk; Group 3 (n=429) included those at high risk, who underwent carotid angioplasty with stenting (CAS) due to the high risk of complications associated with carotid endarterectomy (CEA); and Group 4 (n=825) did not use CarotidSCORE (carotidscore.ru). Patients in Groups 1, 2, and 4 underwent CEA.

Results

During the postoperative hospital stay, the highest number of complications, including fatal outcomes (p=0.0007), ischemic strokes (p<0.0001), and the combined endpoints (p<0.0001) were observed in Group 4. No complications were reported in Group 1.

Conclusion

The use of CarotidSCORE (carotidscore.ru) allows for the identification of high-risk patients, enabling clinicians to opt for CAS instead of CEA and reduce the incidence of complications.
Literatur
1.
Zurück zum Zitat Aboyans V, Ricco J-B, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39:763–816. https://doi.org/10.1093/eurheartj/ehx095.CrossRefPubMed Aboyans V, Ricco J-B, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39:763–816. https://​doi.​org/​10.​1093/​eurheartj/​ehx095.CrossRefPubMed
7.
Zurück zum Zitat Stolker JM, Mahoney EM, Safley DM, Pomposelli FB Jr, Yadav JS, Cohen DJ. Health-related quality of life following carotid stenting versus endarterectomy: results from the SAPPHIRE (Stenting and Angioplasty with Protection in Patients at HIgh Risk for Endarterectomy) trial. JACC Cardiovasc Interv. 2010;3:515–23. https://doi.org/10.1016/j.jcin.2010.02.009.CrossRefPubMed Stolker JM, Mahoney EM, Safley DM, Pomposelli FB Jr, Yadav JS, Cohen DJ. Health-related quality of life following carotid stenting versus endarterectomy: results from the SAPPHIRE (Stenting and Angioplasty with Protection in Patients at HIgh Risk for Endarterectomy) trial. JACC Cardiovasc Interv. 2010;3:515–23. https://​doi.​org/​10.​1016/​j.​jcin.​2010.​02.​009.CrossRefPubMed
9.
Zurück zum Zitat Kazantsev AN, Abdullaev IA, Danilchuk LB, Shramko VA, Korotkikh AV, Chernykh KP, et al. CAROTIDSCORE.RU-The first Russian computer program for risk stratification of postoperative complications of carotid endarterectomy. Vascular. 2022:17085381221124709. https://doi.org/10.1177/17085381221124709. Kazantsev AN, Abdullaev IA, Danilchuk LB, Shramko VA, Korotkikh AV, Chernykh KP, et al. CAROTIDSCORE.RU-The first Russian computer program for risk stratification of postoperative complications of carotid endarterectomy. Vascular. 2022:17085381221124709. https://​doi.​org/​10.​1177/​1708538122112470​9.
10.
Zurück zum Zitat Kazantsev A, Korotkikh A, Lider R, Lebedev O, Sirotkin A, Palagin P, et al. Results of carotid endarterectomy with the use of temporary shunts with reduced retrograde pressure in the internal carotid artery — analysis of the multicenter Russian register. Indian J Thorac Cardiovasc Surg. 2023. https://doi.org/10.1007/s12055-023-01487-7.CrossRefPubMed Kazantsev A, Korotkikh A, Lider R, Lebedev O, Sirotkin A, Palagin P, et al. Results of carotid endarterectomy with the use of temporary shunts with reduced retrograde pressure in the internal carotid artery — analysis of the multicenter Russian register. Indian J Thorac Cardiovasc Surg. 2023. https://​doi.​org/​10.​1007/​s12055-023-01487-7.CrossRefPubMed
Metadaten
Titel
Prospective multicenter online testing of the carotid endarterectomy risk stratification calculator carotidscore.ru
verfasst von
Anton Nikolaevich Kazantsev
Alexander Korotkikh
Merab Dzhanelidze
Elguja Kharchilava
Nonna Zarkua
Elena Alekseeva
Valeria Staroverova
Victoria Koplik
Roman Leader
Aslan Zakeryaev
Goderzi Bagdavadze
Kristina Zakharova
Igor Semyin
Anton Kostenkov
Konstantin Chernykh
Dmitry Shmatov
Oleg Lebedev
Sergey Artyukhov
Otabek Mukhtorov
Shuowen Wang
Roman Komarov
Lyudmila Roshkovskaya
Mikhail Khetagurov
Vladimir Unguryan
Maxim Chernyavin
Petr Palagin
Alexey Sirotkin
Yuri Belov
Publikationsdatum
14.06.2023
Verlag
Springer Nature Singapore
Erschienen in
Indian Journal of Thoracic and Cardiovascular Surgery / Ausgabe 6/2023
Print ISSN: 0970-9134
Elektronische ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-023-01538-z

Neu im Fachgebiet Chirurgie

Nur selten ernste Komplikationen bei endoskopischer Sinuschirurgie

Etwa 3% der Menschen mit einer endoskopischen Nasennebenhöhlenoperation entwickeln ausgeprägtes Nasenbluten. Andere Komplikationen, wie Verletzungen des Nervus opticus oder eine Meningitis, treten nur äußerst selten auf, legt eine Registeranalyse nahe.

Hochrisiko-Spinaliom am besten mit der Mohs-Chirurgie entfernen

Die Mohs-Chirurgie ist zwar mit mehr Aufwand verbunden als die herkömmliche Exzision; für die Versorgung kutaner Hochrisiko-Plattenepithelkarzinome lohnt sich die zeitintensive Technik aber in jedem Fall. Laut einer aktuellen Studie sinkt im Vergleich das Sterberisiko.

Mechanische Herzklappe beschert jüngeren Betroffenen längeres Leben

Patienten und Patientinnen bevorzugen bioprothetische Herzklappen gegenüber mechanischen Klappenprothesen. Diese Wahl könnte sich zumindest für jüngere Patienten nachteilig auswirken: Ihnen bietet eine mechanische Klappe anscheinend einen Überlebensvorteil.

Darmpolyp weg – Peptid-Gel gegen Nachblutungen drauf?

Das Nachblutungsrisiko nach einer endoskopischen Mukosaresektion von flachen kolorektalen und duodenalen Adenomen war in der deutschen PURPLE-Studie mit einem hämostatischen Gel nicht kleiner als ohne Prophylaxe.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.